Closing the gap in prophylactic antiemetic therapy: patient factors in calculating the emetogenic potential of chemotherapy.

The ability to provoke emesis is defined by the emetogenic potential of each antineoplastic agent and by individual prognostic factors that determine the risk for each patient. The risk of chemotherapy-induced emesis is increased for females, patients between the ages of 6 and 50, and patients who drink little or no alcohol. Other risk factors include susceptibility to motion sickness and high levels of anxiety. Patients with one or more risk factors may require antiemetic treatment typically prescribed for a highly emetogenic regimen, even when a chemotherapy regimen is considered moderately emetogenic. The 5-HT3 receptor antagonists are the most effective agents against chemotherapy-induced nausea and should become standard antiemetic therapy for high-risk patients. Knowledge of factors affecting emesis and the antiemetic agents available for treating high-risk patients are the keys to successful nursing management of emesis in patients receiving chemotherapy.