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Okafor D, Kaye AD, Kaye RJ, et al. The role of neurokinin-1 (substance P) antagonists in the prevention of postoperative nausea and vomiting. J Anaesthesiol Clin Pharmacol. 2017;33(4):441-445doi: 10.4103/0970-9185.222511.
Okafor, D., Kaye, A. D., Kaye, R. J., & Urman, R. D. (2017). The role of neurokinin-1 (substance P) antagonists in the prevention of postoperative nausea and vomiting. Journal of anaesthesiology, clinical pharmacology, 33(4), 441-445. https://doi.org/10.4103/0970-9185.222511
Okafor, Dionne, et al. "The role of neurokinin-1 (substance P) antagonists in the prevention of postoperative nausea and vomiting." Journal of anaesthesiology, clinical pharmacology vol. 33,4 (2017): 441-445. doi: https://doi.org/10.4103/0970-9185.222511
Okafor D, Kaye AD, Kaye RJ, Urman RD. The role of neurokinin-1 (substance P) antagonists in the prevention of postoperative nausea and vomiting. J Anaesthesiol Clin Pharmacol. 2017 Oct-Dec;33(4):441-445. doi: 10.4103/0970-9185.222511. PMID: 29416232; PMCID: PMC5791253.
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J Anaesthesiol Clin Pharmacol. 2017 Oct-Dec;33(4):441-445. doi: 10.4103/0970-9185.222511.

The role of neurokinin-1 (substance P) antagonists in the prevention of postoperative nausea and vomiting.

Journal of anaesthesiology, clinical pharmacology

Dionne Okafor, Alan David Kaye, Rachel J Kaye, Richard D Urman

Affiliations

  1. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
  2. Department of Anesthesiology, Louisiana State University Health Science Center, New Orleans, LA 70112, USA.
  3. Department of Pharmacology, Louisiana State University Health Science Center, New Orleans, LA 70112, USA.
  4. Department of Biochemistry, Bowdoin College, Brunswick, ME 04011, USA.

PMID: 29416232 PMCID: PMC5791253 DOI: 10.4103/0970-9185.222511

Abstract

Postoperative nausea and vomiting (PONV) can be very debilitating for surgical patients, and effective management reduces potential morbidity, aiding in patient satisfaction, and minimizing the need for unintended hospital stays. Risk factors include female sex, nonsmoker, and having a previous history of motion sickness or PONV. Anesthetic risk factors include receiving opioids, not receiving a total intravenous anesthetic (TIVA), exposure to nitrous oxide, and extended length of anesthetic. Many treatments, including serotonin antagonists, dopamine antagonists, corticosteroids, inhaled isopropyl alcohol, and anticholinergics, as well as techniques such as TIVA, have been utilized over recent decades in an attempt to reduce PONV incidence. However, it remains a problem for a significant number of surgical patients. Aprepitant is a neurokinin-1 (substance P) antagonist, which exerts its effects via a final common pathway of the emetic centers after crossing the blood brain barrier. Aprepitant is commonly used in the cancer population to help prevent cancer chemotherapy-induced nausea and vomiting and has shown great promise in both acute and delayed phase PONV. Published data has shown improved efficacy when compared with ondansetron administered prior to surgery. The use of aprepitant in combination with other antiemetics potentially may help decrease unplanned hospital admissions and potentially, reduce costs associated with PONV.

Keywords: Antiemetics; aprepitant; neurokinin-1 (substance P) antagonist; postoperative nausea and vomiting

Conflict of interest statement

Dr. Urman received research funding from Premier Research.

References

  1. Drugs. 2000 Sep;60(3):533-46 - PubMed
  2. Drugs. 2013 Sep;73(14):1525-47 - PubMed
  3. Support Care Cancer. 2016 Feb;24(2):871-878 - PubMed
  4. J Vet Pharmacol Ther. 2008 Dec;31(6):533-7 - PubMed
  5. Br J Cancer. 1997;76(8):1055-61 - PubMed
  6. Int J Urol. 2015 Oct;22(10):915 - PubMed
  7. J Clin Oncol. 1999 Sep;17(9):2971-94 - PubMed
  8. J Anesth. 2013 Jun;27(3):396-401 - PubMed
  9. Br J Pharmacol. 1995 May;115(1):84-94 - PubMed
  10. J Anesth. 2015 Dec;29(6):836-41 - PubMed
  11. Physiol Rev. 1993 Apr;73(2):229-308 - PubMed
  12. JAMA. 1989 Dec 1;262(21):3008-10 - PubMed
  13. J Clin Oncol. 2011 Nov 1;29(31):4189-98 - PubMed
  14. Ann Oncol. 1996 Feb;7(2):189-95 - PubMed
  15. Medicine (Baltimore). 2015 May;94(19):e762 - PubMed
  16. J Natl Cancer Inst. 2012 Sep 5;104(17):1280-92 - PubMed
  17. Korean J Anesthesiol. 2013 Mar;64(3):212-7 - PubMed
  18. Br J Anaesth. 2012 Nov;109(5):716-22 - PubMed
  19. Curr Med Res Opin. 2007 Oct;23(10):2559-65 - PubMed
  20. Br J Anaesth. 2007 Aug;99(2):202-11 - PubMed
  21. BMJ. 2003 Oct 4;327(7418):762-3 - PubMed
  22. J Clin Oncol. 1997 Jan;15(1):103-9 - PubMed
  23. Ann Oncol. 2010 Dec;21(12):2316-23 - PubMed
  24. Anaesthesia. 2008 Jun;63(6):610-5 - PubMed
  25. Anesthesiology. 2000 Apr;92(4):958-67 - PubMed
  26. Br J Anaesth. 2009 Jul;103(1):7-13 - PubMed
  27. Drug Metab Dispos. 2008 Sep;36(9):1846-52 - PubMed
  28. Biomed Res Int. 2014;2014:307025 - PubMed
  29. Anesthesiology. 2000 Oct;93(4):931-7 - PubMed
  30. Anesth Analg. 2014 Jan;118(1):85-113 - PubMed
  31. Support Care Cancer. 1994 Sep;2(5):286-92 - PubMed
  32. J Anesth. 2015 Oct;29(5):696-701 - PubMed
  33. Drugs. 1996 Nov;52(5):639-48 - PubMed

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