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Sub-category:
Cancer-Related Complications
Category:
Patient and Survivor Care
Meeting:
2011 ASCO Annual Meeting
Session Type and Session Title:
Poster Discussion Session, Patient and Survivor Care
Abstract No:
9021
Citation:
J Clin Oncol 29: 2011 (suppl; abstr 9021)
Author(s):
T. J. Smith, J. K. Ritter, P. J. Coyne, G. L. Parker, P. Dodson, D. S. Fletcher; Massey Cancer Center of Virginia Commonwealth University, Richmond, VA; Virginia Commonwealth University, Richmond, VA; Thomas Palliative Care Program, Virginia Commonwealth University Massey Cancer Center, Richmond, VA
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^) here and in the printed Proceedings.
Abstract Disclosures
Abstract:
Background: Nausea and vomiting due to cancer or its treatment is a common symptom in oncology, palliative care and hospice. ABH topical gel is currently widely used in home hospice due to perceived efficacy and low cost, and has been suggested for cancer chemotherapy. As many as 60% of cancer hospice patients are prescribed ABH gel. All these drugs work by reaching the brain in sufficient concentration to prevent emesis or nausea. However, there are no well controlled studies of effectiveness, and none of absorption. We determined if ABH gel was absorbed. Methods: 10 healthy volunteers, age 25-58 (mean 37), 2 African-American and 8 Caucasian-American, applied the standard 1.0 ml dose (2 mg of lorazepam, 25 mg of diphenhydramine, and 2 mg of haloperidol in a pluronic lecithin organogel) rubbed on the volar surface of the wrists by the subject. The ABH gel was analyzed to confirm that it had ABH at proper concentrations. Blood samples were obtained at 0, 30, 60, 90, 120, 180 and 240 minutes. Plasma concentrations were analyzed by reverse phase high performance liquid chromatography (HPCL) or HPLC-UV. Results: No subject noted any side effects. No lorazepam (A) or haloperidol (H) was detected in any sample from any of the 10 patients down to a level of 0.05ng/mL. Diphenhydramine (B) was detectable in concentrations over the lowest calibration standard (0.1 ng/mL) in 3 patients, including one who inadvertently took an over-the-counter drug with B. The highest concentration of B recorded from ABH gel was 0.18 ng/ml in 1 person at 240 minutes. Overall, 5 of 9 patients exhibited one or more samples positive for B supporting limited absorption of B from the ABH gel. Conclusions: As commonly used, none of the lorazepam (A) or haloperidol (H) in ABH gel is absorbed in sufficient quantities to be effective in the treatment of nausea and vomiting. Benadryl (diphenhydramine) is absorbed at low levels, late, and erratically. The efficacy of ABH gel should be confirmed in randomized trials before its use is recommended.
 Associated Presentation(s):
Other Abstracts in this Sub-Category:
Abstracts by T. J. Smith:
Presentations by T. J. Smith:
Educational Book Manuscripts by T. J. Smith:
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