What should I do if I vomit from chemotherapy?

  Chemotherapy-induced nausea and vomiting (CINV) seriously affects the compliance of oncology treatment and the quality of patients’ survival.  The occurrence of CINV seriously affects the quality of life of patients and significantly decreases the compliance of patients with treatment. CINV can also increase the psychological burden on family members, increase the nursing workload, and increase the financial burden on the patient’s family.  CINV treatment is based on prevention: Once CINV appears, it is difficult to be controlled by drugs, therefore, the key to CINV treatment is based on prevention rather than treatment. Therefore, before the start of tumor-related treatment, the risk of vomiting should be fully assessed, an individualized vomiting prevention and treatment plan should be developed, and preventive antiemetic treatment should be given before chemotherapy. After the final dose of chemotherapy, the risk of nausea and vomiting still persists for at least 2 to 3 days in patients receiving chemotherapy with high and moderate emetic risk drugs, so protection against vomiting is needed throughout the risk period.  Commonly used antiemetic drugs include 5-hydroxytryptamine 3 (5-HT3) receptor antagonists, neuropeptide 1 (NK-1) receptor antagonists, dopamine receptor blockers, adrenocorticosteroids, phenothiazines, and psychotropic antiemetics. The newest anti-emetic drug on the market, aripitant, is the first NK-1 receptor antagonist with a novel pharmacological mechanism of action. It has good permeability to the blood-brain barrier and selectively binds to NK-1 receptors, but has little binding to NK-2 and NK-3 receptors; moreover, it has a high affinity for NK-1 receptors and can maintain prolonged central activity, thus significantly inhibiting the occurrence of acute and delayed vomiting. Arepitant has been recommended by several domestic and international guidelines for the prophylactic use of CINV.  Chinese medicine to prevent chemotherapy-related vomiting: 1. Chinese herbal medicine treatment: start oral administration of herbal tonics that have the ability to strengthen the spleen and stomach before chemotherapy, such as Six Gentlemen’s Soup and Hexia Diarrhea Heart Soup; preferably after four consultations of Chinese medicine to identify the evidence.  2. Acupoint injection for antiemetic: Before chemotherapy, start acupuncture therapy by selecting bilateral Neiguan and Feisanli acupoints respectively; during chemotherapy, take the drug Gastrofluan to perform acupoint closure therapy, which can delay drug absorption and achieve better antiemetic effect.  3, acupuncture point patch therapy: before chemotherapy to chemotherapy period, take ginger slices and apply it to the Shen Que point, can combine with herbs that have the effect of lowering rebelliousness, anti-vomiting and grind them into powder, take rice vinegar to mix and apply it to the Zhonggui, or Shen Que point.  4, Chinese medicine ear point buried beans also have the auxiliary effect of prevention and treatment of vomiting.  The above Chinese medical methods are commonly used in our clinical work, the effect is better than simply using Western medicine, with fewer side effects, you can refer to try.