Document Detail


Lorazepam, diphenhydramine, and haloperidol transdermal gel for rescue from chemotherapy-induced nausea/vomiting: results of two pilot trials.
MedLine Citation:
PMID:  18257398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite their use of prophylactic antiemetic therapies, cancer patients continue to consider chemotherapy-induced nausea and vomiting (CINV) to be a significant problem. Patients frequently use various "breakthrough" medications for these symptoms. Unfortunately, there is a paucity of trials regarding treatment of breakthrough CINV. This study investigated the efficacy of "ABH," a topical gel containing lorazepam (Ativan), diphenhydramine (Benadryl), and haloperidol (Haldol), in reducing breakthrough CINV. Adults receiving standard recommended prophylactic antiemetics as outpatients were instructed to use 0.5 mL of the gel topically when they experienced significant CINV. Patients then were contacted retrospectively to respond to a questionnaire rating their nausea and/or vomiting and their response to ABH-gel treatment. The results were collected during two trials: Trial I began in April 2003, and Trial II began in March 2006. During Trial I, 23 patients were evaluated; 17 patients (74%) reported that use of the gel decreased their CINV, with 15 (70%) reporting relief within 30 minutes of its application. Three patients believed that the gel caused sedation; no troubles with skin irritation or muscle spasms were reported. In Trial II, all 10 patients believed that the treatment was effective. When the severity of CINV was quantified on a scale of 0-10, the mean CINV score decreased significantly from a 6.1 before gel application to a 1.7 as evaluated 30 minutes following gel application (P < 0.005). Topical use of ABH gel appears to be a promising and safe rescue therapy for breakthrough CINV that occurs despite prophylactic antiemetic therapy. These results warrant further confirmation in a large, randomized, placebo-controlled trial.
Authors:
Jacob Bleicher; Achala Bhaskara; Tim Huyck; Susan Constantino; Aditya Bardia; Charles L Loprinzi; Peter T Silberstein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journal of supportive oncology     Volume:  6     ISSN:  1544-6794     ISO Abbreviation:  J Support Oncol     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-02-08     Completed Date:  2008-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181305     Medline TA:  J Support Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  27-32     Citation Subset:  IM    
Affiliation:
Hematology/Oncology Division, Creighton University Medical Center, Omaha, NE 68132-2867, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Cutaneous
Adult
Antiemetics / administration & dosage*
Antineoplastic Combined Chemotherapy Protocols / adverse effects
Clinical Trials as Topic
Diphenhydramine / administration & dosage*
Drug Delivery Systems
Gels
Haloperidol / administration & dosage*
Humans
Lorazepam / administration & dosage*
Nausea / chemically induced,  prevention & control*
Neoplasms / complications,  drug therapy
Pilot Projects
Questionnaires
Skin / chemistry,  metabolism*
Vomiting / chemically induced,  prevention & control*
Chemical
Reg. No./Substance:
0/Antiemetics; 0/Gels; 52-86-8/Haloperidol; 58-73-1/Diphenhydramine; 846-49-1/Lorazepam

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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