Reappraisal of the role of dolasetron in prevention and treatment of nausea and vomiting associated with surgery or chemotherapy

ppraisal of the role of dolasetron in prevention and treatment of nausea and vomiting associated with surgery or chemotherapy Review (1745) Total Article Views Authors: Roberts SM, Bezinover DS, Janicki PK Published Date February 2012 Volume 2012:4 Pages 67 - 73 DOI: http://dx.doi.org/10.2147/CMAR.S15545 Received: 24 December 2011 Accepted: 08 February 2012 Published: 24 February 2012 S Michael Roberts, Dmitri S Bezinover, Piotr K Janicki Department of Anesthesiology, Penn State College of Medicine, Penn State Milton S Hershey Medical Center, Hershey, PA, USA Abstract: Chemotherapy-induced nausea and vomiting and postoperative nausea and vomiting are one of the most frequent but also very concerning consequences for patients undergoing chemotherapy or surgical procedures under general anesthesia. There are a variety of mechanisms involved in the activation of nausea and vomiting. Serotonin, a ubiquitous central and peripheral neurotransmitter, is thought to be the predominant mediator of the perception of nausea and triggering of the vomiting response in both the brain and the periphery via the 5-hydroxytryptamine type 3 (5-HT3) receptor pathways. 5-HT3 receptor antagonists disrupt this pathway, largely at the level of the vagal afferent pathways, to decrease nausea and vomiting. This review will focus on dolasetron, an older but sill commonly used 5-HT3 receptor antagonist and its multimodal mechanism of action, safety and tolerability, patient considerations, and a review of the current literature on its use to combat both chemotherapy-induced and postoperative nausea and vomiting in these two important patient populations.