SUCCESSFUL CONTROL OF INTRACTABLE NAUSEA AND VOMITING REQUIRING COMBINED ONDANSETRON AND HALOPERIDOL IN A PATIENT WITH ADVANCED CANCER

Chemically induced nausea and vomiting is a common symptom of advanced cancer effected through stimulation of dopamine (D2) or serotonin (5-HT3) receptors located in the chemoreceptor trigger zone (CTZ). These may be blocked by therapeutic doses of haloperidol and ondansetron, respectively. This case, reporting on a single patient acting as her own control, establishes that combined blockade of these receptors is sometimes required to relieve intractable nausea and vomiting. R also demonstrates the value of clinical review, audit of care, and quality assurance in the palliative care setting.