Farmacoterapia atual das náuseas e vômitos induzidos por antineoplásicos
DOI:
https://doi.org/10.33448/rsd-v10i9.18435Palavras-chave:
Antagonistas dos receptores 5-HT3; Antagonistas dos receptores NK-1; Corticosteroide; Náuseas e vômitos induzidos por quimioterapia.Resumo
As náuseas e vômitos induzidos por quimioterapia (NVIQ) são reações adversas à medicamentos comuns com o uso de antineoplásicos. Embora existam avanços na terapêutica profilática, o manejo de medicamentos antieméticos na prática clínica ainda tem sido um desafio a ser enfrentado. O objetivo do presente estudo foi buscar na literatura científica as principais terapias farmacológicas utilizadas nesta condição. Uma revisão sistemática foi realizada, no qual buscou-se artigos científicos indexados no PubMed, ScienseDirect e Web of Science, utilizando os seguintes descritores: chemotherapy; nausea; vomiting; drug therapy; serotonin 5-HT3 receptor antagonists, neurokinin-1 receptor antagonista. O grau de emetogenicidade causado pelos agentes antineoplásicos influencia diretamente no tratamento das NVIQ, que incluem os antagonistas dos receptores de serotonina (5-HT3), antagonistas dos receptores de neurocinina (NK-1). Este tratamento pode ser feito de forma individualizada, porém, caso ele não seja responsivo, é possível fazer a associação entre essas duas classes. Em casos mais complicados é indicado uma terapia tripla que é composta pela combinação de antagonistas dos receptores de 5-HT3 com antagonistas dos receptores de NK-1 e dexametasona. Portanto, a eficácia da terapia antiemética é aumentada nessa tríadequando comparados ao tratamento desses medicamentos de forma individualizada. Os antagonistas dos receptores de 5-HT3 de primeira geração são muito eficazes, contudo, a palonosetrona, de segunda geração, é mais eficaz e seguro. Uma formulação de netupitanto e palonosetrona, quando administrado juntamente com a dexametasona, tem sido uma boa opção para o tratamento de NVIQ.
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