Davan B Bevoor¹*, Himanshu Patel², B M Dinnimath³ and Renukaradhya Chitti¹

¹Assistant Professor, Department of Pharmacy Practice, KAHER’S College of Pharmacy, Hubballi, Karnataka, India
²Assistant Professor, Department of Pharmacy Practice, JSS University’s College of Pharmacy, Mysore, Karnataka, India
³Assistant Professor Department of Pharmaceutical Chemistry, KAHER College of Pharmacy, Hubballi, Karnataka, India

*Corresponding Author: Davan B Bevoor, Assistant Professor, Department of Pharmacy Practice, KAHER’S College of Pharmacy, Hubballi, Karnataka, India.

Received: June 22, 2018; Published: July 23, 2018

Citation: Davan B Bevoor., et al. "Drug Utilization Evaluation of Antiemetics in Chemotherapy Induced Nausea and Vomiting in Oncology Setting" Acta Scientific Pharmaceutical Sciences 2.8 (2018).

Abstract

Background: Many of the Patients with carcinoma has poor-quality of life because of their disease conditions. Chemotherapy should improve the quality of life but adverse drug reactions of anticancer drugs are producing nausea and vomiting.

Objectives: To assess utilization pattern and appropriateness of antiemetic’s in chemotherapy induced nausea and vomiting.

Methods: In a prospective study medication orders of patients on chemotherapy for breast cancer were reviewed and patients were interviewed to assess treatment pattern and its appropriateness in Bharath specialty oncology hospital Mysore. Drug selection, dose, route and administration technique used were reviewed with respect to standard international recommendations to evaluate the appropriateness of the antiemetics.

Results: 316 patients were followed over six months. In treatments with AC regimen (Doxorubicin + Cyclophosphamide Combination) 48.8% were ondansetron. In PT regimen (Paclitaxel and Carboplatin) treatments 76% with combination of palonosetron, dexamethasone, and Metoclopramide/promethazine. In TC regimen (Docetaxel and Cyclophosphamide) treatments two combinations were dominantly used i.e. Palonosetron with dexamethasone was 29.4% and Ondansetron with dexamethasone was 35.2%. In Paclitaxel alone treatments combination antiemetic Palonosetron with Dexamethasone with/without Promethazine/Metoclopramide were used in 76% treatments. Intriguing part of this dissection is treatments weekly CT cisplatin which is HEC (high emetogenic concentration) and 50.9% were receiving mild antiemetic metoclopramide of which 8 of 26 patients receiving Metoclopramide vomited i.e. 70% of treatments with Metoclopramide in Cisplatin weekly CT were found successful. 93.3% Antiemetic regimens were inappropriate to emetogenic potential of chemotherapy regimen. 45.8% of antiemetic doses in regimen were inappropriate and 27.2% administration errors were found. Here administration error is time gap between premedication antiemetic and chemotherapy which supposed to be at least 30 min and not more than 3.30 hours.

Conclusion: The antiemetic used in CINV were not compliant with NCCN guidelines. However most of the treatments which were found non-compliant is justifiable with patients poor economic status or denial of government insurance to fund for Neurokinin 1 antagonist.

Keywords: Emetogenic Potential; Cisplatin; Ondansetron; Metoclopramide

Copyright: © 2018 Davan B Bevoor., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.