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Initial Selection of Antiemetics in End-of-Life Care: A Retrospective Analysis

Author(s):  Tolen Laura, McMath Jill A, Alt Calvin, Weschules Douglas J, Knowlton Calvin H, McPherson Mary Lynn

Issue:  Mar/Apr 2006 - Hospice/Palliative Care
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Abstract:  The purpose of this study was to compare the relative severity of nausea and vomiting scores before and after initiation of treatment regimens in end-of-life cancer patients, and secondarily to evaluate the efficacy of a combination antiemetic preparation (ABHR; lorazepam [Ativan], diphenhydramine [Benadryl], haloperidol [Haldol], and metoclopramide [Reglan]) in this patient population. A retrospective analysis of antiemetic use was performed through a systematic chart review of patients with an end-of-life diagnosis of lung, pancreatic, or colorectal cancer whose medications were provided through Hospice Pharmacia. Information collected included patient age and sex; terminal diagnosis; pre- and post-antiemetic nausea and vomiting scores; and initial antiemetic choice. A total of 584 patient records were examined, and the most widely used antiemetics were prochlorperazine, promethazine, metoclopramide, and ABHR. The most prevalent diagnosis was lung cancer. All of the agents and preparations were determined t

Related Keywords: Laura Tolen, Jill A McGrath, PharmD, Calvin Alt, RPh, Douglas J. Weschules, PharmD, Calvin H. Knowlton, RPh, MDiv, PhD, Mary Lynn McPherson, PharmD, BCPS, palliative care, palliation, hospice, nausea, vomiting, antiemetics, ABHR, lorazepam, diphenhydramine, haloperidol, metoclopramide, prochlorperazine, promethazine, topical preparation, suppositories, cancer


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