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Lorazepam for Chemotherapy-Induced Emesis

Lorazepam for Chemotherapy-Induced Emesis Abstract To the Editor. —Stoudemire et al1 eloquently described the difficult clinical problem of managing chemotherapy-induced emesis. Our experience with lorazepam suggests it is satisfactory for use even in regimens using cisplatin and in patients who previously suffered from anticipatory nausea and vomiting.2Lorazepam is a benzodiazepine with sedative, anxiolytic, and amnesic properties. We give it as a 4-mg dose, intramuscularly, two hours before treatment, then as 1 to 2 mg sublingually, hourly as needed, for up to six hours to maintain mild to moderate sedation, as defined by Gralla et al3 (mild: patient lethargic but aroused by verbal stimuli and completely oriented when awakened; moderate: patient aroused only by physical stimuli and completely oriented when awakened). Prochlorperazine is usually given rectally in a 25-mg dose at the beginning of treatment and four hours later if necessary.Our regimen resulted in adequate amnesia for emesis in 94% of References 1. Stoudemire A, Cotanch P, Laszlo J: Recent advances in the pharmacologic and behavioral management of chemotherapy-induced emesis. Arch Intern Med 1984;144:1029-1033.Crossref 2. Semrad NF, Leuchter RS, Townsend DE, et al: A pilot study of lorazepam-induced amnesia with cis-platinum containing chemotherapy. Gynecol Oncol 1984;17:277-280.Crossref 3. Gralla RJ, Itri LM, Piska SE, et al: Antiemetic efficacy of high dose metoclopramide: Randomized trials with placebo and prochlorperazine in patients with chemotherapy-induced nausea and vomiting. N Engl J Med 1981;305: 905-909.Crossref 4. Gralla RJ: Metoclopramide: A review of antiemetic trials. Drugs 1983;25( (suppl 1) ):63-73.Crossref 5. Maher J: Intravenous lorazepam to prevent nausea and vomiting associated with cancer chemotherapy. Lancet 1981;1:91-92.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Lorazepam for Chemotherapy-Induced Emesis

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1984.00350220168047
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —Stoudemire et al1 eloquently described the difficult clinical problem of managing chemotherapy-induced emesis. Our experience with lorazepam suggests it is satisfactory for use even in regimens using cisplatin and in patients who previously suffered from anticipatory nausea and vomiting.2Lorazepam is a benzodiazepine with sedative, anxiolytic, and amnesic properties. We give it as a 4-mg dose, intramuscularly, two hours before treatment, then as 1 to 2 mg sublingually, hourly as needed, for up to six hours to maintain mild to moderate sedation, as defined by Gralla et al3 (mild: patient lethargic but aroused by verbal stimuli and completely oriented when awakened; moderate: patient aroused only by physical stimuli and completely oriented when awakened). Prochlorperazine is usually given rectally in a 25-mg dose at the beginning of treatment and four hours later if necessary.Our regimen resulted in adequate amnesia for emesis in 94% of References 1. Stoudemire A, Cotanch P, Laszlo J: Recent advances in the pharmacologic and behavioral management of chemotherapy-induced emesis. Arch Intern Med 1984;144:1029-1033.Crossref 2. Semrad NF, Leuchter RS, Townsend DE, et al: A pilot study of lorazepam-induced amnesia with cis-platinum containing chemotherapy. Gynecol Oncol 1984;17:277-280.Crossref 3. Gralla RJ, Itri LM, Piska SE, et al: Antiemetic efficacy of high dose metoclopramide: Randomized trials with placebo and prochlorperazine in patients with chemotherapy-induced nausea and vomiting. N Engl J Med 1981;305: 905-909.Crossref 4. Gralla RJ: Metoclopramide: A review of antiemetic trials. Drugs 1983;25( (suppl 1) ):63-73.Crossref 5. Maher J: Intravenous lorazepam to prevent nausea and vomiting associated with cancer chemotherapy. Lancet 1981;1:91-92.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Dec 1, 1984

References