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Antiemetic treatment for children undergoing chemotherapy

Definitions

Different types of chemotherapy cause different grades of nausea. Children react differently to drugs; some experience more nausea than others. 

Emetic effect of different chemotherapy drugs 

 
Mild emetic activity Antiemetic regimen
Vincristine/vinblastine Antiemetic treatment is usually not necessary, but there are great individual diferences.
Methotrexate (standard dose)
Doxorubicin
Bleomycin
Etoposide
Moderate emetic activity Antiemetic regimen
Cytarabine high dose (> 1 g/m2)

Ondansetron

Eventually granisetron or tropisetron

Actinomycin D
Melfalan
Procarbazine
Doxorubicin (> 50 mg/m2)
Methotrexate high dose (≥ 5 g/m2)
High emetic activity Antiemetic regimen
Cisplatin

Ondansetron/granisetron/tropisetron

Dexamethasone

Ifosfamide high dose (> 1 g/m2)
Cyclophosphamide high dose (> 1 g/m2)
Dacarbazine (DTIC)
Carboplatin
Lomustine (CCNU)

All regimens with cisplatin or moderate emetogenic chemotherapy drugs in high doses are considered highly emetogenic.

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