A patient is being treated for chemotherapy-induced nausea and vomiting (CINV) with ondansetron [Zofran] and dexamethasone
The patient reports getting relief during and imme-diately after chemotherapy but has significant nausea and vomiting several days after each che-motherapy treatment. What will the nurse do? a. Contact the provider to discuss increasing the dose of ondansetron.
b. Suggest giving prolonged doses of dex-amethasone.
c. Suggest adding aprepitant [Emend] to the medication regimen.
d. Tell the patient to ask the provider about changing the ondansetron to aprepitant.
C
The current regimen of choice for patients taking highly emetogenic drugs consists of three agents: aprepitant plus dexamethasone plus a 5-HT3 antagonist, such as ondansetron. Aprepitant has a prolonged duration of action and can prevent delayed CINV as well as acute CINV. In-creasing the dose of ondansetron will not help treat the delayed CINV. Glucocorticoids should be given intermittently and for short periods to avoid side effects. Changing the ondansetron to aprepitant is not recommended.
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