Antiemetic Medications for Chemotherapy: PTCB Exam Review
Review antiemetic drug classes used in chemotherapy, including 5-HT3 antagonists, NK1 inhibitors, and combination regimen protocols.
Chemotherapy-Induced Nausea and Vomiting
Chemotherapy-induced nausea and vomiting (CINV) is one of the most distressing side effects of cancer treatment. Pharmacy technicians in oncology settings must understand antiemetic regimens and their proper use. Review this and other medication topics in our PTCB exam prep.
Antiemetic Drug Classes
5-HT3 Receptor Antagonists
Ondansetron (Zofran), granisetron (Kytril), and palonosetron (Aloxi) block serotonin receptors in the chemoreceptor trigger zone. Ondansetron is available in oral, IV, and orally disintegrating tablet forms. Palonosetron has the longest half-life in this class.
NK1 Receptor Antagonists
Aprepitant (Emend) and fosaprepitant (Emend IV) are effective against delayed CINV occurring 24 hours or more after chemotherapy. Netupitant is combined with palonosetron in the fixed-dose product Akynzeo.
Corticosteroids
Dexamethasone is a cornerstone of antiemetic therapy and is included in most CINV prevention protocols. It is effective for both acute and delayed nausea.
Combination Regimens
- High emetogenic risk: 5-HT3 antagonist + NK1 antagonist + dexamethasone + olanzapine
- Moderate emetogenic risk: 5-HT3 antagonist + dexamethasone
- Low emetogenic risk: Dexamethasone alone or a single-agent 5-HT3 antagonist
Additional Agents
Olanzapine has emerged as an effective addition to antiemetic regimens. Lorazepam and dronabinol serve as adjunct therapies for anticipatory or breakthrough nausea. Prochlorperazine remains a commonly used rescue antiemetic.
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