We recently had a patient admitted for his first chemo for colorectal cancer. On admission he told us an anti-emetic he had had from a previous (unrelated) surgery years ago and not at our hospital had made him very ill.
Concerned we bent over backwards to find out what drug this actually was. His GP didn't know and neither could we get hold of any records of a surgery many years before.
In the end we concluded it was probably cyclizine and the chemo regime wasn't using that anyway but had more modern drugs consisting of aprepitant and ondansetron. These are routinely used for in chemo protocols known to be emeteogenic such as anything involving Cisplatin.
Well the patient kicked up a hell off a fuss. Refused the anti-emetics, threatened to take us to court if we killed him with our nasty drugs. Our on-call doctor finally persuaded him to take the anti=emetics and the patient sailed through chemo with no nausea issues at all. And this was Cisplatin. The most barf-inducing drug known to man.
So we discharged him then three weeks later he came back for his next chemo cycle. This time however his complaint was "Those tablets made me sick" this being the domperidone and ondansetron he had been sent home with , was supposed to take for five days post-chemo and had not taken at all.
OF COURSE it wasn't the Cisplatin. Now he is getting a lawyer because we gave him anti-emetics that made him sick!
We recently had a patient admitted for his first chemo for colorectal cancer. On admission he told us an anti-emetic he had had from a previous (unrelated) surgery years ago and not at our hospital had made him very ill.
Concerned we bent over backwards to find out what drug this actually was. His GP didn't know and neither could we get hold of any records of a surgery many years before.
In the end we concluded it was probably cyclizine and the chemo regime wasn't using that anyway but had more modern drugs consisting of aprepitant and ondansetron. These are routinely used for in chemo protocols known to be emeteogenic such as anything involving Cisplatin.
Well the patient kicked up a hell off a fuss. Refused the anti-emetics, threatened to take us to court if we killed him with our nasty drugs. Our on-call doctor finally persuaded him to take the anti=emetics and the patient sailed through chemo with no nausea issues at all. And this was Cisplatin. The most barf-inducing drug known to man.
So we discharged him then three weeks later he came back for his next chemo cycle. This time however his complaint was "Those tablets made me sick" this being the domperidone and ondansetron he had been sent home with , was supposed to take for five days post-chemo and had not taken at all.
OF COURSE it wasn't the Cisplatin. Now he is getting a lawyer because we gave him anti-emetics that made him sick!
I just lost the will to live.