Slabost in bruhanje pri bolnikih na sistemskem zdravljenju raka Systemic treatment-induced vomiting and nausea

Abstract

Preprečevanje ter kontrola slabosti in bruhanja sta med najpomembnejšimi nalogami pri podpornem zdravljenju bolnikov z rakom. Poznamo akutno, pozno in anticipatorno slabost, ki so povzročene s citostatsko terapijo, ter kronično slabost in bruhanje pri bolnikih z napredovalim rakom. Osnova antiemetskega zdravljenja je nevrokemijska kontrola slabosti in bruhanja. V sluznici prebavil in v osrednjem živčevju so številni serotoninski, nevrokininski, dopaminski, histaminski in drugi receptorji, na katere se vežejo ustrezni prenašalci. Mnogi antiemetiki delujejo po mehanizmu kompetitivne inhibicije prek teh receptorjev tako v perifernem kot v osrednjem živčevju.

Abstract (Eng)

Prevention and control of nausea and vomiting are of paramount importance in the treatment of cancer patients. The most commonly described types are acute, delayed, and anticipatory chemotherapyinduced nausea and vomiting and chronic nausea and vomiting in advanced cancer patients. The basis for antiemetic therapy is the neurochemical control of both. Although the exact mechanism is not well understood,the peripheral neuroreceptors and the chemoreceptor trigger zone are known to contain receptors for serotonin, substance P, dopamine, histamine, opioids, and numerous other endogenous neurotransmitters. Many antiemetics act by competitively blocking the receptors for these substances, thereby inhibiting stimulation of peripheral nerves at the chemoreceptor zone, and perhaps at the vomiting center.