Cancer patients receiving cytotoxic drugs often experience severe nausea and vomiting. Effective antiemetic therapy has not been established. Cisplatin, a prototype of anti-cancer drugs, produces a dose-related emetic response in the ferret. Newly developed 5-HT
3 receptor antagonists can prevent emesis induced by anti-cancer drugs. The enteric serotonin (5-HT) concentration of a cisplatin-administered group increased significantly compared with that of control frrrets. A pharmacokinetic study revealed that the efficacy of 5-HT
3 antagonists depended on its concentration in the blood. Cytotoxic therapy stimulates the synthesis and release of neurochemical agents including 5-HT from the gut. The vomiting center may be activated directly by visceral afferent neurons or by input from the chemoreceptor trigger zone of the area postrema. It was demonstrated that 5-HT
3 antagonists were useful for treatment of the emesis evoked by anti-cancer drugs. Further studied are required to evaluate the site of action of anti-emetic drugs and the precise mechanism of the vomiting induced by anti-cancer drugs.
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