Treatment-Related Nausea and Vomiting in Children
- Nausea and vomiting in children treated with chemotherapy is a serious problem.
- Anticipatory nausea and vomiting may occur in children.
- In children, acute nausea and vomiting is usually treated with drugs and other methods.
- Delayed nausea may be hard to detect in children.
Nausea and vomiting in children treated with chemotherapy is a serious problem.
Like adults, nausea in children receiving chemotherapy is more of a problem than vomiting. Children may have anticipatory, acute, and/or delayed nausea and vomiting.
Anticipatory nausea and vomiting may occur in children.
Children who have nausea and vomiting after a chemotherapy treatment may have the same symptoms before their next treatment when the child sees, smells, or hears sounds from the treatment room. This is called anticipatory nausea and vomiting.
When the child’s nausea and vomiting is well controlled during and after a chemotherapy treatment, the child may have less anxiety before the next treatment and less chance of having anticipatory symptoms.
Health professionals caring for children who have anticipatory nausea and vomiting have found that children may benefit from:
- Drugs used to treat anxiety in doses adjusted for the age and needs of the child.
In children, acute nausea and vomiting is usually treated with drugs and other methods.
Drugs may be given before each treatment to prevent nausea and vomiting. After chemotherapy, drugs may be given to prevent delayed vomiting. Patients who are given chemotherapy several days in a row may need treatment for both acute and delayed nausea and vomiting. Some drugs last only a short time in the body and need to be given more often. Others last a long time and are given less often.
The following table shows drugs that are commonly used to prevent nausea and vomiting caused by chemotherapy and the type of drug. Different types of drugs may be given together to treat acute and delayed nausea and vomiting.
|Drug Name||Type of Drug|
|Chlorpromazine, prochlorperazine, promethazine||Dopamine receptor antagonists: phenothiazines|
|Metoclopramide||Dopamine receptor antagonists: substituted benzamides|
|Granisetron, ondansetron, palonosetron||Serotonin receptor antagonists|
|Aprepitant, fosaprepitant||Substance P/NK-1 antagonists|
|Dronabinol, nabilone||Other drugs|
Non-drug treatments may help relieve nausea and vomiting, and may help anti nausea drugs work better in children. These treatments include:
- Guided imagery.
- Music therapy.
- Muscle relaxation training.
- Child and family support groups.
- Virtual reality games.
Dietary support may include:
- Eating smaller meals more often.
- Avoiding food smells and other strong odors.
- Avoiding foods that are spicy, fatty, or highly salted.
- Eating "comfort foods" that have helped prevent nausea in the past.
- Taking anti nausea drugs before meals.
Delayed nausea may be hard to detect in children.
Unlike in adults, delayed nausea and vomiting in children may be harder for parents and caregivers to see. A change in the child’s eating pattern may be the only sign of a problem. In addition, most chemotherapy treatments for children are scheduled over several days. This makes the timing and risk of delayed nausea unclear.
Studies on the prevention of delayed nausea and vomiting in children are limited. Children are usually treated the same way as adults, with doses of drugs that prevent nausea adjusted for age.
Rachel Namery, MS
Manager of R&D, Formulator and Nutrition Coach
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