The use of post-operative vomiting as a means of evaluating anti-emetics.
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A randomized, double-blind controlled trial of nabilone versus chlorpromazine was performed in 20 patients with advanced gynaecological cancer who received chemotherapy including cis-platinum. Each patient served as his own control. Nabilone was administered at a dose of 3 mg given orally three times a day, starting the day before cis-platinum and ending the day after. Chlorpromazine was administered at a dose of 12.5 mg given IM, 15 minutes before the start of cis-platinum. Nabilone, in comparison with chlorpromazine did not significantly reduce the number of vomiting. Ten patients preferred nabilone, 5 preferred chlorpromazine and 3 were undecided. Predominant side effects noted by patients were similar for both agents and included somnolence, dry mouth and orthostatic hypotension. No other intervention besides reassurance of the patient was necessary to treat these adverse reactions.
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The effect of cDDP (cis-diamminedichloroplatinum) on NK (natural killer) activity of peripheral blood lymphocytes in 12 patients (7 primary lung cancer, 3 metastatic pulmonary tumor and 2 malignant mediastinal tumor) was examined with emphasis on the combination of corticosteroid. To all patients, 80 mg/m2 of CDDP was administered intravenously every 3 weeks. Four patients were treated with CDDP alone, and 8 patients received 375 mg of methylprednisolone on the same day of CDDP administration and 125 mg on each of following consecutive 5 days respectively. 1) NK activity was not suppressed for 3 weeks after CDDP administration, in the group of 4 patients without receiving corticosteroid. 2) Significant NK suppression was found 1 week after CDDP administration, and recovered 2 weeks later, in the group of 8 patients who were treated for their emesis by corticosteroid. It can be concluded that 80 mg/m2 of CDDP does not reduce NK activity at all. However, the additional administration of corticosteroid strongly inhibited NK activity. Therefore, one should be very careful when combines the corticosteroid in order to relieve emesis induced by CDDP treatment, even if it has some antiemetic effect.
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