A 60 yr old lady is diagnosed to have breast CA and receiving a course of chemotherapy. She is experiencing troublesome vomiting which has not been helped by domperidone.
What is the most appropriate next course of action?
A. Add an antihistamine
B. Add a dopamine receptor antagonist
C. Add a 5HT3 antagonist
D. Add a 5HT2 antagonist
E. Add a phenothiazine
Answer is C
For patients at low-risk of symptoms then drugs such as metoclopramide may be used first-line.
For high-risk patients then 5HT3 receptor antagonists such as ondansetron are usually effective, especially if used along with dexamethasone