An overview of the clinical use of ondansetron in preschool age children

Figures & data

Table 1 Risk factors for postoperative nausea and vomiting in children

Surgery — type	Use of volatile anesthetics
Surgery — duration	Use of nitrous oxide
History of PONV	Use of opioids
History of motion sickness	Use of reversal agents

Adapted from Gan et al (2003).

Abbreviations:PONV, postoperative nausea and vomiting.

Table 2 Emetogenic potential of chemotherapy agents risk and (%)

High risk (<90 %)	Carmustine <250 mg/m^2 Cisplatin >50 mg/m^2 Cyclophosphamide >1.5 g/m^2 Dacarbazine >500 mg/m^2	Lomustine >60 mg/m^2 Mechlorethamine Streptozocin
High risk (60–90%)	Carmustine <250 mg/m^2 Cisplatin <50 mg/m^2 yclophosphamide 0.75–1.5 g/m^2 Dacarbazine <500 mg/m^2	Dactinomycin >1.5 mg/m^2 Doxorubicin >60 mg/m^2 Mitoxantrone >15 mg/m^2 Methotrexate >1000 mg/m^2
High risk (30–60%)	Cyclophosphamide <0.75 g/m^2 Dactinomycin <1.5 mg/m^2 Daunorubicin Doxorubicin 20–60 mg/m^2	Epirubicin ≤90 mg/m^2 Idarubicin Ifosfamide Methotrexate 0.25–1 g/m^2
Moderate risk (10–30%)	Asparaginase Cytarabine <1 g/m^2 Doxorubicin <20 mg/m^2 Docetaxel	Etoposide Fluorouracil <1 g/m^2 Methotrexate 50–250 mg/m^2 Mitomycin
Low risk (>10%)	Bleomycin Busulfan Chlorambucil Fludarabine	Methotrexate <50 mg/m^2 Thioguanine Vinblastine Vincristine

Adapted from Hesketh et al (1997).

Table 3 Guidelines for prophylactic therapy for children at risk for nausea and vomiting

Risk category	PONVa	CINVb, c	RINVc
High	5-HT3 rcpt Antagonists plus corticosteroids plus drug of another class^d	5-HT3 rcpt Antagonists plus corticosteroids plus drug of another class^d	Corticosteroids plus 5-HT3 rcpt antagonists
Moderate	5-HT3 rcpt Antagonists plus corticosteroids or drug of another class^d	5-HT3 rcpt Antagonists plus corticosteroids or drug of another class^d	Corticosteroids or 5-HT3 rcpt antagonists
Low	No prophylaxis	Corticosteroids or 5-HT3 rcpt antagonists	No prophylaxis

a Gan et al (2003);

b Dupuis and Nathan (2003);

c Aapro (2005).

Notes:Dopamine antagonists (metoclopramide, droperidol, and prochlorpromazine) or substance P/neurokinin 1 (NK1) receptor antagonist (aprepitant) pending pediatric studies.

Abbreviations:CINV, chemotherapy-induced nausea and vomiting; PONV, postoperative nausea and vomiting; rcpt, receptor; RINV, radiation-induced nausea and vomiting.

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