A 55-year-old had severe acute and delayed nausea during her first cisplatin cycle after receiving ondansetron and dexamethasone alone. Which

Question

A 55-year-old had severe acute and delayed nausea during her first cisplatin cycle after receiving ondansetron and dexamethasone alone. Which prophylaxis is most appropriate before the next cycle?

Accepted Answer

Use an NK1-receptor antagonist plus a 5-HT3 antagonist and dexamethasone, with olanzapine considered as part of the high-emetic-risk regimen

Answer

Use ondansetron alone at a higher dose because delayed emesis is mediated predominantly by serotonin

Answer

Use metoclopramide alone before treatment and add dexamethasone only if vomiting occurs

Answer

Withhold prophylaxis and treat symptoms with prochlorperazine because prior emesis does not predict recurrence

Answer

Use dexamethasone alone for four days because cisplatin-associated emesis is predominantly inflammatory

CINV Prophylaxis — RACP Adult Medicine MCQ

A 55-year-old had severe acute and delayed nausea during her first cisplatin cycle after receiving ondansetron and dexamethasone alone. Which prophylaxis is most appropriate before the next cycle?