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Management of postoperative nausea and vomiting: focus on palonosetron.

Muchatuta NA, Paech MJ - Ther Clin Risk Manag (2009)

Bottom Line: Postoperative nausea and vomiting (PONV) remains a significant problem in modern anesthetic practice, with an incidence in high-risk groups of up to 80%.Advances in PONV prophylaxis over recent years include using non-pharmacological means to reduce baseline risk, a change to less emetogenic anesthetic techniques and the combination of multiple antiemetic drugs.It has unique structural, pharmacological and clinical properties that distinguish it from other agents in its class.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Perth, Western Australia;

ABSTRACT
Postoperative nausea and vomiting (PONV) remains a significant problem in modern anesthetic practice, with an incidence in high-risk groups of up to 80%. In addition to being unpleasant and distressing for the patient, PONV has the potential to adversely affect patient and surgical outcomes. Advances in PONV prophylaxis over recent years include using non-pharmacological means to reduce baseline risk, a change to less emetogenic anesthetic techniques and the combination of multiple antiemetic drugs. The 5-hydroxytryptamine-3 (5-HT(3)) antagonists have proven a particularly valuable addition to the armamentarium against PONV. Palonosetron is a second-generation 5-HT(3) antagonist that has recently been approved for prophylaxis against PONV. It has unique structural, pharmacological and clinical properties that distinguish it from other agents in its class. This review summarizes current evidence on PONV prophylaxis, reviews the 5-HT(3) antagonists in particular and focuses on the established and future roles of palonosetron.

No MeSH data available.


Related in: MedlinePlus

Structures of palonosetron and other 5-HT3 antagonists.Reproduced with permission from Rojas C, Grunberg S, Rosti G. 2007. Creating real benefit for patients at risk of nausea and vomiting: palonosetron-from bench to bedside. Clin Adv Hematol Oncol, 5(12 Suppl 19):1–20.122 Copyright © 2007 Millenium Medical Publishing.
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f1-tcrm-5-0021: Structures of palonosetron and other 5-HT3 antagonists.Reproduced with permission from Rojas C, Grunberg S, Rosti G. 2007. Creating real benefit for patients at risk of nausea and vomiting: palonosetron-from bench to bedside. Clin Adv Hematol Oncol, 5(12 Suppl 19):1–20.122 Copyright © 2007 Millenium Medical Publishing.

Mentions: Traditional 5-HT3 antagonists are based on a 3-substituted indole ring which mimics the structure of serotonin. In contrast palonosetron is a single stereoisomer isoquinoline based on a fused tricyclic ring system attached to a quinuclidine moiety (Figure 1). This novel chemical structure may explain some of the differences in its receptor affinity, interaction and binding.


Management of postoperative nausea and vomiting: focus on palonosetron.

Muchatuta NA, Paech MJ - Ther Clin Risk Manag (2009)

Structures of palonosetron and other 5-HT3 antagonists.Reproduced with permission from Rojas C, Grunberg S, Rosti G. 2007. Creating real benefit for patients at risk of nausea and vomiting: palonosetron-from bench to bedside. Clin Adv Hematol Oncol, 5(12 Suppl 19):1–20.122 Copyright © 2007 Millenium Medical Publishing.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2697527&req=5

f1-tcrm-5-0021: Structures of palonosetron and other 5-HT3 antagonists.Reproduced with permission from Rojas C, Grunberg S, Rosti G. 2007. Creating real benefit for patients at risk of nausea and vomiting: palonosetron-from bench to bedside. Clin Adv Hematol Oncol, 5(12 Suppl 19):1–20.122 Copyright © 2007 Millenium Medical Publishing.
Mentions: Traditional 5-HT3 antagonists are based on a 3-substituted indole ring which mimics the structure of serotonin. In contrast palonosetron is a single stereoisomer isoquinoline based on a fused tricyclic ring system attached to a quinuclidine moiety (Figure 1). This novel chemical structure may explain some of the differences in its receptor affinity, interaction and binding.

Bottom Line: Postoperative nausea and vomiting (PONV) remains a significant problem in modern anesthetic practice, with an incidence in high-risk groups of up to 80%.Advances in PONV prophylaxis over recent years include using non-pharmacological means to reduce baseline risk, a change to less emetogenic anesthetic techniques and the combination of multiple antiemetic drugs.It has unique structural, pharmacological and clinical properties that distinguish it from other agents in its class.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Perth, Western Australia;

ABSTRACT
Postoperative nausea and vomiting (PONV) remains a significant problem in modern anesthetic practice, with an incidence in high-risk groups of up to 80%. In addition to being unpleasant and distressing for the patient, PONV has the potential to adversely affect patient and surgical outcomes. Advances in PONV prophylaxis over recent years include using non-pharmacological means to reduce baseline risk, a change to less emetogenic anesthetic techniques and the combination of multiple antiemetic drugs. The 5-hydroxytryptamine-3 (5-HT(3)) antagonists have proven a particularly valuable addition to the armamentarium against PONV. Palonosetron is a second-generation 5-HT(3) antagonist that has recently been approved for prophylaxis against PONV. It has unique structural, pharmacological and clinical properties that distinguish it from other agents in its class. This review summarizes current evidence on PONV prophylaxis, reviews the 5-HT(3) antagonists in particular and focuses on the established and future roles of palonosetron.

No MeSH data available.


Related in: MedlinePlus