Chemotherapy Induced Nausea and Vomiting (CINV) ??????

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Chemotherapy Induced Nausea and Vomiting (CINV)
??????

• ????? ?????? ???? ?????? ?? ????? ????? ?????.
• ?????? ??????
• ?70????????? ??????? ????? ????.
• 10-40 - ?????? ?????? ??????
• CINV ????? ?????? ?????? ?? ?? ?????? ????????.

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??? ???????? ?? ????? ????

• ???? ?????? ?????? ?????? ??? ? CINV
• ????? ????? ?????? ?? ?? ??? ????????
• ????? 90
• ??????? 30-90
• ????? 10-30
• ????????? ???? ?10
• ??????? ??????? ?? ???? ?????? ?????? ?CINV ???
  ????? ??????
• ????? ????? ??????
• ?????,??? ??? ???? ???.

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(No Transcript)
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??????? ???????? ?????? ??????

• ???? ?????? ???? ????? ??????
• ?????? ?CINV ???? ????? ???????? ???? ????? 4
  ???? -?? ???? ?????
• ????? ?????? ????? ???? ????? ?? ?????????
  ???????? ?? ??????, ?????? ???? ??? ?????? ??????
  ?? ????? ??? ?????? ???,?????, ?????? ,????? ???.
• ????? ????? ?????? ????? ???? ????? ?????? ??????
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• ??????? ????? ????? ???? ?????????? ????? ???????
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????? ????? ??????
0 1 2 3 4-5
????? ??? ????? ???? ????? ????? ???????? ? ????? ???? ??? ????? ???? ??? ????? ???? ??????
???? ??? 1 ??????? 24 ???? 2-5 ???????? ? 24 ???? 6-10 ???????? ? 24 ????, ???? ??????? ???? ? 10 ???????? ? 24 ????, ????? ???? ??????????
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EMEND ( Apprepitant)

• ????? ???? ??????? ?????? ?? ?????? ???? ??????
  ?????, ?????? ?? CINV ???? ??????
• ?????? ?????
• ?????? ????? ?? ?????? ???????- neurokinin-1
  ????? ????? ???? ??? ??????? ?????? ?????? ?? ???
  Substance P ??? ??? ?? ???? ???? ????? ??????
  ?????? ?????.

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EMEND ( Apprepitant)

• ?????? ????????
• ??? ???????? ????? ????? ????? ????? ????
  ???????? ??????? ?????? ?? 5HT3 ????????
  ????????? ?3 ???? .
• ?????? ?????
• ?????-18 , ????? 13, ????? 11, ?????? 10
  ,????? 10, ???? ????? 10.

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?????? ????????

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  ??????? ?????? ???????? ?????????
• ?????? ????? ?????? ?? ?? ??? ???????? ??????? ??
  ????. ???? ?????? ??????? ?? ?? ??? ?????? ??????
  ?????? ?CINV ???? ???????.
• ?? ?????? ??????? ???? ?? ??? ???? ????? ?????
• ????? ?????? ??? ???? ??? ??????? ?? ????? ????
  ??? ?????? ????? ??????? ????? ?? ?????

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International Guidelines
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Key Societies (including ESMO) now include EMEND
as part of standard therapy in their antiemetic
guidelines.
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Clinical guidelines Y2008
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Clinical guidelines Y2008
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Clinical guidelines Y2008
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Clinical guidelines Y2008
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????? ??????? ?????? ??????? BREAKTHROUGH CINV

• ??????? ????? ????? ?????? ?????????.
• ????? ?? ????? ???????????
• ????? ??? ?5HT3 ?????????
• Cannabinoid ????? ?????? ??? ????? ??????
  ???????? ?????.
• ??? ????? ?? ?????? ??????? ????? ??? ?????
  ??????????? ????????(??????) ,?????????????
  ,?????????, ??????,??????.
• ??? ????? ????? ??? ?????
• ??? ?????? ????? ????? ????? ?????? ?????? ?????.

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• ????? ??? ????????? ??????
• ??? ????? ?????? ???? ????? ????
• ??? ????? ?????? ???? ??????? ????? ?? ???????
  ?????? ????? ??? ?? ?????? ????????
• ??? ???? ??? ????, ??? IV ???? ???? ????.
• ????? ????? ???? ????? ????? ??????,?"?, ?????

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• ?????? ?? ??? ??????? ??? ???? ????? ???? ????
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• ?????? ?????? ????? ????????? ????? ??????
  ???????? ??????? ?????? ?????? ?????

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(No Transcript)
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Backup Slides
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????? ?? CINV

• ??? ???????? ?????
• ??????- ????? 5HT3 , ?????????, ????.
• ??????? - ?????????, ????- ???? ????? 2-3 ????
  ???? ???? ?????? ?????
• ??? ???????? ???????
• ??????- ????? 5HT3 , ?????????/- ???? (??
  ???).
• ??????? ?????????/- ????
• ??? ???????? ?????, ?????????/??????