Klinischer Einsatz von Cannabinoiden

Zusammenfassung

Hintergrund Cannabinoide gelten als wirksam in der Behandlung der chemotherapieinduzierten Übelkeit und Emesis (CINV). Palliativpatienten leiden neben einer Vielzahl anderer Begleitsymptome vor allem an Übelkeit und Erbrechen, deren Ursache vielseitig sein kann. Über den Einsatz von Dronabinol bei nicht chemotherapieinduzierter Übelkeit und Emesis gibt es nur wenige Berichte.

Methodik In einer retrospektiven Erhebung von 2012 – 2013 wurden Daten von Palliativpatienten mit therapierefraktärer Übelkeit und Emesis ausgewertet, die mit Dronabinol behandelt wurden. Übelkeit, Erbrechen und Appetitlosigkeit wurde dreimal täglich dokumentiert.

Ergebnisse Insgesamt wurden 33 Patienten mit Dronabinol behandelt. Im Verlauf der Dronabinol-Therapie zeigte sich eine Verbesserung in allen drei Symptomen. Der Anteil der Patienten, die stark unter Übelkeit, Erbrechen bzw. Appetitlosigkeit litten, nahm ab.

Schlussfolgerung Bei therapierefraktärer Übelkeit und Emesis ist die Behandlung mit Dronabinol zusätzlich zu etablierten Antiemetika sinnvoll. Für die Therapie des reduzierten Appetits ist Dronabinol erste Wahl, da hier kaum andere Optionen in der Palliativmedizin zur Verfügung stehen.

Abstract

Background Cannabinoids are considered beneficial in chemotherapy-induced nausea and vomiting (CINV). In addition to several problems, patients under palliative care often suffer from nausea and emesis; there are multiple causes for these symptoms. There are only a few reports available about the treatment of non-chemotherapy-induced nausea and emesis with dronabinol.

Methods In a retrospective analysis, data of palliative care patients with therapy-resistant nausea and emesis treated with dronabinol during 2012 to 2013, were evaluated. Severity of nausea, emesis and loss of appetite was assessed three times a day.

Results In total, 33 patients were treated with dronabinol. During treatment, improvements in all three symptoms were observed. The proportion of patients suffering from severe nausea, emesis or loss of appetite was reduced.

Conclusion Dronabinol represents an option for treatment-refractory nausea and emesis as an add-on therapy to established antiemetics. With respect to reduced appetite, dronabinol is the treatment of choice, as for this indication, there are only very few available options in palliative care.

Schlüsselwörter

Cannabinoide - Dronabinol - Chemotherapie - Übelkeit - Erbrechen - Appetitlosigkeit

Keywords

cannabinoids - dronabinol - chemotherapy - nausea - emesis - loss of appetite

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