Chemotherapy-induced nausea and vomitting

Doxorubicin, etoposide, or cyclophosphamide are usually associated with mild to moderate nausea and vomiting, whereas nitrosoureas, dacarbazine, and particularly cisplatin cause more severe symptoms. Antiemetic clearly reduce and often eliminate nausea and vomiting.
Ondansentron, granisetron,dolasetron have now replaced other drugs as the primary agents for the prevention and treatment of emesis from chemotherapy. These drugs are serotonin receptor-blocking agents with few side effects. Ondansentron, a single dose of 32mg prior to chemotherapy and may be repeated every 24hours, or 8 mg every 8 hours.
Dexamethasone has an antiemetic effects at a dossage 6-10 mg as a single dose prior to or both prior to and every 6 hours following-the administration of chemotherapy for two to four total doses.
Aprepitant is selective high-affinity neurokinin-1 receptor antagonist. It is approved for the treatment of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy. It is given for 3 days beginning on the day chemotherapy starts.
Prochlorperazine is given 10mg orally or iv, every 6-8 hours not exceed 40mg. Side effect is extrapyramidal.
Metoclopramide is given 10-20mg orally or iv, every 6 hours, usually in combination with dexamethasone. Side effects is extrapyramidal.
Lorazepam has both antiemetic and sedative effects. A Dose of 0,5-1mg every 4-6hours by the sublingual.
Combination: ondansentron and lorazepam, prochlorperazine and dexamethasone with aprepitant.
omeprazole, ranitidine can be useful adjunctive therapy to the antinausea regiment.