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Antiemetisk behandling vid cytostatikabehandling NEPA, APR, 5-HT3-receptorblockare: en jämförande litteraturstudie
Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
2019 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesisAlternative title
Antiemetic treatment during chemotherapy, NEPA, APR, 5-HT3 receptor antagonists : a comparative literature study (English)
Abstract [sv]

Cytostatikabehandlingars emetiska biverkningar har en stor negativ inverkan på patientens livskvalitet. För behandling av cytostatikainducerat illamående och kräkningar så ges flera olika läkemedel, däribland 5-HT3-receptorblockare och NK1-receptorblockare. Syftet: finns det en skillnad i effekt, och i så fall vilken, mellan kombinationsbehandlingen NEPA (netupitant (NETU) och palonosetron (PALO)) och behandlingen APR (aprepitant) + 5-HT3-receptorblockare? Hur stor andel lindras av att få en NK1-receptorblockare (APR, NETU) utöver en 5-HT3-receptorblockare vid cytostatikabehandling? Litteraturstudie valdes som metod och 5 studier ingick med nästan 3000 deltagare. Resultaten av studierna visade på ett numeriskt övertag för NEPA över APR samt en signifikant skillnad i effekt vid tillägg av NK1-receptorblockare till behandling med 5-HT3-receptorblockare. Diskussionen ställde syftet mot resultatet genom att göra jämförande sammanfattningar av samtliga studier och diskutera och förklara fynden. Slutsatsen som drogs utifrån arbetet var att NEPA och APR behandlingen saknar signifikant skillnad, för patienten kan NEPA vara en enklare behandling att följa. Andelen som lindras av att få mot att inte få en NK1-receptorblockare var mellan 8% och 15%.

Abstract [en]

The emetic side effects that comes with chemotherapy have a big negative impact on the patient’s quality of life and is because of that important to treat to improve compliance with the chemotherapy treatment. Important antiemetic treatments include 5-hydroxitryptamin-3 (5-HT3) receptor antagonists and neurokinin-1 (NK1) receptor antagonists, they each block receptors that are involved in the emetic response that is triggered by chemotherapy treatment. The purpose of this thesis was to see if there was a difference in effect between NEPA, a fixed combination of netupitant and palonosetron, and APR combined with a 5-HT3 receptor antagonist, and if so, what the difference was. The second purpose was to find out the percent of patients that was helped by being given a NK1 receptor antagonist on top of a 5-HT3 receptor antagonist treatment. This literature study included five clinical trial studies found on the database PubMed. The results showed a numeric advantage for NEPA over APR as well as a significant difference in effect when NK1 receptor antagonists were added to 5-HT3 receptor antagonist treatment. The discussion put the purpose against the result by making comparative summaries of the studies while discussing and explaining the findings. The conclusion was that no significant difference existed between NEPA and APR-treatment, but for the patient NEPA might be an easier treatment to follow since NEPA is a single dose treatment taken on day one while APR is a treatment that is taken over three days. The usage of NK1 receptor antagonists on top of 5-HT3 receptor antagonist treatment significantly improved the relieving effects with 11%-13,1% in the overall phase for the patients.

Place, publisher, year, edition, pages
2019. , p. 30
Keywords [sv]
NEPA, APR, cytostatika, antiemetika, 5-HT3-receptorblockare
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-86047OAI: oai:DiVA.org:lnu-86047DiVA, id: diva2:1332968
Educational program
Bachelor of Science Programme in Pharmacy, 180 credits
Supervisors
Examiners
Available from: 2019-07-01 Created: 2019-06-28 Last updated: 2019-07-01Bibliographically approved

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