The Mechanism of Emesis Induced by Chemotherapy and Radiotherapy

  • Paul L. R. Andrews
Conference paper
Part of the ESO Monographs book series (ESO MONOGRAPHS)


Nausea and vomiting are two of the side-effects of major concern to patients undergoing palliative or curative chemo- or radiotherapy for cancer and both have a variety of deleterious effects on the patient’s quality of life during treatment. Vomiting itself places a considerable physical stress on the body in patients who may already be weakened by their disease and any concomitant surgery. Tearing of the oesophagus (Mallory-Weiss Syndrome) and herniation of the stomach may occur, as can abdominal muscle strain, purpura, fatigue and even fracture of ribs if the vomiting is particularly violent [1]. The main danger is from aspiration of vomitus, although this is considered to be a greater risk in patients vomiting during emergence from anaesthesia.


Motion Sickness Nucleus Tractus Solitarius Area Postrema Anticipatory Nausea Delayed Emesis 
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  1. 1.
    Andrews PLR: Vomiting: a gastrointestinal tract defensive reflex. In: Andrews PLR and Widdicombe JG eds Pathophysiology of the Gut and Airways. Portland Press, London, UK 1993 pp 97–11Google Scholar
  2. 2.
    Cull A: Psychological effects of anti-cancer therapy: In: Andrews PLR and Sanger GJ: Emesis in Anti-Cancer Therapy, Mechanisms and Treatment. Chapman and Hall Medical, London 1993 pp 211–228Google Scholar
  3. 3.
    Morrow GR: Behavioural factors influencing the development and expression of chemotherapy induced side effects. Br J Cancer 1992 66 Suppl 14:S54–S61Google Scholar
  4. 4.
    Andrews PLR and Davis CJ: The mechanism of emesis induced by anti-cancer therapies. In: Andrews PLR and Sanger GJ eds Emesis in Anti-Cancer Therapy, Mechanisms and Treatment. Chapman and Hall Medical, London 1993 pp 113–162Google Scholar
  5. 5.
    Morrow GR, Angel C, Dubeshter B: Autonomic changes during cancer chemotherapy induced nausea and emesis. Br J Cancer 1992 66 Suppl XIX: S42–45Google Scholar
  6. 6.
    Lang IM: New perspectives on the mechanism controlling vomitus expulsion. In: Bianchi AL, Grelot L, Miller AD, King GL eds Mechanisms and Control of Emesis. Colloque INSERM, John Libbey, Eurotext 1993 223:71–80Google Scholar
  7. 7.
    De Ponti F, Malagelada J, Azpiroz F, Yaksh TL, Thomforde GM: Variations in gastric tone associated with duodenal motor events after activation of central emetic mechanisms in the dog. J Gastrointestinal Motility 1990 2:1–11CrossRefGoogle Scholar
  8. 8.
    Lang IM: Digestive tract motor correîates of nausea and vomiting. Can J Physiol Pharmacol 1990 68: 242–253PubMedCrossRefGoogle Scholar
  9. 9.
    Monges H, Salducci J, Naudy B: Dissociation between the electrical activity of the diaphragmatic dome and crura muscular fibres during oesophageal distention, vomiting and eructation. An electromyographic study in the dog. J Physiol Paris 1978 74:541–554PubMedGoogle Scholar
  10. 10.
    Koga T and Fukuda H: Characteristic behaviour of the respiratory muscles, esophagus, and external anal and urethral sphincters during straining, retching and vomiting in the decerebrate dog. Jap J Physiol 1990 40:789–807CrossRefGoogle Scholar
  11. 11.
    Andrews PLR, Bhandari P, Garland et al: Does retching have a function? An experimental study in the ferret. Pharmacodyn Ther Life Sci Adv 1990 9:135–152Google Scholar
  12. 12.
    Miller AD, Nonaka S, Jakus J: Brain areas essential or non-essential for emesis. Brain Res 1994 647: 255–264PubMedCrossRefGoogle Scholar
  13. 13.
    Koga T and Fukuda H: Neurons in the nucleus of the solitary tract mediating inputs from emetic vagal afferents and the area postrema to the pattern generator for the emetic act in dogs. Neurosci Res 1992 14:166–179PubMedCrossRefGoogle Scholar
  14. 14.
    Mehler WR: Observations on the connectivity of the parvicellular reticular formation with respect to the vomiting centre. Brain Behav Evol 1983 23: 63–80PubMedCrossRefGoogle Scholar
  15. 15.
    Fukuda H and Koga T: The Bötzinger complex as the pattern generator for retching and vomiting in the dog. Neurosci Res 1991 12:471–485PubMedCrossRefGoogle Scholar
  16. 16.
    Fukuda H and Koga T: Non-respiratory neurons in the Bötzinger complex exhibiting appropriate firing patterns to generate the emetic act in dogs. Neurosci Res 1992 14:180–194PubMedCrossRefGoogle Scholar
  17. 17.
    Costello DJ and Borison HL: Naloxone antagonises narcotic self-blockade of emesis in the cat. J Pharmacol Exp Ther 1977 203:222–230PubMedGoogle Scholar
  18. 18.
    Borison HL: Area postrema: Chemoreceptor circumventricular organ of the medulla oblongata. Prog Neurobiol 1989 32:351–390PubMedCrossRefGoogle Scholar
  19. 19.
    Scott R, Manikon Ml, Andrews PLR: Actions of cisplatin on the electrophysiological properties of cultured dorsal root ganglion neurones from neonatal rats. Naunyn-Schmiedeberg’s Arch Pharmacol 1994 349:287–294Google Scholar
  20. 20.
    Harris AL: Cytotoxic therapy induced vomiting is mediated via enkephalin pathways. Lancet 1982 1:714–716PubMedCrossRefGoogle Scholar
  21. 21.
    Matsuki N, Torii Y, Ueno S, Saito H: Suncus murinus as an experimental animal model for emesis and motion sickness. In: Bianchi AL, Grelot L, Miller AD, King GL eds Mechanisms and Control of Emesis. Colloque INSERM, J Libbey, Eurotext 1992 223:323–329Google Scholar
  22. 22.
    Herrstedt J, Hytetel J, Pedersen J: Interaction of the anti-emetic metopimozine and anti-cancer agents with brain dopamine D2, 5-hydroxytrypta-mine3, histamines muscarinic cholinergic and alpha-1 adrenergic receptors. Cancer Chemother Pharmacol 1993 33:53–56PubMedCrossRefGoogle Scholar
  23. 23.
    Carpenter DO, Briggs DB, Knox AP, Strominger N: Excitation of area postrema neurons by transmitters, peptides and cyclic nucleotides. J Neurophysiol 1988 59:358–369PubMedGoogle Scholar
  24. 24.
    Grundy DG and Scratcherd T: Sensory afferents from the gastrointestinal tract. In: Wood JD ed Handbook of Physiology, Section 6, Vol 1, Part 1. American Physiological Society, Bethesda, Maryland, USA 1989 pp 593–620Google Scholar
  25. 25.
    Hawthorn J, Ostler KJ, Andrews PLR: The role of the abdominal visceral innervation and 5-hydroxy-tryptamine-M receptors in vomiting induced by the cytotoxic drugs cyclophosphamide and cisplatin in the ferret. Q J Exp Physiol 1988 73:7–21PubMedGoogle Scholar
  26. 26.
    Andrews PLR, Bhandari P, Davis CJ: Plasticity and modulation of the emetic reflex. In: Bianchi AL, Grelot L, Miller AD, King GL eds Mechanisms and Control of Emesis. Colloque INSERM, John Libbey, Eurotext 1992 223:275–284Google Scholar
  27. 27.
    Isaacs B: The influence of head and body position on the emetic action of apomorphine in man. Clin Science 1957 16:215–221Google Scholar
  28. 28.
    Sem-Jacobsen CW: Depth Electrographic Stimulation of the Human Brain and Behaviour. Thomas, Springfield, IIL 1968Google Scholar
  29. 29.
    Robinson BW and Mishkin M: Alimentary responses to forebrain stimulation in monkeys. Exp Brain Res 1968 4:330–366PubMedCrossRefGoogle Scholar
  30. 30.
    Fennegan FM and Puiggari MJ: Hypothalamic and amygdaloid influence on gastric motility in dogs. J Neurosurg 1966 24:497–504PubMedCrossRefGoogle Scholar
  31. 31.
    Muraoka M, Mine K, Matsumoto K, Nakai Y, Nakagawa T: Psychogenic vomiting: the relation between patterns of vomiting and psychiatric diagnosis. Gut 1990 31:526–528PubMedCrossRefGoogle Scholar
  32. 32.
    Borison HL, Brand ED, Orkland RK: Emetic action of nitrogen mustard mechlorethamine hydrochloride in dogs and cats. Am J Physiol 1958 192:410–416PubMedGoogle Scholar
  33. 33.
    Koch KL, Summy-Long J, Bingaman S, Sperry N, Stern RM: Vasopressin and oxytocin responses to illusory self-motion and nausea in man. J Clin Endocrinol Metab 1990 71:1269–1275PubMedCrossRefGoogle Scholar
  34. 34.
    Feldman M, Samson WK, O’Dorisio TM: Apomorphine-induced nausea in humans: release of vasopressin and pancreatic polypeptide. Gastroenterology 1988 95:721–726PubMedGoogle Scholar
  35. 35.
    Nussey SS, Hawthorn J, Page SR, Ang VTY, Jenkins JS: Responses of plasma oxytocin and arginine vasopressin to nausea induced by apomorphine and ipecacuanha. Clin Endocrinol 1988 28:297–304CrossRefGoogle Scholar
  36. 36.
    Edwards CM, Carmichael J, Baylis PH, Harris AL: Arginine vasopressin — a mediator of chemotherapy-induced emesis? Br J Cancer 1989 59:467–470PubMedCrossRefGoogle Scholar
  37. 37.
    Hawthorn J, Andrews PLR, Ang VTY, Jenkins JS: Differential release of vasopressin and oxytocin in response to abdominal vagal afferent stimulation or apomorphine in the ferret. Brain Research 1988 438:193–198PubMedCrossRefGoogle Scholar
  38. 38.
    Verbalis JG, Richardson DW, Stricker EM: Vasopressin release in response to nausea producing agents and cholecystokinin in monkeys. Am J Physiol 1987 252:R749–753PubMedGoogle Scholar
  39. 39.
    Thomford NR and Sirinek KR: Intravenous vasopressin in patients with portal hypertension. J Surg Res 1975 18:113–117PubMedCrossRefGoogle Scholar
  40. 40.
    Kohl RL and MacDonald S: New pharmacologic approaches to the prevention of space/motion sickness. J Clin Pharmacol 1991 31:934–946PubMedGoogle Scholar
  41. 41.
    Clevers GH, Smout AJPM, Van Der Schee EJ, Akkermans LM: Changes in gastric electrical activity in patients with severe postoperative nausea and vomiting. J Gastrointest Mot 1992 4:61–69CrossRefGoogle Scholar
  42. 42.
    Stern RM, Koch KL, Stewart WR, Lindblad IM: Spectral analysis of tachygastria recorded during motion sickness. Gastroenterology 1987 92:92–97PubMedGoogle Scholar
  43. 43.
    Geldof H, van der Schee EJ, van Blankenstein M, Grashuis JL: Electrogastrographic study of gastric myoelectrical activity in patients with unexplained nausea and vomiting. Gut 1986 27:799–808PubMedCrossRefGoogle Scholar
  44. 44.
    Xu LH, Koch KL, Summy-Long J et al: Hypothalamic and gastric myoelectrical response during vection-induced nausea in healthy Chinese subjects. Am J Physiol 1993 265:E578–584PubMedGoogle Scholar
  45. 45.
    Harding RK, Young RW, Anno GH: Radiotherapy-induced emesis. In: Andrews PLR and Sanger GJ eds Emesis in Anti-Cancer Therapy: Mechanisms and Treatment. Chapman and Hall Medical, London 1993 pp 163–178Google Scholar
  46. 46.
    McCarthy LE and Borison HL: Cisplatin-induced vomiting eliminated by ablation of the area postrema in cats. Cancer Treat Rep 1984 68:401–404PubMedGoogle Scholar
  47. 47.
    Fukui H, Yamamoto M, Sasaki S, Sato S: Emetic effects of anticancer drugs and involvement of visceral afferent fibres and 5-HT3 receptors in dogs. Eur J Pharmacol 1993 250:281–287PubMedCrossRefGoogle Scholar
  48. 48.
    Fukui H, Yamamoto M, Sato S: Vagal afferent fibres and peripheral 5-HT3 receptors mediate cisplatin-induced emesis in dogs. Jap J Pharmacol 1992 59:221–222PubMedCrossRefGoogle Scholar
  49. 49.
    Fukui HM, Yamamoto S, Sasaki S, Sato S: Involvement of 5-HT3 receptors and vagal afferents in copper sulphate and cisplatin-induced emesis in monkeys. Eur J Pharmacol 1993 249:13–18PubMedCrossRefGoogle Scholar
  50. 50.
    Reynolds DJM, Barber NA, Grahame-Smith DG, Leslie RA: Cisplatin-evoked induction of c-fos protein in the brainstem of the ferret: the effect of cervical vagotomy and the anti-emetic 5-HT3 receptor antagonist granisetron BRL 43694. Brain Res 1991 565:231–236PubMedCrossRefGoogle Scholar
  51. 51.
    Andrews PLR, Davis CJ, Bingham S, Davidson HIM, Hawthorn J, Maskell L: The abdominal visceral innervation and the emetic reflex: pathways, pharmacology and plasticity. Can J Physiol Pharmacol 1990 68:325–345PubMedCrossRefGoogle Scholar
  52. 52.
    Kelsen DP, Minsky B, Smith M, Beitier J, Niedzwiecki D, Chapman D, Bains M, Burt M, Heelan R, Hilaris B: Preoperative therapy for oesophageal cancer: A randomized comparison of chemotherapy versus radiation therapy. J Clin Oncol 1990 8: 1352–1361PubMedGoogle Scholar
  53. 53.
    Lindstrom PA and Brizzee KR: Relief of intractable vomiting from surgical lesions in the area postrema. J Neurosurg 1962 19:228–236PubMedCrossRefGoogle Scholar
  54. 54.
    Schwörer H, Racke K, Kilbinger H: Cisplatin increases the release of 5-hydroxytryptamine 5-HT from the isolated vascularly perfused small intestine of the guinea pig: Involvement of 5-HT3 receptors. Naunyn-Schmiedeberg’s Arch Pharmacol 1991 344:143–149CrossRefGoogle Scholar
  55. 55.
    Davidson HIM and Andrews PLR: Stimulation of gastrointestinal motility by cisplatin in the ferret: activation of an intrinsic cholinergic mechanism dissociated from emesis. Naunyn-Schmiedeberg’s Arch Pharmacol 1993 347:506–513CrossRefGoogle Scholar
  56. 56.
    Andrews PLR: 5-HT3 receptor antagonists and anti-emesis. In: King FC, Jones B and Sanger GJ eds 5-HT3 Receptor Antagonists. CRC Press, Boca Raton, USA 1994 pp 255–317Google Scholar
  57. 57.
    Leslie RA and Reynolds DJM: The area postrema and vomiting: how important is serotonin? In: Osborne NN ed Current Aspects of the Neurosciences. Macmillan, London 1991 pp 79–101Google Scholar
  58. 58.
    Blackshaw LA and Grundy D: Effects of 5-hydroxytryptamine on discharge of vagal mucosal afferent fibres from the upper gastrointestinal tract of the ferret. J Auton Nerv Syst 1993 45:41–50PubMedCrossRefGoogle Scholar
  59. 59.
    Andrews PLR and Davidson HIM: Activation of vagal afferent terminals by 5-hydroxytryptamine is mediated by the 5-HT receptor in the anaesthetized ferret. J Physiol 1990 422:92PGoogle Scholar
  60. 60.
    Endo T, Takahashi M, Minami M, Yoshioka M, Saito H, Pavez SH: Effects of anticancer drugs on enzyme activities and serotonin release from ileal tissue in ferrets. Biogenic Amines 1993 9:479–489Google Scholar
  61. 61.
    Endo T, Minami M, Monma Y, Saito H, Takeuchi M: Emesis-related biochemical and histopathological changes induced by cisplatin in the ferret, J Toxicol Sci 1990 15:235–244PubMedCrossRefGoogle Scholar
  62. 62.
    Fukui H, Yamamoto M, Ando T, Sasaki S, Sato S: Increase in serotonin levels in the dog ileum and blood by cisplatin as measured by microdialysis. Neuropharmacology 1993 32:959–968PubMedCrossRefGoogle Scholar
  63. 63.
    Cubeddu LX, Hoffman IS, Fuenmayor NT, Malave JJ: Changes in serotonin metabolism in cancer patients; its relationship to nausea and vomiting induced by chemotherapeutic drugs. Br J Cancer 1992 66:198–203PubMedCrossRefGoogle Scholar
  64. 64.
    Barnes NM GeJ, Jones WG, Naylor RJ, Rudd JA: Cisplatin-induced emesis: preliminary results indicative of changes in plasma levels of 5-Hydroxytryptamine. Br J Cancer 1990b 62:862–864PubMedCrossRefGoogle Scholar
  65. 65.
    Torii Y, Mutoh M, Saito H, Matsuki N: Involvement of free radicals in cisplatin-induced emesis in Suncus murinus. Eur J Pharmacol — Env Toxicol and Pharmacol 1993 248:131–135CrossRefGoogle Scholar
  66. 66.
    Gebauer A, Merger M, Kilbinger H: Modulation by 5-HT3 and 5-HT4 receptors of the release of 5-hydroxytryptamine from the guinea-pig small intestine. Naunyn-Schmiedeberg’s Arch Pharmacol 1993 347:137–140Google Scholar
  67. 67.
    Lee CR, Plosker G, McTavish D: Tropisetron: A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential as an antiemetic. Drugs 1993 46:925–943PubMedCrossRefGoogle Scholar
  68. 68.
    Yarker YE and McTavish D: Granisetron: an update of its therapeutic use in nausea and vomiting induced by antineoplastic therapy. Drugs 1994 48: 761–793PubMedCrossRefGoogle Scholar
  69. 69.
    Markham A and Sorkin EM: Ondansetron: An update of its therapeutic use. Drugs 1993 46/2:268Google Scholar
  70. 70.
    Cubeddu LX: The role of serotonin in chemotherapy-induced emesis in cancer patients. In: Diaz-Rubio E and Martin M eds Antiemetic Therapy: Current Status and Future Prospects. Creaciones Elba SA, Madrid 1992 pp 39–56Google Scholar
  71. 71.
    Gunning SJ, Hagan RM, Tyers MB: Cisplatin induces biochemical and histological changes in the small intestine of the ferret. Br J Pharmacol 1987 90 Suppl:135Google Scholar
  72. 72.
    Allan SG and Smyth JS: Small intestinal mucosal toxicity of cisplatinum. Comparison of toxicity with platinum analogues and dexamethasone. Br J Cancer 1986 53:355–360PubMedCrossRefGoogle Scholar
  73. 73.
    Maxwell A, Gaffin SL, Wells MT: Radiotherapy, endotoxins and nausea. Lancet 1986 1:1148–1149PubMedCrossRefGoogle Scholar
  74. 74.
    Roos IA, Fairlie DP, Whitehouse MW: A peculiar toxicity manifested by platinum II amines in rats: gastric distension after peritoneal administration. Chem Biol Int 1981 35:111–117CrossRefGoogle Scholar
  75. 75.
    Fredrikson M, Hursti T, Furst C-J, Steineck G, Borjeson S, Wikblom M, Peterson C: Nausea in cancer chemotherapy is inversely related to urinary Cortisol excretion. Br J Cancer 1992 65:779–780PubMedCrossRefGoogle Scholar
  76. 76.
    Rudd JA, Jordan CC, Naylor RJ: Profiles of emetic action of cisplatin in the ferret: a potential model of acute and delayed emesis. Eur J Pharmacol 1994 262:R1–R2PubMedCrossRefGoogle Scholar
  77. 77.
    Rudd JA and Naylor RJ: Effects of 5-hydroxytryptamine-3 receptor antagonists on models of acute and delayed emesis induced by cisplatin in the ferret. Neuropharmacol 1994 33:1607–1608CrossRefGoogle Scholar
  78. 78.
    Watson JW, Gonsalves SF, Fossa AJ, McLean S, Seeger T, Andrews PLR: The role of the NK-1 receptor in emetic responses: the anti-emetic effects of CP-99,994 in the ferret and the dog. Br J Pharmacol 1995 115:84–94PubMedGoogle Scholar
  79. 79.
    Watson JW, Nagahisa A, Lucot J, Andrews PLR: The role of the NK-1 receptor in emetic responses. In: Reynolds DJM, Andrews PLR, Davis CJ eds Serotonin and the Scientific Basis of Anti-Emetic Therapy. Oxford Clinical Communications, Oxford 1995 pp 233–239Google Scholar
  80. 80.
    Grelot L, Milano S, Le Stunff H: Does serotonin play a role in the delayed phase of cisplatin-induced emesis? In: Reynolds DJM, Andrews PLR, Davis CJ eds Serotonin and the Scientific Basis of Anth Emetic Therapy. Oxford Clinical Communications, Oxford 1995 pp 181–191Google Scholar
  81. 81.
    Fox RA: Current status: animal models of nausea. In: Bianchi AL, Grelot L, Miller AD, King GL eds Mechanisms and Control of Emesis. Colloque INSERM, John Libbey, Eurotext 1992 223:341–350Google Scholar
  82. 82.
    Blijham GH: Does granisetron remain effective over multiple cycles? Eur J Cancer 1992 28A Suppl 1:S17–S21PubMedCrossRefGoogle Scholar
  83. 83.
    Cubeddu LX and Hoffmann IS: Participation of serotonin on early and delayed emesis induced by initial and subsequent cycles of cisplatinum-based chemotherapy: effects of dexamethasone and metoclopramide. J Clin Pharmacol 1993 33:691–697PubMedGoogle Scholar
  84. 84.
    Andryowski MA: Psychological aspects of nausea and vomiting. In: Bianchi AL, Grelot L, Miller AD, King GL eds Mechanisms and Control of Emesis. Colloque INSERM, John Libbey, Eurotext 1992 223:313–322Google Scholar
  85. 85.
    Morrow GR: The effect of a susceptibility to motion sickness on the side effects of cancer chemotherapy. Cancer 1985 55:2766–2770PubMedCrossRefGoogle Scholar
  86. 86.
    Reason JT and Brand JJ: Motion Sickness. Academic Press, London 1975 p 181Google Scholar
  87. 87.
    Palazzo MGA and Strunin L: Anaesthesia and emesis I: Etiology. Can Anaesth Soc J 1984 31:178–187PubMedCrossRefGoogle Scholar
  88. 88.
    Palazzo MGA and Strunin L: Anaesthesia and emesis II: Prevention and management. Can Anaesth Soc J 1984 31:407–415PubMedCrossRefGoogle Scholar
  89. 89.
    Andrews PLR: Physiology of nausea and vomiting. Br J Anaesth 1992 69 Suppl 1:2S-19SPubMedCrossRefGoogle Scholar
  90. 90.
    Begg CB, Cohen JL, Ellerton J: Are the elderly predisposed to toxicity from cancer chemotherapy? Cancer Clin Trials 1980 3:369–374PubMedGoogle Scholar
  91. 91.
    Morrow GR: Behaviorial factors influencing the development and expression of chemotherapy induced side effects. Br J Cancer 1992 66:554–561Google Scholar
  92. 92.
    Marr HE, Davey PT, Boyle EA, Blower PB: The antiemetic activity of granisetron against cytostatic treatment-induced emesis in 10–13 week-old ferrets. J Cancer Res Clin Oncol 1994 120:204–207PubMedCrossRefGoogle Scholar
  93. 93.
    Mirabile CS: Motion sickness susceptibility and behaviour. In: Crampton GH ed Motion and Space Sickness. CRC Press, Boca Raton, USA 1990 pp 391–410Google Scholar
  94. 94.
    Miaskiewicz SL, Stricker E, Verbalis JG: Neurohypophyseal secretion in response to cholecystokinin, but not meal-induced gastric distention in human. J Clin Endocrinol Metab 1989 68:837–843PubMedCrossRefGoogle Scholar
  95. 95.
    Roila F, Tonato M, Del Favero A: Prognostic factors of chemotherapy-induced emesis. In: Diaz-Rubio E and Martin M eds Antiemetic Therapy: Current Status and Future Prospects. Creaciones Elba SA, Madrid 1992Google Scholar
  96. 96.
    Martin M, Diaz-Rubio E: Emesis during past pregnancy: a new prognostic factor in chemotherapy-induced emesis. Ann Oncol 1990 1:152–153PubMedGoogle Scholar
  97. 97.
    Andrews PLR and Whitehead SA: Pregnancy sickness. News Physiol Sci 1990 5:5–10Google Scholar
  98. 98.
    Sullivan JR, Leyden MJ, Bell R: Decreased cisplatin-induced nausea and vomiting with chronic alcohol ingestion. N Engl J Med 1983 309:796PubMedGoogle Scholar
  99. 99.
    Spiess JL, Adelstein DJ, Hines JD: Evaluation of ethanol as an antiemetic in patients receiving cisplatin. Clin Ther 1987 9:400–404PubMedGoogle Scholar
  100. 100.
    D’Acquisto RW, Tyson LB, Gralla RJ et al: The influence of a chronic high alcohol intake on chemotherapy-induced nausea and vomiting. Proc Am Soc Clin Oncol 1986 5:257Google Scholar
  101. 101.
    Stern RM, Hu S, LeBlanc R, Koch KL: Chinese hyper-susceptibility to vection-induced motion sickness. Aviat Space Environ Med 1995 in pressGoogle Scholar
  102. 102.
    Xu LH, Koch KL, Summy-Long J et al: Hypothalamic and gastric myoelectrical responses during vection-induced nausea in healthy Chinese subjects. Am J Physiol 1993 265:E578–E584PubMedGoogle Scholar
  103. 103.
    Alfieri AB and Cubeddu LX: Treatment with parachlorophenylalanine antagonises the emetic response and the serotonin-releasing actions of cisplatin in cancer patients. Br J Cancer 1995 71: 629–632PubMedCrossRefGoogle Scholar
  104. 104.
    Fink-Jensen A, Judge ME, Hansen JB et al: Inhibition of cisplatin-induced emesis in ferrets by the non-NMDA receptor antagonists NBQX and CNQX. Neurosci Lett 1992 137:173–177PubMedCrossRefGoogle Scholar
  105. 105.
    Göthert M, Hamon M, Barann M et al: 5-HT3 receptor antagonism by anpirtoline, a mixed 5-HT1 receptor agonist/5-HT3 receptor antagonist. Br J Pharmacol 1995 114:269–274PubMedGoogle Scholar
  106. 106.
    Aggarwal SK: A histochemical approach to the mechanism of action of cisplatin and its analogues. J Histochem Cytochem 1993 41:1053–1073PubMedCrossRefGoogle Scholar
  107. 107.
    Scott RH, Woods AJ, Lacey MJ, Fernando D, Crawford JH, Andrews PLR: An electrophysiological investigation of the effects of cisplatin and the protective actions of dexamethasone on cultured dorsal root ganglion neurones from neonatal rats. Naunyn-Schmiedeberg’s Arch Pharmacol 1995 352:247–255Google Scholar
  108. 108.
    Roila F: Dexamethasone, granisetron, or both for the prevention of nausea and vomiting during chemotherapy for cancer. New Engl J Med 1995 332: 1–5CrossRefGoogle Scholar
  109. 109.
    Woods AJ and Andrews PLR: Cisplatin acutely reduces 5-HT-induced vagal depolarization in the rat: Protective effect of dexamethasone. Eur J Pharmacol 1995 278:275–278PubMedCrossRefGoogle Scholar
  110. 110.
    Aapro MS, Alberts DS, Serokman R: Lack of dexamethasone effect on the antitumour activity of cisplatin. Cancer Treat Rep 1983 67:1013–1017PubMedGoogle Scholar
  111. 111.
    Maridonneau-Parini I, Errasfa M, Russo-Marie F: Inhibition of 02 generation by dexamethasone is mimicked by lipocortin I in alveolar macrophages. J Clin Invest 1989 261:395–400Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • Paul L. R. Andrews
    • 1
  1. 1.Department of PhysiologySt George’s Hospital Medical SchoolLondonUK

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