From Ms 5 144X47

Antiemetics can be administered either IV or orally in this situation, depending on patient characteristics such as ability to take oral medications, dosage form availability, and cost considerations.5 The IV and oral routes are equally effective. When used at equipotent doses, the 5-HT3 antagonists have similar efficacy in preventing acute CINV, despite pharmacokinetic and receptor-binding affinity differences.5,14

Patients undergoing chemotherapy should have antiemetics available to treat breakthrough nausea and vomiting even if prophylactic antiemetics were given.5,43 A variety of antiemetics may be used, including lorazepam, dexamethasone, methyl-

prednisolone, prochlorperazine, promethazine, metoclopramide, and dronabinol. If breakthrough CINV occurs, it may be best treated with an antiemetic with a mechanism of action that differs from the medications already administered. The 5-HT3 antagonists are effective for treating breakthrough nausea and vomiting, but they have not been shown to be superior to more traditional and less expensive antiemetics.

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