1. Noradrenergic activity in anticipatory nausea.
- Author
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Fetting JH, Stefanek ME, Sheidler VR, Elsworth JD, Piantadosi S, and Roth RH
- Subjects
- Administration, Oral, Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Clonidine administration & dosage, Double-Blind Method, Female, Humans, Male, Methoxyhydroxyphenylglycol blood, Middle Aged, Nausea chemically induced, Nausea psychology, Neoplasms psychology, Receptors, Adrenergic drug effects, Receptors, Adrenergic physiology, Vomiting, Anticipatory psychology, Antineoplastic Combined Chemotherapy Protocols adverse effects, Conditioning, Classical drug effects, Nausea physiopathology, Neoplasms drug therapy, Norepinephrine physiology, Vomiting, Anticipatory physiopathology
- Abstract
Two studies were conducted to examine the hypothesis that noradrenergic activity is a cause of the anticipatory nausea associated with cancer chemotherapy. In the first study concentrations of plasma 3-methoxy-4-hydroxyphenyl-glycol (MHPG) on day 1 of cycle 5 of initial chemotherapy were significantly higher in patients with than without anticipatory nausea. To determine whether elevated MHPG reflected a clinically significant causative role for noradrenergic activity in anticipatory nausea, we conducted a randomized, double-blind, placebo-controlled, crossover trial of clonidine for anticipatory nausea. At a dose of clonidine that produced significant side effects and reductions of plasma MHPG, anticipatory nausea was improved only marginally. These studies do not support a causative role for noradrenergic activity in anticipatory nausea that can be reduced by clonidine with an acceptable therapeutic index.
- Published
- 1992
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