#Chemotherapy-induced nausea and vomiting

[jcsmicasereports]

Use of acupressure to reduce nausea and vomiting in cancer patients receiving chemotherapy (literature study) by Maher Battat in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

Nausea and vomiting are distressing and serious problems for cancer patients receiving chemotherapy despite the fact that they are receiving antiemetics according to the standard guidelines which this problem is a huge challenge to nurses involved in cancer care.

Purpose: To explore and assess the effectiveness of using acupressure as a non-pharmacological intervention in addition to pharmacological interventions in reducing nausea and vomiting in cancer patients receiving chemotherapy.

Method: A literature review was conducted of 8 articles published between 2006 and 2014. These included one study of a randomized, double-blind, placebo controlled trial; one quasi-experimental model with a control group; four articles reporting on randomized control trials (RCTs); one systematic review study; and one review study. Key Findings: Seven of the articles we read supported the effect of an acupressure P6 Wristband in reducing chemotherapy induced nausea and vomiting in cancer patients and other databases also supported that finding. The one article with neutral results showed that there was no difference between a combination of acupuncture and acupressure treatment at P6 and at the sham point for the nausea score, but the level of nausea was very low in both groups.

Conclusion: We conclude that the acupressure P6 wrist band when applied to acupuncture point P6 is effective, safe, convenient, cost effective, and provides an easy, self-administrated, non-pharmacological intervention that can be used to reduce chemotherapy induced nausea and vomiting.

Keywords: Acupressure, Chemotherapy, Nausea and Vomiting, Cancer patients, Chemotherapy-induced nausea and vomiting.

Introduction

Nausea and vomiting are serious and troublesome side effects of cancer therapy. We chose this research topic in order to become familiar with the topic of the nausea and vomiting facing cancer patients during their chemotherapy treatment, which we have observed during our experience in the Oncology departments.

As nurses, we normally use updated and standard guidelines for managing clinical challenges. We reviewed the literature to explore whether there are alternative approaches to pharmacological management that might reduce or eliminate this problem. We found there are many interventions, such as music, acupuncture, acupressure, and yoga. We decided to assess the effectiveness of using acupressure to reduce the nausea and vomiting in cancer patients receiving chemotherapy. Acupressure is a type of complementary and alternative medicine which the National Cancer Institute (NCI Dictionary of Cancer Terms) defines as follows: “Acupressure is the application of pressure or localized massage to specific sites on the body to control symptoms such as pain or nausea".

The Research Question

Can acupressure reduce nausea and vomiting in cancer patients receiving chemotherapy?

We have chosen to use the definitions of the NCI Dictionary of Cancer Terms:

“Nausea is an unpleasant wavelike feeling in the back of the throat and/or stomach that may lead to vomiting", and “Vomiting is throwing up the contents of the stomach through the mouth”.

Nausea and vomiting affect the patient’s whole life. These side effects lead to metabolic imbalance, fatigue, distress, and lowered quality of life. We would like to fine a simple, effective and cost effective way to manage these problems so we can put it to use in our hospital.

Method

A literature study is, “A critical presentation of knowledge from various academic written sources, and a discussion of the sources in view of a particular research question" (Synnes 2014). There are many challenges when doing a literature study. There are many databases and much literature and our search process had to find the correct, scientific and relevant databases. It required a lot of time and effort to find the full text of all relevant articles. Fortunately, we received excellent help from the librarian at the Betanien University High school.

We started the search process by making a PICO outline to narrow down the search and to find the correct key words and mesh terms.

P: (Population or participants) Cancer patients experiencing chemotherapy-induced nausea and vomiting.

I:  (Intervention or indicator) Acupressure.

C: (Comparator or control) No comparison or placebo.

O: (Outcome) Reduce nausea and vomiting.

We used PUBMED, Google scholar, scholar.najah.edu and other search engines. When we used Acupressure as a search word we found more than 800 studies. When we added chemotherapy, cancer patients, and nausea and vomiting, we brought this down to 14 articles. We read these and decided to use 8 articles only, one of which was a systematic review. We also used an unpublished Master’s thesis from An Najah National University. This thesis was cited in one of the articles that we decided to review. The key words used were: Acupressure, Chemotherapy, Nausea and Vomiting, Cancer patients, Chemotherapy-induced nausea and vomiting, with Acupressure as a mesh term.

We then critically appraised all the articles according to our checklist. We included only those articles that followed the IMRAD style (i.e. those including an introduction, method, results and discussion section). We excluded all articles that were more than ten years old (i.e. published before 2004), except for two articles: one was about the mechanism of acupressure, which seemed to be directly relevant to our research topic, while the second article was used in the discussion section to discuss certain factors related to the topic. We also excluded one of the review articles because its method appeared to be weak. One of the Cochran reviews was also dropped because it had not been updated.

Despite applying these strict criteria, we were still concerned lest we had left out some important articles or included an inappropriate one. However, we were reassured by the fact that the librarian at Betanien had guided us in our search.

Theoretical part

Nursing Need Theory and basic human needs

The Nursing Need Theory was developed by Virginia A. Henderson to define the unique focus of nursing practice. The theory focuses on the importance of increasing the patients’ independence to hasten their progress in the hospital. Henderson’s theory emphasizes the basic human needs and how nurses can assist in meeting those needs.

The 14 components of Need Theory present a holistic approach to nursing that covers the patient’s physiological, psychological, spiritual and social needs.

Physiological components

Breathe normally.

Eat and drink adequately.

Eliminate body wastes.

Move and maintain desirable postures.

Sleep and rest.

Select suitable clothes – dress and undress.

Maintain body temperature within normal range by adjusting clothing and modifying the environment.

Keep the body clean and well groomed and protect the integument.

Avoid dangers in the environment and avoid injuring others.

Psychological aspects of communicating and learning

Communicate with others in expressing emotions, needs, fears, or opinions. Spiritual and moral

Worship according to one’s faith. Sociologically oriented to occupation and recreation

Work in such a way that there is sense of accomplishment.

Play or participate in various forms of recreation.

Learn, discover, or satisfy the curiosity that leads to normal development and health, and use the available health facilities.

There is much similarity between Henderson’s 14 components and Abraham Maslow’s Hierarchy of Needs. Henderson’s Components 1 to 9 are comparable to Maslow’s physiological needs, with the 9th component also being a safety need. Henderson’s 10th and 11th components are similar to Maslow’s love and belonging needs, while her 12th, 13th and 14th components match Maslow’s self-esteem needs (Vera 2014).

The second of Henderson’s physiological needs is the need to “Eat and drink adequately”. Only the need to breathe is given a higher priority than the need for adequate nutrition. For cancer patients receiving chemotherapy and suffering from chemotherapy-induced nausea and vomiting, this need is the most critical.

Cancer prevalence and treatment

Cancer is a group of diseases characterized by uncontrolled growth and the spread of abnormal cells. It may be caused by internal factors, such as an inherited mutation, or a hormonal or immune condition, or it may result from a mutation from metabolism, or from external sources, such as tobacco use, radiation, chemicals and infectious organisms. Cancer is prevalent all over the world, in both developed and developing nations; it affects both sexes at all ages (Said 2009). The American Cancer Society (2010) estimated that 1,529,560 new cases of cancer were diagnosed in 2010 and that 80 % would be treated with chemotherapy; this means more than 1 million patients will be undergoing chemotherapy in any given year (Lee et al. 2010).

Cancer treatment may be based on chemotherapy, radiotherapy and surgical interventions. Chemotherapy is an important treatment in cancer care but it is associated with several side effects, such as bone marrow suppression, increased susceptibility to infection, diarrhea, hair loss, appetite changes, nausea and vomiting, among others (NCI Chemotherapy Side Effects Series, 2014).

Chemotherapy-induced nausea and vomiting (CINV) is the most prevalent and one of the hardest side effects to manage (Suh 2012).

Nausea and vomiting

Nausea and vomiting (N&V) can be acute or delayed. The incidence of acute and delayed N&V was investigated in highly and moderately emetogenic chemotherapy treatment regimens. Patients were recruited from 14 oncology practices in six countries. Overall, more than 35% of patients experienced acute nausea, and 13% experienced acute emesis. In patients receiving highly emetogenic chemotherapy, 60% experienced delayed nausea and 50% experienced delayed emesis. In patients receiving moderately emetogenic chemotherapy, 52% experienced delayed nausea and 28% experienced delayed emesis. CINV was a substantial problem for patients receiving moderately emetogenic chemotherapy in ten community oncology clinics. Thirty-six percent of patients developed acute CINV, and 59% developed delayed CINV (NCI, Nausea and Vomiting, 2015).

Chemotherapy is the most common treatment-related cause of N&V. The incidence and severity of acute emesis in persons receiving chemotherapy varies according to many factors, including the particular drug, dose, schedule of administration, route, and individual patient variables.

Risk factors for acute emesis include:

Poor control with prior chemotherapy

Female gender

Younger age

Emetic classification:

The American Society of Clinical Oncology has developed a rating system for chemotherapeutic agents with their respective risk for acute and delayed emesis.

High risk: Emesis has been documented to occur in more than 90% of patients on the following chemotherapeutic agents:

Cisplatin (Platinol).

Mechlorethamine (Mustargen).

Streptozotocin (Zanosar).

Cyclophosphamide (Cytoxan), 1,500 mg/m2 or more.

Carmustine (BiCNU).

Dacarbazine (DTIC-Dome).

Moderate risk: Emesis has been documented to occur in 30% to 90% of patients on the following chemotherapeutic agents:

Carboplatin (Paraplatin).

Cyclophosphamide (Cytoxan), less than 1,500 mg/m2.

Daunorubicin (DaunoXome).

Doxorubicin (Adriamycin).

Epirubicin (Pharmorubicin).

Idarubicin (Idamycin).

Oxaliplatin (Eloxatin).

Cytarabine (Cytosar), more than 1 g/m2.

Ifosfamide (Ifex).

Irinotecan (Camptosar).

Low risk: Emesis that has been documented to occur in 10% to 30% of patients on the following chemotherapeutic agents:

Mitoxantrone (Novantrone).

Paclitaxel (Taxol).

Docetaxel (Taxotere).

Mitomycin (Mutamycin).

Topotecan (Hycamtin).

Gemcitabine (Gemzar).

Etoposide (Vepesid).

Pemetrexed (Alimta).

Methotrexate (Rheumatrex).

Cytarabine (Cytosar), less than 1,000 mg/m2.

Fluorouracil (Efudex).

Bortezomib (Velcade).

Cetuximab (Erbitux).

Trastuzumab (Herceptin).

Minimal risk: Emesis that has been documented to occur in fewer than 10% of patients on the following chemotherapeutic agents:

Vinorelbine (Navelbine).

Bevacizumab (Avastin).

Rituximab (Rituxan).

Bleomycin (Blenoxane).

Vinblastine (Velban).

Vincristine (Oncovin).

Busulphan (Myleran).

Fludarabine (Fludara).

2-Chlorodeoxyadenosine (Leustatin).

In addition to the emetogenic potential of the agent, the dose and schedule used are also extremely important factors. For example, prescribing a drug with a low emetogenic potential to be given in high doses may cause a dramatic increase in its potential to induce N&V. For example, standard doses of cytarabine rarely produce N&V, but these often occur with high doses of this drug. Another factor to consider is the use of drug combinations. Because most patients receive combination chemotherapy, the emetogenic potential of all of the drugs combined needs to be considered, and not only that of individual drug doses.

Delayed (or late) N&V is that which occurs more than 24 hours after chemotherapy administration. Delayed N&V is associated with cisplatin and cyclophosphamide, and with other drugs (e.g., doxorubicin and ifosfamide) when given at high doses, or if given on 2 or more consecutive days.

Delayed emesis: Patients who experience acute emesis with chemotherapy are significantly more likely to have delayed emesis as well.

Risk factors: All the predicative characteristics for acute emesis are also considered risk factors for delayed emesis (NCI, Nausea and Vomiting, 2015).

The nausea and vomiting that are often associated with chemotherapy are a serious problem for cancer patients. Despite recent improvements in pharmaceutical technology, about 60% of cancer patients who receive antiemetic medications with their chemotherapy still suffer from nausea and vomiting, and as many as 20% of patients refuse to continue chemotherapy due to the severity of the nausea and vomiting (Shin et al. 2004). Early studies reported that patients cited nausea and vomiting as the most distressing symptoms when receiving chemotherapy. The distressing effect of severe nausea and vomiting can lead to nutritional deficiencies, dehydration, electrolyte imbalance, fatigue, depression and anxiety; they can also disrupt the activities of daily living and cause a lot of work time to be lost (Said 2009).

Uncontrolled nausea and vomiting can interfere with adherence to treatment regimens, and may cause the oncologists to reduce chemotherapy doses. Chemotherapy-induced nausea and vomiting is classified as being either “acute” if it happens within 24 hours post chemotherapy, or “delayed” if it occurs on days 2–5 of the chemotherapy cycle. The latter is particularly troublesome because there is no reliable pharmacological treatment for this problem. The American Society of Clinical Oncology’s (ASCO) recommendations include giving 5-HT3 (5-hydroxytryptamine, or serotonin) receptor antagonists plus corticosteroids before chemotherapy to patients who are at high risk for emesis. Nevertheless, many patients still experience nausea and vomiting related to chemotherapy, and approximately one-third of patients have nausea of at least moderate intensity, resulting in a significant reduced quality of life (QOL). Therefore, the experts emphasize the need for an evaluation of additional ways to reduce these symptoms (Said 2009).

Pharmacological interventions for the management of nausea and vomiting

Historically, antiemetic treatment has steadily improved since the introduction, in 1981, of high-dose metoclopramide which reduced the amount of emesis. This was followed by the development of serotonin (5-HT3) antagonist in the early 1990s, and the 5-HT3 antagonists proved to be more effective than the prior medications in preventing CINV. The concomitant use of corticosteroids was found to further improve the control of emesis. Despite these improvements, nausea and vomiting still remain a problem for many patients. Recently, a new drug, the neurokinin NK (1) receptor antagonist has been shown to be more effective at preventing both acute and delayed CINV for patients treated with highly emetogenic chemotherapy (Said 2009).

Non-pharmacological intervention for management of nausea and vomiting

Traditional Chinese medicine offers a possible intervention for the non-pharmacological treatment of nausea and vomiting in cancer patients. Traditional Chinese medicine (TCM) is a system of medical care that was developed in China over thousands of years. It looks at the interaction between mind, body and environment, and aims to both prevent and cure illness and disease.

TCM is based on Chinese views and beliefs about the universe and the natural world. It is a very complex system. In this essay we can only give a brief overview of what TCM involves. It is very different from Western medicine; Chinese medicine practitioners believe there is no separation between the mind and body and that illness of every kind can be treated through the body. They use a combination of various practices that may include:

Herbal remedies (traditional Chinese medicines).

Acupuncture or acupressure.

Moxibustion (burning moxa – a cone or stick of dried herb).

Massage therapy.

Feng shui.

Breathing and movement exercises called qi gong (pronounced chee goong).

Movement exercises called tai chi (pronounced tie chee).

TCM practitioners say that TCM can help to:

Prevent and heal illness.

Enhance the immune system.

Improve creativity.

Improve the ability to enjoy life and work in general.

Beliefs behind TCM

According to traditional Chinese belief, humans are interconnected with nature and affected by its forces. The human body is seen as an organic whole in which the organs, tissues, and other parts have distinct functions but are all interdependent. In this view, health and disease relate to the balance or imbalance between the various functions. TCM treatments aim to cure problems by restoring the balance of energies.

There are important components that underlie the basis of TCM:

Yin-yang theory is the concept of two opposing but complementary forces that shape the world and all life. A balance of yin and yang maintains harmony in the body, the mind and the universe.

Qi (pronounced chee) energy or vital life force flows through the body along pathways known as meridians, and it is affected by the balance of yin and yang. It regulates spiritual, emotional, mental, and physical health. If there is a blockage or an imbalance in the energy flow, the individual becomes ill. TCM aims to restore the balance of qi energy.

The five elements – fire, earth, metal, water, and wood – is a concept that explains how the body works, with the elements corresponding to particular organs and tissues in the body.

The TCM approach uses 8 principles to analyse symptoms and puts particular conditions into groups: cold and heat, inside and outside, too much and not enough, and yin and yang (Cancer Research, UK, 2015).

In summary, chemotherapy related nausea is not well controlled by pharmacological agents and identifying methods to prevent and alleviate treatment-related nausea remains a major clinical challenge. Non-pharmacological interventions such as music, progressive muscle relaxation (Said 2009), and ginger herbal therapy (Montazeri A et al. 2013) have all been shown to reduce CINV. Among the non-pharmacological interventions that reduce CINV are acupuncture and acupressure, based on the assumption that the individual’s welfare depends on a balance of energy in the body and their overall energy level (Said 2009). Yarbro et al. (2011, p. 645) also indicate in Cancer nursing: principles and practice book that acupuncture and acupuncture-related interventions (electroacupoint stimulation, acupressure, acustimulation wrist bands, and electroacupuncture) can be used to control nausea and vomiting in cancer patients.

Molassiotis et al. (2007) claim that the need for additional relief has led to the interest in non-pharmacological adjuncts to drugs, such as acupuncture or acupressure, since combining anti-emetics with other non-pharmacological treatments may prove to be more effective, safe and convenient in decreasing nausea than antiemetics alone.

From the National Cancer Institute website we found that acupressure is recognised as one of the non-pharmacologic strategies used to manage nausea and vomiting (Nausea and Vomiting, 3 September 2014). We used this website to get up to date, relevant information.

Acupressure

Acupressure involves putting pressure with the fingers, or with bands, on the body’s acupoints and is easy to perform, painless, inexpensive, and is effective. The P6 (Pericardium 6) point (Nei-Guan) refers to a point located on the anterior surface of the forearm, 3-finger widths up from the first wrist crease and between the tendons of flexor carpiradialis and Palmaris longus (figure1). P6 can be stimulated by various methods. The most well-known technique is manual stimulation by the insertion and manual rotation of a very fine needle (manual acupuncture). An electrical current can be passed through the inserted needle (electroacupuncture). Electrical stimulation can also be applied via electrodes on the skin surface or by a ReliefBand, a wristwatch-like device providing non-invasive electrostimulation. Pressure can be applied either by pressing the acupoint with the fingers or by wearing an elastic wristband with an embedded stud (acupressure).

Acupressure is based on the ancient Eastern concept that Chi energy travels through pathways known as meridians. Along the meridians are acu-points, which are controlling points for the Chi energy flow. If the energy flow in meridians is slowed, blocked, or hyper-stimulated, it can be rebalanced or re-stimulated either by applying pressure (acupressure) or by inserting a needle (acupuncture) into one or more of these acupoints. Two points are known for relieving nausea and vomiting: the Nei-Guan point (P6) and the Joksamly point (ST36, located at 4-finger breadths below the knee depression lateral to the tibia).

Patients tend to prefer the P6 point over the ST36 point, Because of its ease of access and the freedom from restriction. When these points are correctly located and pressure applied, either through acupressure or acupuncture, the Chi energy flow is rebalanced, resulting in relief from nausea and vomiting.

The practice of acupressure requires some training and experience, but the technique is widely accessible to any healthcare professionals, particularly to clinical nurses. This acupressure technique is an approach that should be tried not only by healthcare professionals but also by family members or the patients themselves (Shin et al. 2004).

According to the teaching of traditional Chinese medicine, illness results from an imbalance in the flow of energy through the body. This energy or Qi (chee) is restored through the use of acupuncture and acupressure at certain points on the body that have been identified through critical observation and testing over 4000 years. In scientific terms, the neurochemicals that are released after needling or pressure at a specific point may be responsible for this effect. The most commonly used point for nausea and vomiting is Pericardium 6 (Neiguan or P6), located above the wrist (Molassiotis et al. 2007).

The literature review on acupressure

Acupressure for chemotherapy-induced nausea and vomiting in breast cancer patients: a multicentre, randomised, double-blind, placebo-controlled clinical trial. (Said 2009)

For a master degree in public health from An-najah National University, Said (2009) described a randomized, double-blind, placebo controlled trial that was done in Palestine with 126 women on chemotherapy for breast cancer. In this study the researcher divided the patients into 3 groups: the first group (n=42) received acupressure with bilateral stimulation of P6, the second group (n=42) received bilateral placebo stimulation, and the third group (n=42), which served as a control group, received no acupressure wrist band, but all groups received pharmacological management of their nausea and vomiting. Acupressure was applied using a Sea-Band (Sea-Band UK Ltd, Leicestershire, England) that patients had to wear for five days following the administration of chemotherapy. Assessment of acute and delayed nausea and emesis, quality of life, patients’ satisfaction, recommendation of treatment and requests for a rescue antiemetic were obtained. Said (2009) concluded that the acupressure showed benefits for delayed nausea and the mean number of delayed emetic episodes. Acupressure may therefore offer an inexpensive, convenient, and self-administered intervention for patients on chemotherapy to reduce nausea and vomiting at home during days 2-5 after chemotherapy. In addition, the percentage of patients who were satisfied with the treatment (≥ 3 on a 0-6 scale) was 81% (35/42) in the P6-acupressure group, and 64% (27/42) in the placebo group (p= 0.0471). The percentage of patients who would recommend acupressure treatment was 79% (34/42) in the P6-acupressure group, and 62% (26/42) in the placebo group (p= 0.0533). We used this study because it had a lot of essential information, it used the IMRAD system and was also mentioned in the literature (Genç and Tan 2014). This study demonstrated that the mean scores for the acupressure group were lower for both acute and delayed nausea.

Review of Acupressure Studies for Chemotherapy-Induced Nausea and Vomiting Control. (Lee et al. 2008)

In the Journal of Pain and Symptom Management Jiyeon Lee et al. (2008) reviewed ten controlled studies on acupressure in order to evaluate the effects of a non-invasive intervention, acupressure, when combined with antiemetics for the control of CINV. The review evaluated one quasi-experimental and nine randomized clinical trials, which included two specific acupressure modalities, namely, an acupressure band and finger acupressure. The effects of the acupressure modalities were compared study by study. Four of the seven acupressure band trials supported the positive effects of acupressure, whereas three acupressure band trials did not support the effects of acupressure. However, all the studies with negative results had methodological issues. In contrast, the one quasi-experimental and two of the randomized finger acupressure trials all supported the positive effects of acupressure on CINV control. The reported effects of the two acupressure modalities produced variable results at each stage of CINV. Acupressure bands were most effective in controlling acute nausea, whereas finger acupressure controlled delayed nausea and vomiting. The overall effect of acupressure was strongly indicative but not conclusive. We used this article because it is relevant, a review study, and is from a known journal.

The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. (Molassiotis et al. 2007)

As reported in the journal Complementary Therapies in Medicine, acupressure was applied using wristbands (Sea-Band™) in a randomized controlled trial conducted in two centres in the UK. Patients in the experimental group had to wear these bands for the five days following their chemotherapy administration. Assessments of nausea, retching and vomiting were obtained from all patients, daily, for five days. Molassiotis et al. (2007) evaluated the effectiveness of using acupressure on the Pericardium 6 (Neiguan) acupoint in managing CINV. Thirty-six patients took part in the study, with 19 patients allocated to the control group and 17 to the experimental group. The results showed that nausea with retching, nausea, and vomiting with retching, and the accompanying distress were all significantly lower in the experimental group as compared to the control group (p < 0.05). The only exception was the vomiting, where the difference was close to significance (p = 0.06). We used this article because it had a strong study design and also used an IMRAD system.

Acupuncture and acupressure for the prevention of chemotherapy-induced nausea- a randomized cross-over pilot study. (Melchart et al. 2006)

In a randomized, cross-over trial, Melchart et al. (2006) studied 28 patients receiving moderately or highly emetogenic chemotherapy and a conventional standard antiemetic for one chemotherapy cycle, followed by a combination of acupuncture and acupressure at point P6 for one cycle, and for another cycle a combination of acupuncture and acupressure at a close sham point. The results showed that there was no difference in the nausea score between the combined acupuncture treatment at P6 and at the sham point, but the level of nausea was very low in both cases. We used this study because the article had neutral results and because we trusted the source of article, coming as it did from a cancer support care journal.

The efficacy of acupoint stimulation for the management of therapy adverse events in patients with breast cancer: a systematic review. (Chao et al. 2009)

This is a systematic review of 26 articles published between 1999 to 2008 examining the efficacy of acupressure, acupuncture or acupoint stimulation (APS) for the management of adverse events due to the treatment of breast cancer. Published online on 17 September 2009 in the Breast Cancer Research and Treatment journal, 23 trials reported revealed that APS on P6 was beneficial in treating CINV. Chao et al. (2009) also presented the findings from three high quality studies comparing APS groups with control groups, which indicated that APS is beneficial in the management of CINV and especially in the acute phase, even with the non-invasive intervention. Health care professionals should consider using APS, and in particular acupressure on the P6 acupoint, as an option for the management of CINV. Furthermore, as a cost effective intervention, it warrants further investigation. We used this article because it used the IMRAD structure.

'Until the trial is complete you can’t really say whether it helped you or not, can you?’: exploring cancer patients’ perceptions of taking part in a trial of acupressure wristbands. (Hughes et al. 2013)

In Complementary and Alternative Medicine, Hughes et al. report on qualitative research undertaken with patients receiving chemotherapy in the UK. A convenience sample of 26 patients volunteered to participate in the clinical trial and to explore their experiences of using acupressure wristbands. Participants were recruited from three geographical sites: nine were recruited from Manchester, nine from Liverpool, and eight from Plymouth and the surrounding regions. Ten of the participating patients received true acupressure during the trial, 9 received sham acupressure, and 7 received no acupressure. Hughes et al. (2013) concluded that the research provided insights into cancer patients’ motivations and experience of taking part in a clinical trial for a complementary alternative medicine intervention, in which the participants perceived acupressure wristbands to reduce the level of nausea and vomiting experienced during their chemotherapy treatment. This article is important because it includes the benefits experienced by the patients taking part in the trial. This is also the first qualitative study to explore patients’ experiences of using acupressure wristbands and their perceptions of the effects. In the study, the patients perceived the wristbands as reducing their level of nausea and vomiting experienced due to their chemotherapy treatment. The study was an RCT.

The effect of acupressure application on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer. (Genç and Tan 2014)

Genç and Tan (2014) reported on a quasi-experimental study in Turkey with 64 patients with stages 1–3 breast cancer who received two or more cycles of advanced chemotherapy. Thirty two patients were in the experimental group, and thirty two in the control group. To determine the effect of acupressure P6 on CINV and anxiety in these patients, the P6 acupressure wristband was applied to the experimental group. Genç and Tan (2014) concluded that the total mean scores for patients in the experimental group, for nausea, vomiting and retching, were lower than those of the patients in the control group over the five days of application. We used this article because it is a recent and quasi-experimental study and used the IMRAD system.

The effects of P6 acupressure and nurse-provided counselling on chemotherapy-induced nausea and vomiting in patients with breast cancer. (Suh 2012)

Suh (2012) reported in the Oncology Nursing Forum on a RCT in South Korea with 120 women who were receiving chemotherapy for breast cancer. These patients had all had more than mild levels of nausea and vomiting during their first cycle of chemotherapy. The participants were assigned randomly to one of four groups: a control group (a placebo on a specific location on the hand); a counselling only group; a P6 acupressure only group; and a P6 acupressure plus nurse-provided counselling group. The purpose of the study was to evaluate the effects of pericardium 6 (P6) acupressure and nurse-provided counselling on CINV in patients with breast cancer. Suh (2012) concluded that nurse-provided counselling and P6 acupressure were together the most effective in reducing CINV in patients with breast cancer. We used this article because it is the first RCT evaluating the isolated and combined effects of P6 acupressure and counselling in reducing CINV among non-Western patients. The findings of the study support the use of P6 acupressure together with counselling that is focused on cognitive awareness, affective readiness, symptom acceptance, and the use of available resources as an adjunct to antiemetic medicine for the control of CINV. The article used the IMRAD system.

Discussion

Can acupressure reduce nausea and vomiting in cancer patients receiving chemotherapy?

In our experience, we have usually used metoclopramide (pramin) plus serotonin (5-HT3) antagonist (as Ondansetron and Granisetron), plus Dexamethasone plus neurokinin NK (1) (as Emend - aprepitant) for moderate to high ematogenic chemotherapy, yet some of the patients have still suffered from nausea and vomiting. After reviewing the literature we would like to use the acupressure P6 wrist band to solve this problem as the findings of our literature review confirm that the acupressure P6 wrist band reduces CINV in cancer patients receiving chemotherapy. This result is corroborated by 7 of the articles reviewed.

The National Cancer Institute website supports the finding that acupressure is one of the non-pharmacologic strategies that may be used to manage nausea and vomiting (NCI Dictionary of Cancer Terms). Said (2009) adds that acupressure may offer an inexpensive, convenient, and self-administered intervention for patients on chemotherapy, helping to reduce nausea and vomiting at home on days 2-5 of chemotherapy. Genç and Tan (2014) conclude that the total mean scores for CINV in patients in the experimental group to whom they applied the P6 acupressure wristband were lower compared to patients in the control group over the five days of application. Lee et al. (2008) found that the two acupressure modalities produced variable results in each phase of CINV: acupressure bands were effective in controlling acute nausea, whereas acupressure controlled delayed nausea and vomiting. Molassiotis et al. (2007) showed that the experience of nausea and vomiting was significantly lower in the experimental group than in the control group. Chao et al. (2009) found that P6 acupoint stimulation was an option for the management of CINV. In the study reported by Hughes et al. (2013) the participants perceived that acupressure wristbands reduced the levels of nausea and vomiting experienced during chemotherapy treatment. Suh (2012) concluded that the synergistic effects of P6 acupressure together with nurse-provided counselling appeared to be effective in reducing CINV in patients with breast cancer.

Five of the seven articles investigating breast cancer patients, namely Said (2009), Chao et al.( 2009), Molassiotis et al. (2007), Suh (2012) and Genç and Tan (2014), involved breast cancer patients receiving highly ematogenic chemotherapy (e.g. Cisplatin and cyclophosphamide), and moderate risk ematogenic chemotherapy (like doxorubicin).

It is necessary to mention other therapeutic regimens that can also be used in cancer treatment that contain other types of chemotherapy that cause nausea and vomiting, for example, doxorubicin-containing regimens like ABVD (Adriamycin, Bleomycin, Vinblastine, Dacarbazine), CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisone) and FAC (5-Fluorouracil, Adriamycin, Cyclophosphamide), and ACT (Adriamycin, Cyclophosphamide, Taxol) (Said 2009) and from our experience cisplatin-containing regimens which that classified as highly ematogenic chemotherapy we noticed the patients still experienced nausea and vomiting after they received the antiemitecs. We think it is necessary to use additional intervention like acupressure to be included in the nausea and vomiting management.

Based on the reviewed findings we plan to use acupressure for cancer patients receiving chemotherapy, because the acupressure in the studies conducted in breast cancer patients reported was used with highly ematogenic chemotherapy in addition to the standard antiemetic treatment, so it is reasonable to conclude that it will work equally well with other less ematogenic types of chemotherapy.

We prefer the use of the acupressure wrist band at P6 acupoint because it is an inexpensive, convenient, and self-administered intervention involving pressure instead of needles at the same point as that used in acupuncture. Furthermore it is safer than acupuncture and patients can easily learn to put pressure on their own wrists, whereas the acupuncture involves using needles that are about the diameter of a hair and can cause temporary discomfort during insertion (Said 2009; Molassiotis et al. 2007). Acupressure seems to be a good way to complement antiemetic pharmacotherapy as it is safe and convenient, with minimal (with bands) or no (finger acupressure) costs involved. It is thus an easy to use, cost-effective, non-invasive intervention (Lee et al. 2008; Melchart et al. 2006).

There was no study result that showed any negative effect from the acupressure wrist band at P6 point, except the review by Lee et al. (2008), which mentioned that three of the ten reported acupressure band trials did not support the possible positive effects of acupressure, but these studies all had methodological issues, such as a small sample size, no true control group, and a concern about the sham acupressure band having a possible antiemetic effect. Melchart et al. (2006) said that no difference was detected in the nausea score between the acupuncture treatment at P6 acupoint, and that at the sham point. Said (2009) mentioned that the acupressure showed no benefit in relation to the incidence of delayed vomiting, early vomiting, or acute nausea, but Melchart and Said’s studies were done with breast cancer patients and it could be that the acupressure benefits were not evident due to the breast cancer patients having had axillary lymph node resection that may have affected the meridian pathway or caused damage to the median nerve as mentioned by Roscoe et al. (2003). Consequently, we think that the evidence suggesting that there is no benefit from the acupressure method for reducing CINV is weak.

Regarding the placebo effect in the articles reviewed here, Melchart et al. (2006) indicated that there was no difference in the nausea score for the combined acupuncture treatment at p6 or that at the sham point, although the level of nausea was very low in both cases. Molassiotis et al. (2007), Said (2009) and Roscoe et al. (2003) all suggested that the placebo effect may be the result of psychological factors.

Application of acupressure in clinical practice

It is important to put this theory into practice, and health care professionals could consider using APS, in particular acupressure on the P6 acupoint, as an option in the management of CINV (Chao et al. 2009). Melchart et al. (2006) said acupressure bands can easily be used in busy oncological wards, while Suh (2012) supported the use of P6 acupressure with counselling focused on cognitive awareness, affective readiness, symptom acceptance, and the use of available resources as an adjunct to antiemetic medications for the control of CINV. Hughes et al. (2013) concluded that the research provides an insight into cancer patients’ motivations for and experiences of taking part in a clinical trial for a complementary alternative medical intervention in which the participants perceived the acupressure wristbands as reducing their level of CINV. Said (2009) suggests that oncology nurses should include acupressure in their list of options for the management of CINV, and especially delayed nausea and vomiting. Special recommendations by oncology nurses are not only useful but are also much appreciated by patients as shown in a study in which the patients were satisfied with the antiemetic treatment given by both P6-acupressure, and placebo-acupressure. The percentage of patients who were satisfied (≥ 3 on 0-6 scale) with their treatment was 81% (35/42) in the P6-acupressure group, which was in agreement with Roscoe et al. (2003), and 64% (27/42) in the placebo group (p= 0.0471). The percentage of the patients who would recommend acupressure treatment was 79% (34/42) in the P6-acupressure group, which again was in agreement with the results of Roscoe et al. (2003) and Hughes et al. (2013), compared to 62% (26/42) in the placebo group (p= 0.0533). This study presented the patients’ compliance with the use of acupressure. Acupressure is easily learnt and taught and patients should be informed about its potential role and taught how to apply it. Leaflets about acupressure for the management of nausea and vomiting could be available in chemotherapy units so that patients who are interested to use such a technique would be encouraged to come forward and learn more from nurses or other health professionals. This could add to the patients’ options for antiemetic approaches and empower them to be involved in the management of these distressing side effects. Acupressure offers a no-cost, convenient, self-administered intervention for chemotherapy patients to reduce acute nausea. Acupressure devices (i.e. Wrist Bands, travel bands, and acupressure bands) have been developed to provide passive acupressure on P6. Acupressure can be administered by healthcare providers, family members, or patients themselves, and does not involve puncture of the skin.

We therefore found that the acupressure wristband is a good way to reduce nausea and vomiting for cancer patients receiving chemotherapy by applying it in the correct position with the stud over the pericardium 6 acupoint located on the anterior surface of the forearm, 3-finger widths up from the first wrist crease, and between the tendons of flexor carpiradialis and Palmaris longus.

Lee et al. (2008) encourage the application of acupressure bilaterally, rather than unilaterally, in CINV control. They recommend three minutes of finger acupressure once daily, with additional acupressure as needed, as the optimal intervention, because both three and five minute trials have succeeded in achieving positive effects. On the other hand, Molassiotis et al. (2007) claimed that there is no correlation between the frequency of pressing the studs and the level of nausea and vomiting. Lee et al. (2008) and Molassiotis et al. (2007) therefore claim opposite results in the relationship between CINV and the frequency of pressing the stud of an acupressure P6 wrist band. But when applying the acupressure P6 wrist band bilaterally, Lee et al. (2008), Said (2009), Molassiotis et al. (2007), Suh (2012), and Genç and Tan (2014) all reported a positive effect with P6 stimulation in reducing CINV.

We would like to discuss some factors related to CINV in relation to nausea and vomiting: expectancy and gender: Roscoe et al. (2003) argued that patients who received the acustimulation bands and expected them to be effective did report having a higher quality of life and less nausea, and in relation to gender, that women are more likely to experience nausea when receiving chemotherapy. Lee et al. (2008) say this may be caused by classical conditioning and also that breast cancer patients may have had a damaged median nerve due to axillary lymph node removal, but Lee et al. (2008) also mention that P6 acupressure in younger women had a significantly greater positive effect on delayed nausea than those on a placebo or those in the no-intervention control group. On the other hand, Molassiotis et al. (2007) mentioned that younger age is associated with greater nausea. We think that men may have tolerated greater stimulation of the acupressure points, and therefore experienced greater symptom relief, so it may be that the acupressure is more effective for men than for women, but these questions of gender, age and the frequency of pressing the studs would need further investigation.

Based on the reported studies, we support the belief that acupressure on P6 is applicable in clinical practice for CINV for cancer patients provided the required education, training and counselling is given to maintain the acupressure benefits.

Acupressure side effects

The study by Molassiotis et al. (2007) found that there were no side effects from the use of the wristbands, but one patient reported that she had to take the bands off because they were too tight and left her with marks for a few days. Chao et al. (2009) also mentioned that very few minor adverse events were observed.

Melchart et al. (2006) did report adverse effects from the treatment in five cases. One suffered a hematoma when wearing the acupressure band at P6. In the sham group, one hematoma was reported after acupuncture, and another three adverse effects from the acupressure band were reported (one hematoma, one skin irritation, one eczema). Hughes et al. (2013) also reported that participants had not experienced any restrictions from wearing the wristbands in terms of everyday activities, other than when washing and bathing. As one female participant commented, for most participants the wristbands were found to be comfortable to wear. However, a few participants reported that they had experienced minor irritation, such as the wristbands feeling tight or painful, or their wrists becoming itchy. Reported adverse side effects were generally deemed minor and acceptable. In the study by Said (2009), no side effect or discomfort was noticed from wearing the acupressure wristband. Said told the patients that if the bands caused discomfort, they could be removed for 30 minutes every two hours. In this way, by taking it off for regular periods, we can prevent the side effects of acupressure, even its minor and rare effects.

Acupressure reduces CINV in cancer patients, in addition it reduces anxiety (Genç and Tan 2014) and that affects overall quality of life (Said 2009). Quality of life is defined by the NCI Dictionary of Cancer Terms as “The overall enjoyment of life and the individual’s sense of well-being and ability to carry out various activities”. Based on the physiological components of the Virginia Henderson’s theory of basic human needs and Abraham Maslow’s Hierarchy of Needs, the patient needs to eat and drink adequately, and sleep and rest (Vera, 2014). This means that when we are providing the required management for distressing symptoms, such as nausea and vomiting, by including the acupressure wrist band in addition to standard antiemetics, the patient’s appetite will improve, leading the patient to eat and drink adequately and improve their sleeping pattern. These may then also improve other aspects of the cancer patient’s life. According to the Henderson Nursing Need Theory, when we meet a patient’s needs, it results in an improved quality of life for the cancer patient receiving chemotherapy. Another way of expressing this is that it restores the balance of Yin and Yang energy that leads to reduced nausea and vomiting and improves the patient’s ability to enjoy life and work in general through a maintaining of the harmony of body and mind, as described in traditional Chinese medicine (Cancer Research UK, 2015).

We believe that it is essential for cancer patients undergoing chemotherapy treatment to have adequate nutrition to maintain their strength to fight the cancer. Different nursing actions are necessary to maintain adequate nutrition including the relieving of CINV. From this we extrapolate that using the acupressure P6 wrist band to reduce CINV improves the patient’s quality of life.

Conclusion

Chemotherapy-induced nausea and vomiting may be life threatening and is therefore a huge challenge to nurses involved in cancer care. Even with the best pharmacological management of CINV, patients continue to experience nausea and vomiting.

From a review of eight articles with strong methodology, seven supported the positive effect of an acupressure P6 wristband in reducing CINV for cancer patients. This was also supported by other databases. The one article with neutral results showed that there was no difference between a combined acupuncture and acupressure treatment at P6 and at a sham point in relation to the nausea score, but the level of nausea was very low in both groups. We conclude that the acupressure wrist band applied to acupuncture point P6 is effective, safe, convenient, cost effective, an easy and self-administrated non-pharmacological intervention from traditional Chinese medicine that reduces CINV. Solving the problem of CINV is a fundamental nursing task that can lead to improved quality of life and nutritional status, reduced anxiety and increases patient compliance. In the light of these results, and due to the effectiveness and inexpensiveness of acupressure, together with its ease of use, we suggest that it should be used in conjunction with pharmacological agents for CINV prophylaxis. To maintain the effectiveness of the acupressure, special education and training is needed to reassure the patient that the acupressure is at the correct point (P6) and counselling by the nurse is required.

We recommend the use of acupressure P6 in oncology departments and that future research should be conducted to include cancer patients receiving radiotherapy, and to investigate more about the relationship between the frequency of pressing the stud on the wrist band for acupressure P6 and CINV, and the relationship between gender and CINV, and whether it is better to apply it unilaterally or bilaterally.

[alicesara611]

Beyond Symptom Relief: Examining the Evolution of Chemotherapy Induced Nausea and Vomiting Drugs by 2030

The global chemotherapy-induced nausea and vomiting (CINV) drugs market is likely to reach value at US$ 2,558.12 million in 2023 and is expected to reach US$ 4,672.82 million by 2030, growing at a CAGR of 6.6% from 2023 to 2030.

Chemotherapy-induced nausea and vomiting (CINV) is a common and debilitating side effect of cancer treatment. It can significantly impact a patient's quality of life and adherence to chemotherapy. The global Chemotherapy-induced nausea and vomiting drugs market is projected to witness significant growth in the coming years, driven by the increasing prevalence of cancer, rising demand for effective Chemotherapy-induced nausea and vomiting control, and advancements in drug development.

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Chemotherapy ranked nausea and vomiting as the first and second most severe side effects, respectively. Up to 20% of patients receiving highly emetogenic agents in this era postponed, or even refused, potentially curative treatments. Since the 1990s, several novel classes of antiemetics have been developed and commercialized, becoming a nearly universal standard in chemotherapy regimens, and helping to better manage these symptoms in a large portion of patients. Efficient mediation of these unpleasant and sometimes crippling symptoms results in increased quality of life for the patient, and better overall health of the patient, and, due to better patient tolerance, more effective treatment cycles.

Types of Chemotherapy-induced nausea and vomiting Drugs:

Chemotherapy-induced nausea and vomiting drugs can be broadly classified into three main categories:

5-HT3 Receptor Antagonists: These drugs block the action of serotonin, a neurotransmitter involved in nausea and vomiting. Examples include ondansetron (Zofran), granisetron (Kytril), dolasetron (Anzemet), and palonosetron (Aloxi).

NK1 Receptor Antagonists: These drugs block the action of substance P, another neurotransmitter involved in nausea and vomiting. Examples include aprepitant (Emend) and fosaprepitant (Apreva).

Corticosteroids: These drugs have anti-inflammatory and antiemetic properties. Dexamethasone is the most commonly used corticosteroid for Chemotherapy-induced nausea and vomiting.

Choosing the Right Chemotherapy-induced nausea and vomiting Drugs:

The choice of Chemotherapy-induced nausea and vomiting drugs depends on several factors, including the type of chemotherapy, the patient's risk of Chemotherapy-induced nausea and vomiting, and any other medical conditions the patient may have.

For patients receiving highly emetogenic chemotherapy (HEC), which has the highest risk of causing CINV, a combination of a 5-HT3 receptor antagonist, an NK1 receptor antagonist, and dexamethasone is recommended. For patients receiving moderately emetogenic chemotherapy (MEC), a 5-HT3 receptor antagonist with dexamethasone is usually sufficient. For patients receiving low-emetogenic chemotherapy, dexamethasone alone may be enough.

Side Effects of Chemotherapy-induced nausea and vomiting Drugs:

Chemotherapy-induced nausea and vomiting drugs are generally well-tolerated, but they can cause side effects such as headache, constipation, and fatigue. Some drugs, such as aprepitant, can also cause dizziness and vertigo.

Overall, Chemotherapy-induced nausea and vomiting drugs play an important role in improving the quality of life for cancer patients and helping them continue their chemotherapy treatment.

Key Market Drivers:

Rising Prevalence of Cancer: The increasing incidence of cancer is a major driver of the Chemotherapy-induced nausea and vomiting drugs market. As the global cancer burden continues to grow, the demand for effective Chemotherapy-induced nausea and vomiting control measures is expected to rise.

Demand for Effective CINV Control: Chemotherapy-induced nausea and vomiting can significantly impair a patient's quality of life and adherence to chemotherapy. The growing demand for effective Chemotherapy-induced nausea and vomiting control measures is driving the development of new and more potent drugs.

Advancements in Drug Development: Continuous advancements in drug development are leading to the introduction of novel and more targeted Chemotherapy-induced nausea and vomiting drugs. These drugs offer improved efficacy and reduced side effects compared to traditional treatments.

Key Takeaways:

The global Chemotherapy-induced nausea and vomiting (CINV) drugs market is likely to reach value at US$ 2,558.12 million in 2023 and is expected to reach US$ 4,672.82 million by 2030, growing at a CAGR of 6.6% from 2023 to 2030.

The growth of the market is driven by the increasing prevalence of cancer, the rising adoption of chemotherapy, and the growing demand for effective Chemotherapy-induced nausea and vomiting prophylaxis and treatment.

The acute emesis segment is expected to dominate the market due to the advancement in chemotherapy and the increasing use of highly emetogenic chemotherapy (HEC) drugs.

North America is expected to hold the largest market share due to the high prevalence of cancer, the early adoption of new technologies, and the strong presence of key players in the region.

Regional Outlook:

North America is expected to hold the largest market share, accounting for approximately 38% of the global market in 2030.

Europe is expected to be the second-largest market, followed by Asia Pacific.

The growth in the Asia Pacific market is expected to be driven by the increasing prevalence of cancer, the growing demand for affordable Chemotherapy-induced nausea and vomiting drugs, and the expanding healthcare infrastructure in the region.

Key Players:

GlaxoSmithKline plc

Pfizer Inc.

Novartis AG

Sanofi SA

Merck & Co., Inc.

Eisai Co., Ltd.

AstraZeneca plc

Daiichi Sankyo Co., Ltd.

Cosmo Pharmaceuticals Ltd.

Heron Therapeutics, Inc.

Segmentation:

By Product:

5-HT3 antagonists

NK1 receptor antagonists

Steroids

Antiemetics

Others

By End User:

Hospitals

Cancer centers

Ambulatory care centers

Others

By Type:

Acute emesis

Delayed emesis

Breakthrough emesis

[megharesearch]

The latest report on the Worldwide Chemotherapy Induced Nausea and Vomiting (CINV) Drugs Market Report is the more professional in-depth of this Industry is providers the status and forecast, categorizes, market size (value & volume) by type, application, region and Forecast 2023 - 2030.

[ciaossu-imagines]

❄️ from end of the year ask game <3

What was the highlight of your year?

I don’t feel like 2024 was really my year. There wasn’t a lot of stand out moments that are automatically coming to mind. I’m trying hard to focus on all the positives about it, but no big moments in particular are popping out, though that could be just my brain.

Martha, Nix, Cathy, Lou, and Butter have all really made my year better through their messages and friendship. I’ve been a really horrible friend in a lot of ways, since I’m struggling with answering messages quickly, but just know you were loved.

There were so many great fanfics and fanfic writers that have made my year better. I really hope, next year, to start being better about commenting, reblogging, and letting them know how much their fics mean to me or their works or their ideas.

I discovered a new author I really love this year in the horror genre, so that was great, and I fell in love with many new fandoms this year, so I have a lot of thanks to give to those professional writers.

I had a lot of absolutely fantastic commissoners this year and had the honour of working on a lot of amazing things because of them and they all have my utmost respect and love.

I got to slip more into my role and grow in my professional career in real life. Pharmacy is a lot more than people think and I have the opportunity to learn something new each and every day in my job or to do something good for people each and every day. Today, I managed to get compassionate care to cover the full cost of someone’s much needed Akynzeo, which he’d been paying several hundred dollars out of pocket for up until that point. For those who don’t recognize the brand name, it’s used for chemotherapy-induced nausea and vomiting. It still astounds me that this man had had to pay, while going through cancer, all this money, only adding more stress to him and I’m so glad that we were able to get that done for him.

I went through a whole ‘nother year of therapy and I worked hard, pushing myself to my limits, tearing down walls brick by brick to try to get myself better and learn coping skills and mechanisms. I volunteer my time for several mental-health causes and that actually made my life better…I regret stopping but I just no longer had the time.

[madamlaydebug]

Ginger is a flowering plant also known as Zingiber officinale. Its root (or rhizome) is a popular ingredient in cooking, but it has also been used for thousands of years for medicinal purposes, particularly in Asian, Arabic, and Indian cultures.

Many of ginger’s professed health benefits have been supported by scientific research:

1. Aids in Digestive Function

Compounds in ginger are known to stimulate bile and saliva production and to increase mobility through the digestive tract. Those who suffer from indigestion may find relief by consuming ginger.

2. May Help Prevent Gastric Ulcers

Gastric ulcers are painful open lesions on the inside lining of the stomach. Use of non-steroidal anti-inflammatory drugs (NSAIDs), like naproxen and ibuprofen, can lead to the development of gastric ulcers. Bacteria called Helicobacter pylori (H. pylori) can also make the gastric lining more prone to ulceration. Ginger, however, inhibits the growth of H. pylori and can prevent the occurrence of stomach ulcers caused by NSAIDs.

3. Reduces Nausea

Ginger has been shown to be effective for relief and prevention of nausea and vomiting related to pregnancy, chemotherapy, and post-operative conditions. While ginger can help reduce nausea induced by motion sickness, it seems to have no effect on the prevention of vomiting caused by such.

Consuming 1 to 1.5 grams of ginger (or 1 to 2 small- to medium-sized pieces of crystallized ginger) can help provide relief for these various types of nausea.

4. Decreases Pain and Inflammation

There is evidence that ginger can be beneficial for pain management. By helping to reduce inflammation of joints, ginger can decrease pain associated with arthritic conditions. Daily supplementation of ginger can also improve exercise-induced muscle pain. Women who experience severe pain during menstruation may find some relief with the consumption of ginger as well.

5. Promotes Sweating

Ginger is a diaphoretic, meaning that it can stimulate sweating, which allows your body to eliminate toxins. After taking ginger there may be a sense of warming from within, which is why it is popular for soothing symptoms of colds and flu.

6. Improves Cognition

With antioxidant and anti-inflammatory properties, ginger can mitigate age-related cognitive decline. There is evidence that ginger can enhance attention and cognitive processing.

7. May Lower Cholesterol

There are studies that have demonstrated significant reductions in LDL cholesterol and blood triglyceride levels associated with the consumption of ginger.

8. May Lower Blood Sugar

Ginger has been shown to lower blood sugar levels in type 2 diabetic individuals. In the same study, HbA1c (a marker used as an indicator for long-term blood sugar control) also improved. While these are promising results, more research is needed to confirm this benefit.

Tips for Taking Ginger

There are many options for consuming ginger. It can be found fresh and dried. It is available in capsules, tinctures, and lozenges. There is also ginger oil and ginger extract.

Side effects of ginger are rare. However, if you take excessive doses, you may develop heartburn, diarrhea, or mouth irritation. Avoid ginger if you have a bleeding disorder. Before starting ginger supplementation, check with your healthcare provider if you plan to take it regularly, if you have gallstones, or if you are on any blood-thinning medication.

[cannabiscardaz]

Unveiling the Therapeutic Benefits of Medical Marijuana

Medical marijuana, derived from the cannabis plant, has garnered attention for its potential therapeutic properties. As attitudes and regulations surrounding its use continue to evolve, it's essential to explore the compelling benefits this natural remedy offers. In this blog post, we delve into the various ways medical marijuana can positively impact health and well-being, shedding light on its potential as an alternative treatment option.

Pain Management:

Alleviating Chronic Pain: Discover how medical marijuana can provide relief for individuals suffering from chronic pain conditions, such as arthritis, fibromyalgia, and neuropathy.

Reducing Inflammation: Explore the anti-inflammatory properties of cannabinoids, which may help ease symptoms associated with conditions like multiple sclerosis and inflammatory bowel disease.

Mental Health Support:

Anxiety and Depression Relief: Learn how certain compounds in medical marijuana, such as cannabidiol (CBD), may offer a natural approach to managing symptoms of anxiety and depression.

PTSD and Trauma Recovery: Uncover the potential of medical marijuana in helping individuals cope with post-traumatic stress disorder (PTSD) and trauma-related conditions.

Nausea and Appetite Stimulation:

Cancer Treatment Support: Discuss the role of medical marijuana in mitigating chemotherapy-induced nausea and vomiting, as well as stimulating appetite for individuals undergoing cancer treatments.

HIV/AIDS Symptom Management: Explore how medical marijuana may alleviate symptoms like nausea, weight loss, and appetite loss in individuals living with HIV/AIDS.

Neurological Disorders:

Epilepsy Management: Learn about the promising effects of medical marijuana, particularly CBD, in reducing seizures in individuals with epilepsy.

Multiple Sclerosis Symptom Relief: Discover how medical marijuana may help manage symptoms like muscle spasticity, pain, and sleep disturbances in individuals with multiple sclerosis.

Sleep Disorders:

Insomnia Treatment: Explore the potential of medical marijuana in improving sleep quality and alleviating insomnia symptoms, promoting restful and rejuvenating sleep.

Palliative Care and End-of-Life Support:

Comfort and Symptom Management: Discuss how medical marijuana can provide comfort and relief to individuals in palliative care, easing symptoms like pain, nausea, and anxiety in the final stages of life.

Potential Adjunct Therapy:

Reduced Reliance on Opioids: Highlight the possibility of medical marijuana serving as an adjunct therapy for chronic pain management, potentially reducing the need for opioid medications.

Medication Side Effect Mitigation: Discover how medical marijuana may help alleviate side effects associated with certain medications, improving overall treatment experiences for individuals.

Medical marijuana holds immense potential as a natural treatment option for various health conditions. From pain management and mental health support to alleviating nausea, stimulating appetite, and providing relief for neurological disorders, its benefits are broad and diverse. As research and understanding continue to evolve, medical marijuana has the potential to transform the lives of countless individuals seeking alternative approaches to their well-being. Embrace the therapeutic benefits of medical marijuana and engage in informed discussions with healthcare providers to determine if it's a suitable option for your unique needs.

[lifesciencesblogss]

Riding the Waves: An In-Depth Look at the Nausea Medicine Market

Nausea and vomiting, those unpleasant and often debilitating sensations, are common experiences stemming from a wide array of causes – from motion sickness and pregnancy to chemotherapy and viral infections. As such, the market for medications aimed at alleviating these symptoms, the nausea medicine market, represents a significant and consistently relevant segment within the pharmaceutical industry. This report delves into the key aspects of this market, exploring its drivers, challenges, trends, and future outlook.

The global nausea medicine market is characterized by a diverse range of products, including both prescription and over-the-counter (OTC) medications. Antihistamines like dimenhydrinate and meclizine are popular OTC choices for motion sickness and mild nausea. Prescription options encompass more potent drugs such as serotonin 5-HT3 receptor antagonists (e.g., ondansetron), dopamine antagonists (e.g., metoclopramide, prochlorperazine), neurokinin-1 (NK1) receptor antagonists (e.g., aprepitant), and cannabinoids. The choice of medication often depends on the underlying cause and severity of the nausea.

Several factors are propelling the growth of the nausea medicine market. The increasing prevalence of chronic diseases like cancer, which often involves chemotherapy-induced nausea and vomiting (CINV), is a significant driver. According to the World Health Organization, cancer is a leading cause of death worldwide, and the number of new cancer cases is projected to rise significantly in the coming decades. This escalating patient pool undergoing chemotherapy directly translates to a higher demand for effective antiemetic therapies.

Furthermore, the rising incidence of gastrointestinal disorders, such as gastritis and irritable bowel syndrome (IBS), which can manifest with nausea as a prominent symptom, contributes to market expansion. The growing geriatric population, more susceptible to various health conditions and medication side effects that can induce nausea, also plays a crucial role. Additionally, the increasing awareness of motion sickness and the availability of convenient OTC remedies are fostering greater adoption of nausea medications.

The Nausea Medicine Market is expected to register a CAGR of 6.5% from 2025 to 2031, with a market size expanding from US$ XX million in 2024 to US$ XX Million by 2031.

Despite the positive growth outlook, the nausea medicine market faces certain challenges. One significant hurdle is the potential for side effects associated with some antiemetic drugs, such as drowsiness, dizziness, and constipation. This necessitates ongoing research and development efforts to create safer and more targeted therapies. Another challenge lies in the accurate diagnosis of the underlying cause of nausea to ensure the most appropriate treatment is administered. Moreover, the availability of generic versions of several established antiemetic drugs can exert price pressure on branded products.

Current trends shaping the nausea medicine market include the development of novel drug formulations, such as orally disintegrating tablets and transdermal patches, 1 aimed at improving patient compliance and ease of administration. There is also a growing focus on personalized medicine approaches, tailoring antiemetic regimens based on individual patient characteristics and the specific emetogenic potential of their treatment (e.g., in CINV management). Research into novel targets and mechanisms of action, including advancements in understanding the neurobiology of nausea and vomiting, is also driving innovation in this space.

Looking ahead, the nausea medicine market is poised for continued growth, fueled by the factors mentioned earlier and ongoing advancements in pharmaceutical research. The increasing focus on patient comfort and quality of life, particularly in the context of cancer treatment and chronic illnesses, will further drive the demand for effective antiemetic therapies. The development of drugs with fewer side effects and more targeted mechanisms of action will be crucial for future market success. Furthermore, the integration of digital health solutions and telemedicine may improve patient access to diagnosis and management of nausea and vomiting.

In conclusion

The nausea medicine market is a vital and dynamic segment of the pharmaceutical industry. Driven by the rising prevalence of chronic diseases, gastrointestinal disorders, and an aging population, the market is expected to maintain a steady growth trajectory. While challenges such as side effects and generic competition exist, ongoing research and development efforts focused on novel formulations and personalized approaches promise to deliver more effective and patient-friendly solutions, ensuring that individuals experiencing nausea can find much-needed relief.

[prism-industries]

Hyoscine Hydro Bromide: Benefits and Medical Applications

Introduction: The Medical Significance of Hyoscine Hydro Bromide

In current pharmacological times, demand for safe, rapid, and handy drugs has never been higher. Of the most reliable active pharmaceutical ingredients utilized in motion sickness as well as postoperative treatment, one of the most established is hyoscine hydro bromide. Famous for its potent antiemetic and anticholinergic activity, this drug is instrumental in treating nausea, vomiting, and spasm of skeletal muscles and smooth muscles.

At Prism Industries Pvt. Ltd., a trusted bulk drugs manufacturer and antiemetic API vendor, we are experts in the manufacturing and export of pure hyoscine hydro bromide to healthcare providers across the globe, following rigorous safety, purity, and regulatory requirements. The article delves into the pharmacological advantages, clinical applications, and industrial significance of hyoscine hydro bromide, while highlighting Prism Industries' ability to cater to the changing demands of healthcare providers and formulators.

What is Hyoscine Hydro Bromide?

Hyoscine hydro bromide, or scopolamine hydrobromide, is an anticholinergic API that inhibits acetylcholine receptors in the central nervous system. Its main action is the inhibition of involuntary muscle movement and glandular secretions, which renders it extremely useful in the treatment of nausea, motion sickness, and post-operative states.

In oral, injectable, and transdermal preparations, hyoscine hydro bromide is a wide-therapeutic-profile active pharmaceutical ingredient used in emergency medicine as well as in the care of patients on a regular basis.

Mechanism of Action: How Hyoscine Hydro Bromide Works

Being an anticholinergic API, hyoscine hydro bromide works by blocking the muscarinic effect of acetylcholine on secretory glands and smooth muscles. It acts specifically on the vestibular system, which is crucial in maintaining balance and sensing motion.

By inhibiting nerve impulses between the inner ear and the vomiting center in the brain, hyoscine hydro bromide blocks nausea, vomiting, and dizziness—hence its frontline use in treating motion sickness and postoperative nausea and vomiting (PONV). Its antispasmodic action also brings relief in gastrointestinal and urinary tract disorders.

Therapeutic Benefits of Hyoscine Hydro Bromide

1. Antiemetic Relief

One of the major hyoscine hydro bromide applications is in the prevention and management of nausea and vomiting. It is often given before operations or chemotherapy in order to prevent motion-induced or drug-induced emesis.

2. Motion Sickness Treatment

Hyoscine hydro bromide is commonly prescribed for sufferers of motion sickness that occurs during travel. Its long action and low side effects make it suitable for long journeys, particularly in patch or oral tablet forms.

3. Use Before and After Surgery

Hyoscine hydro bromide is utilized in operating rooms to dry up secretions and decrease salivation. It is also utilized to keep heart rhythms stable and treat post-anesthesia nausea and vomiting.

4. Adjuvant in Gastrointestinal Disorders

Relaxation of smooth muscles within the gastrointestinal tract by hyoscine hydro bromide provides relief from abdominal spasms, cramps, and discomfort seen with irritable bowel syndrome (IBS) and other gastrointestinal ailments.

Typical Formulations and Dosage Forms

Hyoscine hydro bromide is made available and promoted in several different dosage forms suitable for diverse clinical requirements, including:

Oral tablets

Injectable solutions

Transdermal patches

Buccal tablets

Eye drops (employed in diagnostic ophthalmology)

These preparations provide adaptability and convenience of use in a broad spectrum of patient populations and treatment sites.

Why Prism Industries Pvt. Ltd. is a Preferred Antiemetic API Supplier

At Prism Industries Pvt. Ltd., we provide world-class competence in hyoscine hydro bromide development and distribution to meet domestic as well as international standards of quality. As a reputable antiemetic API supplier, we deliver decades of experience, innovation, and a robust dedication to safety and efficacy.

Core Strengths:

WHO-GMP Certified Manufacturing Units

High-End Quality Control (QC) and Assurance (QA) Processes

Fast Turnaround Time and Bulk Availability

Transparency in Pricing and Regulatory Assistance (COA, MSDS, DMF)

Export-Suitable Logistics for International Distribution

With a substantial presence in the API production market, Prism Industries supplies active pharmaceutical ingredients that suit the rigorous needs of international formulators and pharmaceutical developers.

Hyoscine Hydro Bromide in International Pharmaceutical Markets

The use of hyoscine hydro bromide has increased consistently over the past decade, fueled by its wide range of applications and very good tolerability. Its extensive use in travel medicine, anesthesiology, gastroenterology, and palliative care continues to make it a key player in essential medicines lists globally.

Leading import regions are:

United States

United Kingdom

Germany

Australia

Southeast Asia

Latin America

Being a bulk drugs producer, Prism Industries assists pharmaceutical firms in these areas with bulk amounts and private-labeling possibilities.

Safety Profile and Side Effects

Hyoscine hydro bromide is usually well accepted by patients. However, like any drug, it will have some side effects, particularly at increased doses.

Common Side Effects:

Dry mouth

Blurred vision

Slight drowsiness

Constipation

Urinary retention

Rare but Serious Effects:

Confusion or agitation (in elderly patients)

Allergic reactions

It is contraindicated in patients with glaucoma, myasthenia gravis, and urinary tract obstruction. Caution should be exercised by physicians with pregnant or lactating women.

In spite of these precautions, the margin of safety for hyoscine hydro bromide is high, especially with recommended dosing.

Clinical Research and Current Applications

Recent research continues to confirm the efficacy of hyoscine hydro bromide in a variety of specialties:

Palliative Care: Inhibition of excessive salivation and terminal agitation in hospice patients.

Anesthesia Adjunct: Preoperative to decrease secretions and calm vitals.

Ophthalmology: Diagnostic application for dilation of the pupils and cycloplegia.

Oncology: Alleviation of chemotherapy-induced nausea.

This growing array of uses has put hyoscine hydro bromide among the most sought-after active pharmaceutical ingredients for formulation and development.

Regulatory Compliance and Documentation

Prism Industries Pvt. Ltd. is well positioned to cater to the global regulatory requirements for hyoscine hydro bromide:

USFDA and EDQM Readiness

ICH Guidelines for Stability

Custom Dossiers (COA, MSDS, TSE/BSE, DMF)

REACH Compliance for European Markets

RoHS and CE Certifications as necessary

This holistic regulatory assistance renders us a credible antiemetic API supplier and business partner for pharmaceutical companies across the globe.

Sustainability and Innovation in API Production

Our manufacturing processes embody sustainability. Being a forward-thinking bulk drugs manufacturer, Prism Industries focuses on:

Green chemistry practices

Wastewater treatment technologies

Energy-saving production machinery

Sustainable sourcing of raw material

According to global environmental objectives, our synthesis of hyoscine hydro bromide reduces ecological footprint without compromising the integrity of the product.

Conclusion: Hyoscine Hydro Bromide's Role in Modern Therapeutics

All in all, hyoscine hydro bromide is still one of the most potent and useful antispasmodic and antiemetic pharmaceutical agents today. Its capacity to manage motion sickness, postoperative nausea, and gastrointestinal distress makes it one of the leading essential medicines globally.

As a globally trusted Antiemetic API Supplier, Prism Industries Pvt. Ltd. leads the innovation, quality, and reliability fields. We keep pursuing excellence as an API manufacturer, constantly continuing to provide safe, effective, and sustainable active pharmaceutical ingredients for global pharma companies.

[yourcancerguru]

Oncology Acupuncture: Understanding Its Role in Cancer Care

As an integrative oncology specialist, I often emphasize the importance of supportive therapies that work alongside conventional treatments like chemotherapy, radiation, and surgery. One powerful and evidence-informed modality in this space is oncology acupuncture.

If you've never heard of it, or are wondering how it's different from traditional acupuncture, this blog will walk you through what oncology acupuncture is, who is qualified to provide it, the benefits it offers for those facing cancer, and why it deserves a place in your care plan.

What Is Oncology Acupuncture?

Oncology acupuncture is a specialized form of acupuncture tailored specifically for individuals undergoing or recovering from cancer treatment. It can also be used to support those on palliative and hospice care. While it's rooted in Traditional Chinese Medicine (TCM), this approach integrates modern medical knowledge of cancer, cancer treatments, and common signs, symptoms, and side effects patients often experience.

The goal isn't to treat cancer itself, but rather to support the person who has cancer—by addressing a number of conditions that can improve his/her overall quality of life.

Who Is Qualified to Perform Oncology Acupuncture?

Not all acupuncturists are trained to work with oncology patients. Oncology acupuncture requires additional clinical training beyond a standard acupuncture degree. Qualified practitioners typically meet these criteria:

Licensed Acupuncturists (L.Ac.) or Doctors of Acupuncture and Oriental Medicine (DAOM)

Specialized training in oncology acupuncture through accredited programs or postgraduate certification

Familiarity with Western cancer treatments (chemotherapy, immunotherapy, radiation, surgery) and how they interact with acupuncture

Experience in hospital-based or integrative cancer centers, often working collaboratively with oncologists and palliative care teams

What Are the Benefits of Oncology Acupuncture?

Many people living with cancer experience complex signs and symptoms, as well as many side-effects related to treatment. Oncology acupuncture can help relieve a wide range of conditions. Here are the most commonly treated:

1. Nausea and Vomiting

Acupuncture is one of the best-researched non-pharmacologic interventions for chemotherapy-induced nausea, often reducing reliance on antiemetic medications.

2. Cancer-Related Fatigue

Fatigue is one of the most common and difficult symptoms to manage. Acupuncture has been shown to improve energy and reduce the sensation of heaviness many patients feel during treatment.

3. Peripheral Neuropathy

Some chemotherapy drugs can cause nerve damage, leading to pain, tingling, and numbness. Acupuncture can help reduce neuropathy and promote nerve healing.

4. Hot Flashes and Night Sweats

Both chemotherapy and hormone therapy can induce hot flashes and night sweats.  Both can be alleviated by weekly acupuncture treatments. 

5. Pain Management

Acupuncture can treat neoplastic pain (cancer related pain), post-surgical pain, bone pain, and treatment-related soreness.  It’s a great drug-free option to complement pain management plans.

6. Anxiety, Depression, and Insomnia

Emotional and mental health symptoms often accompany a cancer diagnosis. Acupuncture helps regulate the nervous system and promotes relaxation.

How Does Oncology Acupuncture Differ from Regular Acupuncture?

While both use the same general method of inserting fine, sterile needles into specific points on the body, oncology acupuncture is adapted to the needs, vulnerabilities, and medical context of those who have cancer. Here are some key differences:

Conclusion:

Oncology acupuncture is not a cure for cancer, but for many, it's a lifeline. It offers relief for many signs, symptoms, and side-effects and can dramatically improve one's quality of life.  Oncology acupuncture can be useful for all patients, regardless of where they are in their journey, whether, newly diagnoses, in-treatment, in survivorship, or on palliative / hospice care.

[natuorpathylane]

Methylene Blue Some people have been messaging me about Methylene Blue therapy. I have read the pros and cons. I am going to take the position of con simply because the side effects are not worth the risk and I am in the business of keeping people healthy, I would rather use more natural sources of antioxidants! So, here is the list of things that can go wrong: 1. Nausea or vomiting: Methylene blue may cause nausea, vomiting, or an upset stomach in some individuals. 2. Headaches: In rare cases, headaches can occur after consuming methylene blue. 3. Methemoglobinemia: High doses of methylene blue can cause methemoglobinemia, a condition in which the blood’s oxygen-carrying capacity is reduced. This is usually temporary and resolves once the medication is discontinued. 4. Skin reactions: Some people may experience skin reactions such as itching or rash after using methylene blue. 5. Allergic reactions: In rare cases, an allergic reaction may occur, with symptoms like itching, swelling, or difficulty breathing. 6. Interaction with other medications: Methylene blue can interact with certain medications, such as antihypertensives (medications that lower blood pressure), and should be used cautiously in combination with these drugs. 7. Eye irritation: When applied directly to the eyes, methylene blue can cause eye irritation or discomfort. References: 1. Kelleher J, Methylene Blue, in “Textbook of Chelation Therapy,” (2004) 3rd edition, pages 68-74. 2. Zhang Y, et al., “Antioxidant and Anti-inflammatory Effects of Methylene Blue,” Current Drug Targets, vol. 15, no. 3, pp. 309-316 (2014). 3. Mashour GR, et al., “Methylene blue enhances learning and memory in mice,” Neurobiology of Disease, vol. 75, no. 3, pp. 479-486 (2016). 4. Frenkel A, et al., “Antibacterial properties of methylene blue against Staphylococcus aureus,” Journal of Antimicrobial Chemotherapy, vol. 52, no. 3, pp. 729-735 (2004). 5. Bhatia JP, et al., “Methylene blue inhibits the mitochondrial electron transport chain and protects against reactive oxygen species-induced damage,” European Heart Journal, vol. 28, no. 15, pp. 1370-1376 (2007).

[conversationpoint]

Chemotherapy-Induced Nausea and Vomiting Treatment Market Size in 7MM is expected to grow at a decent CAGR by 2032, estimates DelveInsight

http://dlvr.it/TKHzgh

[universalnewspoint]

Chemotherapy-Induced Nausea and Vomiting Treatment Market Size in 7MM is expected to grow at a decent CAGR by 2032, estimates DelveInsight

http://dlvr.it/TKHzXs

[nshah01801]

Nik Shah: The Role of 5-HT2 Receptors in Psychosis

In The Role of 5-HT2 Receptors in Psychosis, Nik Shah explores how the 5-HT2 receptor family influences conditions like schizophrenia and other psychotic disorders. Shah explains that the 5-HT2 receptors are key to modulating neurotransmitter activity in the brain, which impacts mood and thought processes. Alterations in the function of these receptors are believed to contribute to the development of psychosis. Supported by insights from John DeMinico and Rajeev Chabria, this article provides a detailed exploration of the relationship between 5-HT2 receptors and psychotic disorders, offering potential avenues for treatment and intervention.

Nik Shah’s Exploration of the 5-HT2 Receptor Family: Understanding Its Role in Neuroscience https://www.tumblr.com/nikshahxai/774126774386884608/overview-of-the-5-ht2-receptor-family Nik Shah’s article on the 5-HT2 receptor family offers a detailed exploration of this important class of serotonin receptors and their role in various neurological processes. These receptors are involved in regulating mood, cognition, and even the perception of pain. Nik emphasizes how the 5-HT2 receptors, which are G protein-coupled receptors, influence serotonin signaling in the brain, impacting everything from anxiety and depression to neuroplasticity. He delves into the intricacies of the receptor’s structure and function, providing insights into how modulation of these receptors could lead to potential therapies for mood disorders and cognitive dysfunction. This article serves as a valuable resource for anyone seeking a deeper understanding of the neurobiological mechanisms behind mental health conditions.

Nik Shah Explains the 5-HT2 Receptor Family: A Key Component of Serotonergic Signaling https://www.tumblr.com/nikshahxai/774127000313102336/what-is-the-5-ht2-receptor-family Nik Shah's breakdown of the 5-HT2 receptor family offers an accessible yet comprehensive overview of its critical role in serotonergic signaling. These receptors are involved in diverse functions including mood regulation, appetite control, and the modulation of sleep patterns. Nik explains the various subtypes of the 5-HT2 receptor, such as 5-HT2A, 5-HT2B, and 5-HT2C, each with its unique functions and potential therapeutic implications. By understanding the specific roles of these receptors, readers can better appreciate how altering serotonin pathways can impact conditions like depression, anxiety, and even certain neurodegenerative disorders. Nik’s in-depth insights into these receptors provide essential knowledge for anyone interested in neuroscience and psychopharmacology.

Nik Shah on the Structure and Function of 5-HT3 Receptors: Implications for Neuroscience and Medicine https://www.tumblr.com/nikshahxai/774128476141862912/the-structure-and-function-of-5-ht3-receptors In this detailed article, Nik Shah provides a thorough examination of the structure and function of 5-HT3 receptors. Unlike other serotonin receptors, 5-HT3 receptors are ion channels, meaning they play a crucial role in rapidly transmitting signals across the nervous system. Nik discusses how these receptors are involved in processes like nausea, vomiting, and anxiety, and how they interact with other neurotransmitter systems to regulate bodily functions. He also explores the therapeutic potential of targeting 5-HT3 receptors in treating conditions such as chemotherapy-induced nausea and anxiety disorders. Nik’s insights offer readers a deep understanding of how these receptors contribute to both health and disease, as well as the ongoing research into their therapeutic potential.

Nik Shah's Overview of 5-HT3 Receptors: Understanding Their Role in Neurotransmission https://www.tumblr.com/nikshahxai/774128535515299840/overview-of-5-ht3-receptors-structure-and Nik Shah’s article on 5-HT3 receptors provides a broad overview of their structure and significance in neurotransmission. These receptors are involved in a wide range of physiological processes, including the regulation of mood and digestive function. Nik emphasizes that 5-HT3 receptors are unique in that they function as ligand-gated ion channels, enabling rapid neuronal communication. This rapid signaling makes them essential in processes such as the control of vomiting and anxiety. Nik’s explanation of how 5-HT3 receptors interact with serotonin provides valuable insights into how manipulating these receptors could lead to new treatments for disorders like anxiety, depression, and gastrointestinal diseases.

Exploring the 5-HT3 Receptor Family: Insights into Function and Clinical Relevance with Nik Shah https://www.tumblr.com/nikshahxai/774128599302275072/structure-and-function-of-5-ht3-receptors Nik Shah’s exploration of the 5-HT3 receptor family highlights its important role in the brain and gut. These receptors, which are ion channels, help mediate rapid responses to serotonin, playing a critical role in processes like pain perception, anxiety, and gastrointestinal motility. Nik provides an in-depth look at the structure of these receptors, detailing how their function can impact both central and peripheral systems. By understanding how 5-HT3 receptors work, researchers can target them in developing treatments for a variety of conditions, including irritable bowel syndrome (IBS) and anxiety disorders. This article is crucial for those interested in the intersection of neuroscience and pharmacology.

Nik Shah’s Overview of the 5-HT3 Receptor Family: Unlocking the Mechanisms Behind Serotonergic Signaling https://www.tumblr.com/nikshahxai/774128708687626240/overview-of-the-5-ht3-receptor-family Nik Shah’s overview of the 5-HT3 receptor family provides a concise summary of the key features of these receptors and their role in serotonin signaling. These receptors are critical for the transmission of serotonin’s effects in the nervous system, influencing various physiological processes such as mood regulation and gastrointestinal function. Nik explains how the 5-HT3 receptors are involved in rapid signaling, making them a unique target for drug development, particularly in the treatment of nausea, vomiting, and mood disorders. By exploring these receptors’ mechanisms, Nik provides a foundational understanding of how they contribute to both normal and pathological states in the body.

Nik Shah’s Breakdown of 5-HT3 Receptors: Insights into Structure and Function https://www.tumblr.com/nikshahxai/774128768511098880/overview-of-5-ht3-receptors Nik Shah provides a detailed overview of the 5-HT3 receptors, discussing their structure and the critical role they play in neurotransmission. As ion channels, these receptors allow rapid transmission of serotonin signals, contributing to the regulation of mood, anxiety, and gastrointestinal processes. Nik’s article examines how these receptors’ unique structural properties allow them to be targeted in therapies for conditions such as nausea, vomiting, and anxiety disorders. His insights into the functional importance of 5-HT3 receptors are valuable for anyone interested in understanding how serotonin receptors contribute to health and disease.

Nik Shah’s Examination of 5-HT3 Receptors: What They Are and Why They Matter https://www.tumblr.com/nikshahxai/774128965219647488/what-are-5-ht3-receptors Nik Shah provides a detailed explanation of 5-HT3 receptors, explaining their importance in the brain and gastrointestinal system. These receptors, which are responsible for rapid serotonin signaling, play a crucial role in controlling anxiety, nausea, and gastrointestinal motility. Nik discusses how 5-HT3 receptors are involved in the body's response to serotonin, offering valuable insights into how these receptors can be targeted in medical treatments. His exploration of the role of 5-HT3 receptors in both central and peripheral systems provides a comprehensive understanding of their function and potential therapeutic applications.

Nik Shah’s Insights into the Structure and Function of 5-HT4 Receptors https://www.tumblr.com/nikshahxai/774130426276167680/structure-and-function-of-5-ht4-receptors Nik Shah offers an in-depth look at the 5-HT4 receptors, explaining their role in serotonin signaling and their significance in gastrointestinal function. 5-HT4 receptors are involved in regulating motility and secretion in the gut, and their activation can help treat conditions such as constipation and irritable bowel syndrome (IBS). Nik provides a comprehensive overview of how these receptors work, highlighting their potential as targets for drug development aimed at improving gastrointestinal health. His insights into the structure and function of 5-HT4 receptors are crucial for anyone interested in the intersection of serotonin and gastrointestinal health.

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@nshah01801

[nursingwriter]

¶ … legalization of marijuana and its benefits to the society. Our arguments are focused on its medicinal value, income generated (economic value) to the state as well as the possible losses to tax payer's money as a result of trying to implement its prohibition. Our analysis is done via a thorough review of relevant literature containing expert opinions. We support our proposition that marijuana can be a benefit to society through its legalization. This is due to its medicinal value, revenue stream to the state and the reduced cost attributed to decreased prohibition budgets. Marijuana which is the most commonly used illicit drug has faced has been heavily debated on issues of legalization and safe use. The debate has been so intense to an extent of which it has turned political (NYT, 2008). A recent study by Angus Reid concluded that a majority of Americans are in support of marijuana legalization (53% support) (Angus-Reid,2009).Marijuana can be a benefit to society through its legalization. Throughout its history, it has been proven to have several medicinal as well as economic benefits through its use. Additionally, each year the federal government spends countless hours, resources, and funds to combat the seemingly detrimental effects of marijuana usage within the country. As societal attitudes change through the decades, it is time that marijuana is re-examined for its benefits and advantages within the country as a valid medical remedy as well as valuable monetary resource for the economy. Therapeutic use of marijuana Marijuana has been proven to possess medicinal value. This is because it has been shown that it can aid in the management of certain ailments. The main reason as to why marijuana should be legalized is its medicinal value .Marijuana can be used in the treatment of cancer. The actual use is in the supportive care of the disease (NCI, 2010).The actual mechanism of treatment and management of cancer relies on the action of the cannabinoids that exists in the drug. The cannabinoids help in the management of the side effects of the chemotherapy. Thus "Cannabinoids are undoubtedly effective as anti-emetic agents in vomiting induced by anti-cancer drugs. Some users of both find cannabis itself more effective." (BMA, 1997).The same cannabinoids are also active in the inhibition of nausea which in turn helps in the increasing of appetite in cancer patients. Cannabinoids which is the active ingredient in marijuana is known to be important in the arresting of the growth of cancerous cells. This leads to the reduction in the number of cancerous cells that a patient has. This has been proven by over twenty studies spanning a period of over nine years. The cannabinoids are important in the arresting of growth of different types of cancer such as brain, breast and melanoma (Pranger,2010).The fact that marijuana can aid in the management of cancer which is a terrible disease in terms of its effects on the human body and mind makes it acceptable for legalization. Since cancer and its effects are horrible and causes so much pain to the patients, it is better to legalize it that let the patient suffer in pain and agony. It is better for the nation to decriminalize marijuana that to let the patients turn to more horrible options such as euthanasia. The other therapeutic use of marijuana is the reduction of effects of glaucoma. Glaucoma is at terrible disease which affects approximately 4 million Americans (GRF, 2010). Cannabis has been shown to help in the reduction of pain that is caused by glaucoma. The use of marijuana leads to the reduction of swelling of the affected eye. This effect lasts for a period of about three to fours hours. The economic impact of the glaucoma is that it accounts for an excess of seven million visits to various physicians each and every year (PBA). The economic impact of glaucoma on the government is also far greater. It affects the level of benefits provided by the Social security and increases the amount of lost revenue as well as elevated amount of health care expenditure. The cost to the Unites States government is placed to be in excess of $1.5 billion every year (NEI,1998). Generation of revenue to both the state and federal government The producers and the consumers of marijuana can aid the state and federal government by the injection of revenue into the economy. The consumers of marijuana would inject a lot of cash flow into the state's economy. This is further reinforced by the fact that beer consumption and marijuana consumption are complementary to each other. This fact would drive up the sale of both and hence produce more revenue as a result of their reinforcing effect. More tax could be generated from its regulatory taxation. An increase in the level of taxation would provide the federal, state and local governments with extra revenue. As an example a tax of 10% on cannabis would yield about $1.4 billion to the state of California alone. At the user level, an excise tax could be placed on the users. This could be approximated to be about $660 in terms of taxation at the federal level. Cost of prohibition too high The cost of prohibition of marijuana to the federal, state and local government is too high. The prohibition of marijuana causes the government to incur charges related to the process of enforcement. The process of prohibition leads to the prevention of the taxation of marijuana as well as its sale. If marijuana is to be legalized, the expenditure by the government would decline rapidly while the tax revenue would be increased. Marijuana should therefore be regulated just like any other goods in order to ensure that there is the acceptable and safe use of the drug. The legalization of marijuana would aid in the reduction of government expenditure by about $7.7 billion every year while generating tax revenue of about $2.4 (Miron,2005).Should marijuana be legalized and then taxed at the same rate as alcohol and tobacco, the above estimates would be viable. Conclusion The legalization of marijuana within our society has concrete benefits that can be of substantial gains to the citizens and government. A lot of tax revenue can be generated from its use, more money can be injected into the economy by its sale and consumption at the same time, its medical (therapeutic) benefits make it a substance that can be employed appropriately help in pain as well as disease management References Angus-Reid (2009).Majority of Americans Support Legalizing Marijuana http://www.visioncritical.com/wp-content/uploads/2009/12/2009.12.09_Drugs_US.pdf British Medical Association (1997). Therapeutic Uses of Cannabis. Harwood Academic Pub. Bensinger, P. (2010, Octobe 15). Legalizing marijuana unacceptable, danger to society. Chicago Tribune . Brown, M. (2003, August 14). Legalize, tax marijuana to fill budget gap. Retrieved October 8, 2010, from Seattle PI: http://www.seattlepi.com/opinion/134881_marijuana14.html Clements, K.W., & Daryal, M. (1999). The Economics of Marijuana Consumption. Department of Economics: The University of Western Australia. Drug Policy Alliance. (1997, October 27). Marijuana-like Drugs May Be Effective Painkillers. Retrieved October 7, 2010, from Drug Policy News: http://www.mapinc.org/tlcnews/v97/n520/a06.html?2171 Joy, J.E. (1999). Marijuana and medicine: assessing the science base. Washington, D.C.: National Academy Press. Klein, J. (2009, April 2). Why Legalizing Marijuana Makes Sense. Time. Massi, P., Vaccani, A., Ceruti, S., Colombo, A., Abbracchio, M., & Parolaro, D. (2004). Antitumor Effects of Cannabidiol, a Nonpsychoactive Cannabinoid, on Human Glioma Cell Lines. The Journal of Pharmacology and Experimental Therapeutics, National Cancer Institute (2010). Marijuana Use in Supportive Care for Cancer Patients. http://www.cancer.gov/cancertopics/factsheet/Support/marijuana National Eye Institute (Fall, 1998).Report of the Glaucoma Panel New York Times (2008).Washington to Vote On Marijuana Use. New York Times; 9/18/1998, p26, 0p Pranger, B (2010).The Benefits Of Medical Marijuana For Cancer Patients. http://www.articlefeeder.com/Diseases__Conditions_and_Treatments/The_Benefits_Of_Medical_Marijuana_For_Cancer_Patients.html Prevent Blindness America Roach, C. (2010, March 2). Opinion: Marijuana to save the economy? Retrieved October 2, 2010, from Digital Journal: http://www.digitaljournal.com/article/288375 Russo, E. (1998). Cannabis for migraine treatment: the once and future prescription? International Association for the Study of Pain, 6. USA.gov. (2010). Prime Award Spending Data. Retrieved October 13, 2010, from USASpending.gov: http://www.usaspending.gov/explore?carryfilters=on Read the full article

[canmedaustralia]

Exploring the Past, Present, and Future of Cannabis Therapies

In recent years, medical cannabis has become a significant focus in Australia's healthcare discussions, opening new paths for patient care and symptom management. As treatments continue to evolve, it's crucial to understand the benefits and role of medical cannabis. Its potential to improve the quality of life for patients with chronic conditions has made it an important aspect of modern healthcare, leading to increased research and adoption in medical practices. This shift signifies a promising future where medical cannabis in Australia plays a strong role in extensive patient care.

Understanding Medical Cannabis

Medical cannabis refers to the use of the cannabis plant or its extracts for therapeutic purposes. Unlike recreational marijuana, which is often associated with psychoactive effects due to its tetrahydrocannabinol (THC) content, medical cannabis is formulated to meet pharmaceutical standards, ensuring consistent dosages and purity. It contains known amounts of cannabinoids, primarily THC and cannabidiol (CBD), and is free from harmful substances such as molds, pesticides, and heavy metals.

The Distinction Between Recreational and Medical Cannabis

It's crucial to differentiate between recreational marijuana and medical cannabis. Recreational marijuana is used primarily for its psychoactive effects and is not subject to the stringent manufacturing and quality controls that medical cannabis undergoes. In contrast, medical cannabis is produced under strict regulations to guarantee safety and efficacy for patients. This distinction means that patients receive a product that is both safe and according to their medical needs.

Historical Treatments Prior to Medical Cannabis

Before the integration of medical cannabis into treatment plans, patients often relied on conventional pharmaceuticals to manage conditions such as chronic pain, epilepsy, and multiple sclerosis. These treatments included opioids for pain management, antiepileptic drugs for seizure control, and muscle relaxants for spasticity. While effective for some, these medications often came with significant side effects and varied efficacy, leading researchers and healthcare providers to explore alternative therapies, including medical cannabis.

The Rise of Medical Cannabis in Australia

Since its legalization in 2016, the use of medical cannabis in Australia has seen exponential growth. In 2024, sales of medicinal cannabis products were projected to reach $1 billion, a substantial increase from $234 million in 2022. This surge is attributed to heightened public awareness, an increase in prescribing doctors and pharmacists, and the expansion of telehealth services facilitating easier access for patients.

Patient Benefits and Success Stories

The therapeutic potential of medical cannabis has been recognized in various medical conditions. In Australia, approvals have been granted for its use in managing:

Chemotherapy-induced nausea and vomiting: Helping patients undergoing cancer treatment to alleviate severe nausea.

Refractory epilepsy: Particularly in children, where traditional antiepileptic drugs have failed.

Chronic pain: Offering an alternative to opioids, especially in cases of neuropathic pain.

Multiple sclerosis-related spasticity: Reducing muscle stiffness and improving mobility.

While exact patient numbers are continually evolving, the significant increase in prescriptions indicates that thousands of Australians have benefited from medical cannabis treatments.

Custom Compounding at CanMed

At CanMed, they recognize that each patient's medical needs are unique. Their Custom Compounding Chemist team is experienced in creating personalized medical cannabis formulations that adhere to individual patient requirements. This customised approach provides outstanding therapeutic outcomes by adjusting cannabinoid ratios, dosages, and delivery methods to suit specific conditions and patient preferences.

Potential Side Effects and Considerations

While medical cannabis offers numerous benefits, it's essential to be aware of potential side effects and risks. Common side effects may include dizziness, dry mouth, fatigue, and changes in appetite. More serious considerations involve the psychoactive effects of THC, which can impair cognitive and motor functions. Therefore, it's crucial for patients to consult with healthcare professionals to determine appropriate dosages and to monitor for any adverse reactions.

Projected Growth of Medical Cannabis by 2025

The medical cannabis industry in Australia is poised for continued expansion. With increasing acceptance among healthcare providers and patients, coupled with ongoing research into its therapeutic applications, the market is expected to sustain its growth trajectory. This expansion reflects a broader global trend of integrating medical cannabis into standard medical practice, offering patients alternative treatment options.

Why Choose CanMed for Prescribing and Compounding Services?

At CanMed, they securely integrate complete prescribing and advanced compounding services, creating a healthcare haven under one roof. When traditional solutions fall short, their expert team at Custom Compounding Chemist steps in, crafting personalized treatment plans to calm symptoms and significantly improve patient outcomes. Experience the synergy of innovative healthcare solutions, all conveniently available at your fingertips. At CanMed and Custom Compounding Chemist, your journey to optimal health begins with professional care and precision compounding, giving you a pathway to well-being like never before.

Conclusion

The launch of medical cannabis in Australia signifies a transformative shift in patient care, offering alternative solutions where traditional treatments may have fallen short. As the industry continues to grow, supporting personal and integrated healthcare services becomes paramount. CanMed stands at the head of this movement, dedicated to providing custom medical cannabis solutions that combine patient well-being and therapeutic efficacy.

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https://canmed.hashnode.dev/exploring-the-past-present-and-future-of-cannabis-therapies

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Chronic nausea can significantly impact daily life, making it difficult to eat, stay hydrated, and function normally. Medical marijuana is now a recognized treatment option in Kentucky, offering natural relief by interacting with the body’s endocannabinoid system to reduce nausea and vomiting. Patients suffering from conditions like chemotherapy-induced nausea, digestive disorders, or other chronic illnesses may qualify for an MMJ card. Consult with a licensed medical professional today to see if medical cannabis is the right solution for you and regain control of your well-being.