PubMed · 12703227
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Maurie Markman. 2002. Supportive care.. https://pubmed.ncbi.nlm.nih.gov/12703227/
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With the advent of the 5HT3-receptor antagonists in the 1990s and their combination with dexamethasone, complete emesis protection during the first 24 hours after administration of an emetogenic cytostatic agent became possible in 70% of the patients. Despite acute emesis protection through the use of 5HT3-receptor antagonists and dexamethasone, 40% of the patients do have symptoms during the following days. 5HT3-receptor antagonists and dexamethasone are modestly effective in this delayed phase and the antiemetic protection decreases progressively with multiple cycles. Neurokinine(NK)-1-receptor antagonists belong to a new class of antiemetic agents that specifically target the NK-1-receptor which is involved in both the acute, and in particular, the delayed phase. Clinical studies have demonstrated that the addition of the NK-1-receptor antagonist apprepitant to a 5HT3-receptor antagonist plus dexamethasone combination improves acute emesis protection by about 20% (from approximately 60% to 80%) and by about 30-40% in the delayed phase (from approximately 30% to 60-70%). The effectiveness of this triple therapy is sustained during subsequent cycles. The chance that an individual patient will be completely protected from severe nausea and vomiting during the entire course of chemotherapy (often 6 cycles) consequently increases significantly (from 34% in the placebo group to 59% in the aprepitant group).
The construction and characteristic performance of metoclopramide (MCP)-polyvinyl chloride (PVC) membrane sensor are described. The sensor is based on the use of MCP-tetraiodomercurate ion pair as electroactive material in PVC matrix in presence of dioctylphthalate (DOP) as solvent mediator. MCP membrane sensor shows a stable, near Nernstian response over the concentration range 1 x 10(-2)-6 x 10(-5) M of MCP at 25 degrees C in the pH range 3-7 with cationic slope of 53.0+/-0.5. The detection limit of 4 x 10(-5) M and the response time of 30-60 s have been attained. Selectivity coefficient data for some common ions show negligible intereferences. Direct potentiometric determination of 15-3540 microg/ml MCP show an average recovery of 98.5% and a mean relative standard deviation (R.S.D.) of 1.6% at 100.0 microg/ml. The determination of MCP in Primperan tablets, injection, and syrup gave results that compare favorably with those obtained by the British pharmacopoeia method. Precipitation titrations involving MCP as titrant are monitored with the MCP sensor for some potentiometric precipitation reaction, e.g. sodium tetraphenylborate (STPB) and phosphomolybdic acid (PMA).