The antiemetic treatment of oncologic procedures

Nausea and vomiting are multistep pathway controlled by the brain. The emetic impulses come form cortex, as a psyhotic reaction or throught nervus vagus. In the medulla in the area postrema are the specific nuclei concerning to the emetic episodes. Most important neurotransmitters are the serotonin, substance P and dopamins. The chemotherapeutic drugs caused the emesis and vomiting at different frequences. The effect of 5-HT3 and NK-1 receptor antagonist have not are the most important antiemetic role. The fixed oral combination: netupitant and palonosetron (NEPA) increase instead of ensure the patient adherence. Guidelines recommend the antiemetic combinations in different types of chemotherapy. This rewiev covers the specific nausea and vomitig forms: breakthrough, multiday chemotherapy induced, radiation induced and anticipatory emesis. We summarise also the antiemetic therapy in childhood.