PONV prevention: Emend..every heard of it?

[Nursonegreat]

Higuys, i do pre-op assessments and interviews and always trying to find new ways to prevent PONV. a drug rep introduced us to Emend. has anyone had any experience with this drug? good bad indifferent? feed back please!!

[caroladybelle, BSN, RN]

Emend (aprepitent) is new (within the last 5 years) class of antiemetic (NK1). It initially was approved to be used along with a 5HT3 drug and/or decadron for HIGHLY emetogenic chemo, such as cisplatin. It is not used by itself as a stand alone drug. It consists of 3 doses given one per day, a larger initial dose and two smaller ones. It comes packaged in the three doses. It supposedly has effectiveness for several days out after the last dose. But as yet, it is only used with chemo...not for other types of nausea, or for that matter, delayed cinv.

As to it's effectiveness, I haven't see it used often enough as I work mostly with liquid tumors (no cisplatin). Many facilities do not carry it, and many insurances do not cover it. Some patients buy it out of the facility and bring it in for use with chemo It is also quite expensive ( >$300, in many cases, plus the cost of the 5HT3 - which is also expensive and the decadron).