Vomiting In Adolescents Research Articles

Methotrexate-induced nausea and vomiting in adolescent and young adult patients

This study aims to determine the prevalence of methotrexate-induced nausea and vomiting in both adolescent and adult patients with inflammatory arthritis. A survey of methotrexate side effects was conducted on patients with inflammatory arthritis. We provided a brief questionnaire to unselected patients with inflammatory arthritis being treated with methotrexate attending adolescent and adult rheumatology clinics. The questions related to the presence, absence, and severity of nausea and vomiting, the temporal relationship with methotrexate and whether anti-emetics had been prescribed. A total of 106 patients from the age of 13 years and above—57 adults (over 20 years) and 49 adolescents (13–19 years) were included in this study. The median age for those experiencing nausea was 19 years (interquartile range (IQR) 7) and for those with no nausea 55 years (IQR 46) (p < 0.001). Thirty-six out of 49 adolescent patients reported nausea (73 %) compared to only 20/57 adults (35 %) (p < 0.001). Multiple logistic regression analysis showed that the nausea group had a significantly higher proportion of adolescents (p = 0.0002), patients taking subcutaneous (SC) methotrexate MTX (p = 0.002), and patients with duration of MTX of more than 1 year (p = 0.049). Adolescents were estimated to have over 6 times higher odds of nausea compared to adults (OR 6.31, 95 % CI 2.38 to 16.75, p = 0.0002) after adjusting for SC MTX and duration of MTX. Only 22 % of adolescents and 10 % of adults were prescribed anti-emetics. There is a higher prevalence of MTX-induced nausea and vomiting in adolescents and younger adult patients with inflammatory arthritis compared to older adults. The role of anti-emetics in the treatment of these symptoms is unclear.

Aprepitant for the prevention of chemotherapy‐induced nausea and vomiting in adolescents: Response

Aprepitant for the prevention of chemotherapy‐induced nausea and vomiting in adolescents: Response

Aprepitant for the prevention of chemotherapy‐induced nausea and vomiting in adolescents

Aprepitant for the prevention of chemotherapy‐induced nausea and vomiting in adolescents

Measuring Nausea and Vomiting in Adolescents

Several instruments have been developed over the years to assess nausea and vomiting in adults, yet their validity and reliability with children are unknown. It would be useful to have an instrument simple enough for use with the vast majority of children (regardless of age and developmental level) to provide a consistent way to measure nausea and vomiting throughout the pediatric population. The purpose of this study was to test the feasibility of using one or more adult instruments with adolescents. A feasibility study was conducted using three existing instruments designed to measure nausea and vomiting. A convenience sample of 10 adolescents between the ages of 13 and 18 years receiving chemotherapy was recruited at a Midwestern children's hospital oncology unit. The adolescents were assessed using instruments starting before and continuing after one individual round of chemotherapy. A qualitative analysis demonstrated significant problems in implementing all three instruments with adolescents. Future research should concentrate on original instrument development based on qualitative studies that seek to understand the unique experience of a child with cancer.

Aprepitant for the control of chemotherapy induced nausea and vomiting in adolescents

Nausea and vomiting are common side effects of chemotherapy in adult and pediatric patients. Even with standard antiemetic therapy, a significant number of patients continue to experience acute and delayed symptoms. When used in combination with standard antiemetic therapy, a new class of antiemetics, the neurokinin-1 (NK-1) receptor antagonists, have been shown to improve both acute and delayed nausea and vomiting in adults. In this report, we describe the NK-1 receptor antagonist aprepitant in two adolescent patients receiving highly emetogenic chemotherapy who had experienced refractory nausea and vomiting with previous chemotherapy courses. The addition of aprepitant to the antiemetic regimen in the patients resulted in significant subjective improvement in nausea and vomiting as well as quality of life. These results in our adolescent patients are promising, but there is a need for well-designed studies to determine the efficacy, dosing, and safety of aprepitant in children of all ages.

Behavioral intervention for reducing chemotherapy-related nausea and vomiting in adolescents with cancer

Eight adolescents (10-17 years, mean 12.1) with cancer received behavioral intervention for chemotherapy-related nausea and vomiting. Within 3-5 days after the administration of each course of chemotherapy, patients rated (1-10 scale; 1 = none, 10 = maximum) their nausea and vomiting and the extent to which chemotherapy bothered them and disrupted their daily routine. After a baseline (preintervention) assessment of 2-3 courses of chemotherapy, patients received intervention during another 2-3 courses. While no significant reduction of symptoms were found prior to intervention, with intervention there were reductions in nausea (Z = 2.37, p less than 0.02), vomiting (Z = 2.52, p less than 0.01), bother (Z = 2.24, p less than 0.02), and disruption of activities (Z = 2.38, p less than 0.02). This preliminary study suggests that chemotherapy side effects in adolescents can be reduced with behavioral intervention.