Cannabinoids vs Protein and Ginger to Treat Nausea and ...



Cannabinoids vs. Protein and Ginger to Treat Nausea and Vomiting in Advanced Disease

Sarah DeLaat

Ferris State University

Abstract

This paper will explore the treatment in chemotherapy induced nausea and vomiting (CINV). Research and evidence will be shown for the use of cannabinoids as the pharmacological treatment for CINV and a protein and ginger combination as the non-pharmacological treatment form.

Cannabinoids vs. Protein and Ginger to Treat Nausea and Vomiting in Advanced Disease

Introduction

Nausea and vomiting are very common, specific, and unpleasant complications related to chemotherapy.” Chemotherapy –induced nausea and vomiting (CINV) is a significant, well documented problem” (Cotter, 2009). These symptoms are sometimes intense enough that a patient will withdraw from life saving treatment to avoid their debilitating effects. There are multiple treatments for CINV, but this paper will focus specifically on the use of cannabinoids as the pharmacological treatment and a high protein diet with ginger as the non-pharmacological treatment for these symptoms. It is important for nurses to be familiar with these treatments in order to provide support to their patients as well as appropriate patient education. “Nurses should be cognizant of the side-effect profiles for CINV treatments” (Cotter, 2009).

As nurses it is also important to put aside any personal bias when it comes to a patient’s choice of treatment with specific regards to cannabinoids. Even in this day and age with marijuana now being a legal form of CINV treatment, there sometimes remains a social stigma attached to this form of treatment.

Descriptive Summary

Cannabinoids

“Marijuana has been used medically for millennia and in the United States for over 150 years” (Hollister, 2001). It was not until recently that the use of delta-9 tetrahydrocannabinol (THC) was legalized as an actual medical treatment for nausea and vomiting. “Dronabinol, the active ingredient in Marinol capsules is the synthetic form of THC that is prescribed” (Cotter, 2009). Studies done in the 1970’s and 1980’s have been re-evaluated over the past ten years in order to prove the efficacy of marijuana in relation to CINV. In a THC vs. placebo study, “22 patients received a single dose of THC or placebo two hours prior to chemotherapy treatment and two and six hours after. Fourteen of 20 patients who received the THC capsule reported an antiemetic effect, whereas 0 of 22 patients receiving the placebo reported no antiemetic effect” (Cotter, 2009).

THC has also been compared to prochlorperazine or compazine. “Doses of 15mg of THC were compared to 10mg doses of prochlorperazine in a controlled crossover trial in 84 patients. THC produced complete response in 36 of 79 courses, while prochloperazine was effective in only 16 of 78 courses” (Hollister, 2001). THC provided more central nervous system effects on these patients participating in this study. Even though the nausea and vomiting were controlled, some patients reported undesirable effects such as dizziness, nervousness, decreased motor control, or limited concentration.

Aside from taking the orally administered THC, smoking marijuana or ingesting it in a baked form are also effective ways to treat nausea and vomiting. “Orally administered THC is slow in onset of action though longer in duration. Smoked marijuana produces an immediate effect that might be more desirable to patients” (Hollister, 2001). Smoking marijuana is not always recommended due to the fact that it can further complicate respiratory issues patients may already have.

In a study comparing oral THC to smoked marijuana, a total of 142 patients participated. “67 took the THC capsule, and 75 smoked a marijuana cigarette. Investigators found that both treatments were effective in decreasing CINV with no significant differences observed between the two treatments” (Cotter, 2009). It is important to know that many people are unable to tolerate the harshness of a marijuana cigarette, making it a poor option. As nurses, “infection can also be a concern when an immunocompromised patient is smoking marijuana because it contains many bacteria and fungi, as it is a natural substance” (Cotter, 2009).

Protein and Ginger

“Ginger has a long history of use as a home remedy against nausea, including nausea caused by drugs. It is slowly earning a reputation for its ability to quell nausea induced by some drugs- particularly chemotherapy” (Abascal & Yarnell, 2009).

There was a study done in 2007 that trialed the use of ginger for treating nausea in post chemotherapy patients that occurred 24 hours after their treatment according to Abascal & Yarnell, 2009. The study also included the use of protein mixed with ginger to determine whether or not this improved nausea in this group of patients. This open study consisted of “participants either ate their regular diet, their diet plus a protein drink and 1g of ginger, or their diet plus a high protein drink and 1g of ginger daily. The high-protein/ginger combination reduced the delayed nausea, and participants in that group used less antiemetic medication” (Abascal & Yarnell, 2009).

There was a study conducted in 2011, “composed of intervention (n=15) and control (n=30) patients where control patients received antiemetic drugs for ethical reasons and intervention patients received ginger tablets (800mg)” (Alparslan et al, 2012). According to Alparslan, 2012, “no nausea or vomiting was found to have occurred in those receiving ginger. The rate of nausea/ and or vomiting was 76.7% in the group using only antiemetic drugs. A significant difference was found between the group receiving ginger and the group receiving antiemetic drugs, suggesting that ginger is effective for nausea/and or vomiting (p ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download