Physiology of Chemotherapy-Induced Emesis and Antiemetic Therapy

Drugs - Tập 53 - Trang 206-234 - 2012
Christine Veyrat-Follet1,2, Robert Farinotti2, Jonathan L. Palmer3
1Développement Pharmaceutique, Unité de Biocinétique, Laboratoires GlaxoWellcome, Evreux Cedex 9, France
2Département de Pharmacie Clinique, Université Paris-Sud, Chatenay-Malabry, France
3Oncology and Anti-Emesis, Clinical Pharmacology Division, GlaxoWellcome Research and Development, Greenford, England

Tóm tắt

The physiology of emesis has been studied for several hundred years, focusing on the different centres involved and the mechanics of expulsion. The vomiting centre receives inputs from various emetic detectors such as the gut, the vestibular labyrinths and the chemoreceptor trigger zone. Emesis is a common disabling effect in motion sickness, postoperative conditions and in radio- and chemotherapy. Our current understanding of the mechanisms has been provided mainly by the recent introduction of serotonin 5-HT3 receptor antagonists into therapeutic use. Nevertheless, despite the considerable advances made in the understanding of the different pathways involved in emesis, there are number of areas that still require experimental investigation. Different animal and human models are available to study the physiology of emesis and to evaluate the antiemetic activity of new compounds, but they need to be predictors of clinical situations.

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