Azkalia Rizqi Alfarozy, Evaluation of effectiveness of antiemetics drugs and
nausea vomiting response in breast cancer patients undergoing chemotherapy in
Prof. Dr. Margono Soekardjo hospital in Purwokerto. Advisor : Susanti, M.Phil.,
Apt and Wahyu Utaminingrum, M.Sc., Apt
Antiemetics commonly use to control nausea and vomiting in patients who
receive chemotherapy agents. The emetogenicity of chemotherapy agents and
antiemetic protocol given to patient can contribute to the experience of nausea and
vomiting. This study aimed to determine the effectiveness of antiemetic drugs
used by breast cancer patients and to compare the risk factors of chemotherapyinduced
nausea and vomiting. This observational study with cross sectional design
was conducted in Prof Dr. Margono Soekardjo hospital, Purwokerto. Patient
included in this study were breast cancer patients who received any chemotherapy
protocol from December 2014 to April 2015 and consented to participate. Patients
were required to record episodes of nausea and vomiting in checklist sheet in 24
hours to day 5 after chemotherapy administered. The chemotherapy protocol were
stratified into high and low emetogenicity groups and the episodes of nausea and
vomiting in acute and delayed phase were measured using National Cancer
Institute-Common Toxicity Criteria (NCI-CTC). In this study, there were 47
patients who met the inclusion criterias, 46 patients received Highly Emetogenic
Chemotherapy (HEC) and one patient received Low Emetogenic Chemotherapy
(LEC). All patients received premedication of antiemetic combination:
dexamethasone, ondansetron and ranitidine, and postmedication antiemetic of
metoclorpramid or ondansetron. The antiemetics used in patients who received the
HEC, were reported to be effective to control nausea in acute phase (24 hours) in
89,13% patients and 50% patients in delayed phase days (2-5). Moreover, this
regimen was effective to control vomiting in acute phase in 78,26% patients and
52,17% patients in delayed phase. However, the antiemetics regimen given to the
patient who received the LEC, was reported to be effective to control nausea and
vomiting either in acute and delayed phase in 100% patients. Younger patients
(62,5%) were reported to experience more nausea in acute phase than older
patients (37,5%). Patients in 1-3 cycle of chemotherapy has showed 0,2 times
higher probability of experiencing the vomiting in acute and delayed phase.
Futhermore, the probability of nausea in patients with history of motion sickness
was 5 times higher than patients without history of motion sickness. Overall, the
results of this study showed that antiemetic protocol used in Prof. Dr. Margono
Soekardjo hospital was 100 % effective for controlling nausea and vomiting in
patients who received LEC. However, antiemetics used in patients received HEC
were showed to be less effective to treat nausea and vomiting in acute and delayed
phase. The factors that contributed to the presence of nausea vomiting in acute
phase were history of motion sickness (p=0,040) and cycle of chemotherapy
(p=0.028) and the presence of vomiting in delayed phase phase is cycle of
chemotherapy (p=0.045).