Effective control of chemotherapy-induced nausea and vomiting with oral prednisone and metoclopramide.

Repeated oral doses of metoclopramide (50 mg) and prednisone (25 mg) completely prevented nausea and vomiting (N + V) in approximately 50% and substantially reduced N + V in an additional 27%-36% of 56 chemotherapy courses in 30 consecutive cancer patients who were receiving primarily cisplatin. Toxicity from this antiemetic regimen was minor. Simple oral N + V-prevention with metoclopramide and prednisone is as effective but less cumbersome and considerably less expensive than either high doses of intravenous corticosteroids and/or intravenous metoclopramide.

[Interdisciplinary continuing education in palliative nursing, medicine and care]. / Interdisziplinäre Weiterbildung in Palliativpflege, -medizin und -betreuung.

Changing complementary goals in medicine, nursing and care pose new challenges to health professionals. The needs of the incurably ill or dying individuals and their relations are acknowledged more intensively again today. Quality of life and comprehensive care are corner-stones in the treatment and care of this group of patients. Realisation of the principles of palliative medicine and care demands a targeted approach to this multifaceted and burdening field. Nurses, doctors, social workers and other therapists have not yet been optimally prepared for this task. A common interdisciplinary training in this evolving field gives all the specialists from the different fields an opportunity for preparation to this task.

[Prevention of nausea and emesis during cytostatic therapy. Antiemetic efficacy of high-dosage oral metoclopramide without and with prednisone]. / Nausea- und Emesis-Prophylaxe bei zytostatischer Therapie. Antiemetische Wirksamkeit von hochdosiertem oralem Metoclopramid ohne und mit Prednison.

In a randomized trial of 58 cancer patients receiving strongly emetogenic cytostatic drugs (cisplatin or comparable cytostatic agents, alone or in combination), the anti-emetic action of oral metoclopramide was tested, alone or combined with prednisone. Patients of group A (33 during 46 treatment cycles) received three times 50 mg metoclopramide and three times 25 mg prednisone. Those of group B (25 patients during 35 cycles) received three times 50 mg metoclopramide. The drug was given two hours before as well as two hours and six hours after administration of the cytostatic drugs. Good or satisfactory prophylaxis of nausea and vomiting (no or at most three vomits) was achieved during 37 cycles (80.5%) of group A patients and 30 (85.7%) of group B patients. Complete absence of vomiting was obtained in 52% of cycles in group A, 46% of cycles in group B; complete absence of nausea in 39% and 32%, respectively. There was no statistically significant difference between the two treatments in their preventive action. Three times 50 mg metoclopramide (with or without prednisone) four hours apart during one cytostatic-drug cycle was well tolerated by patients in both groups and can be recommended as a simple, practical prophylaxis of nausea and vomiting in the course of strongly emetogenic treatment of cancer.