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Chemotherapy induced nausea and vomiting, CINV, has been a significant problem with oncology patients over past years. As a result much research was done and has lead to the creation of Zofran (Bernstein and Ong 2002). Ondansetron, marketed as Zofran was the first of its kind; it is a serotonin 5-HT3 receptor blocker, otherwise know as an antiemetic agent. Ondansetron is a tremendous breakthrough and is much more effective than older antiemetics, in some cases by almost 50% (Ramsook 2002). Ondansetron was FDA approved in January 1991 as a treatment for chemotherapy-induced nausea and vomiting with parenteraly administered dosage. It was later approved in oral dosage forms as a treatment for post-operative nausea and vomiting in April 1995. In 1999 ondansetron was approved for use as an "orally disintegrating tablet," Zofran ODTc. This form of ondansetron does not require water to assist in swallowing (Clinical Pharmacology 2002). Now ondansetron is used primarily as a treatment for chemotherapy-induce and post-operative nausea and vomiting; however, it is also being recently used to treat drug dependencies such as alcoholism and to treat gastrointestinal disorders such as acute gastroenteritis.
Ondansetron blocks the serotonin 5-HT3 receptors centrally and peripherally. 5-HT3 receptors are found centrally in the chemoreceptor trigger zone and peripherally in the lining of the small intestines. Most emesis, often associated with chemotherapy and/or radiation therapy, appears to be connected with the release of serotonin 5-HT3 from enterochromaffin cells that line the small intestine walls. By blocking these nerves signals to the central nervous system can no longer be sent. Ondansetron has also been identified as a small combatant of the serotonin 5-HT4 receptor (Physician's Desk Reference 1993). Research is continuing to be done on what other agents ondansetron combats and if its action is mediated centrally or peripherally.
Ondansetron is one a small number of 5-HT3 receptor blockers along with granisetron. Ondansetron was the first on the market, but studies show that when either drug is administered in optimal dosage that they are equally effective (Clinical Pharmacology 2002); however these drugs are not considered to be rescue drugs- they both have to be administered before chemotherapy to obtain optimal results. As compared to other antiemetic drugs such as promethazine and metoclopramide (both considered to be less than 31% effective), ondansetron is considered far superior (about 80% effective) (2002).
Serotonin, 5-HTor 5-hydroxytryptamine is and endogenously produced indolealkyl amine. It is located in many areas of human physiology including platelets, mast cells, enterochromaffin cells, and in specific ne
Terminology mentioned in this term paper
chemotherapy treatments, nervous system, platelets, Clinical Pharmacology,
Technology referenced in this paper
Names talked about in this research material
Zofran, Serotonin, Acute Gastroenteritis, the most "incapacitating adverse effect, Johnson,
Organizations referenced in this research material
Health Conditions mentioned in this term paper
vomiting, nausea, cancer, alcoholism, depression, diarrhea, rash, malnutrition, gastrointestinal disorders, migraine, headache, fever, abdominal pain,
Drug referenced in this research paper
ondansetron, granisetron, promethazine,
Companies referenced in this research paper
Keywords talked about in this research paper
ondansetron, serotonin, 5 ht3 receptor, chemotherapy, vomiting, Zofran, drug, acute gastroenteritis, nausea, enterochromaffin cells, chemotherapy induced nausea and vomiting, side effects, small intestines, central nervous system, alcoholism, emesis, serotonin receptors, placebo, Clinical Pharmacology, group, radiation therapy, cancer chemotherapy, drinks, orally disintegrating tablet, chemoreceptor trigger zone, 5 HT4 receptor, antiemetic, 5 hydroxytryptamine receptor, mast cells, dosage forms, adverse effect, gastrointestinal disorders, age group, abdominal pain, alcohol consumption, dry mouth, clinical trial, human physiology, case study, Web MD, human body, malnutrition, intravenous, rehydration, dehydration, randomized, granisetron, common, results, occurrence,