背景:合成大麻素通常用于治疗疼痛,恶心,肿瘤和姑息治疗中的呕吐。尽管目前接受大麻素作为恶心和呕吐的治疗选择,缺乏有关长期使用的副作用的数据,由于积累而导致可能的毒性,结果,恶心和呕吐加剧而不是缓解。病例报告介绍:患者,一位70岁的女性,住在姑息治疗病房,诊断为小细胞肺癌。她接受了一个由紫杉醇组成的化疗疗程,多西他赛,和顺铂.她出现了脱发,嘴巴酸痛,食欲不振,腹泻,神经痛,恶心,化疗后约5小时出现呕吐。在过去的5年中,纳比隆被用于治疗患者的神经痛。随着她的癌症进展,纳比隆的剂量从0.5毫克增加到2毫克,以控制她的疼痛;然而,它加剧了难治性恶心和呕吐。由于怀疑大麻素呕吐综合征,纳比隆在给药后7周停用。尝试使用临时缓解的热水澡。她的疼痛在阿片类药物和佐剂的作用下得到了很好的控制,并且自纳比隆停止以来没有出现恶心和呕吐的复发。
结论:成功识别和管理大麻素剧吐综合征对于合并疾病的个体尤其重要,以避免大麻毒性。
BACKGROUND: Synthetic cannabinoids are commonly used to manage pain, nausea, and vomiting in oncology and palliative care. Despite the current acceptance of cannabinoids as a treatment option for nausea and vomiting, there is a lack of data regarding the side effects of its prolonged use leading to possible toxicity due to accumulation, and as a result, exacerbation of nausea and vomiting rather than alleviation.
Case Report Presentation: The patient, a 70-year-old female, was residing in the palliative care unit with the diagnosis of small-cell lung cancer. She underwent a course of chemotherapy consisting of paclitaxel, docetaxel, and cisplatin. She presented with hair loss, sore mouth, a loss of appetite, diarrhea, neuralgia, nausea, and vomiting which developed approximately 5 h after chemotherapy. Nabilone was used for the last 5 years to manage the patient\'s neuralgia. As her cancer progressed, a dosage of nabilone was incrementally increased from 0.5 to 2 mg to control her pain; however, it exacerbated refractory nausea and vomiting. Nabilone was discontinued 7 weeks after administration due to suspicion of cannabinoid hyperemesis syndrome. Hot baths were attempted with temporary relief. Her pain became well controlled with opioids and adjuvants and there has been no recurrence of nausea and vomiting since the cessation of nabilone.
CONCLUSIONS: Successful recognition and management of cannabinoid hyperemesis syndrome is especially important in individuals with comorbid disorders in order to avoid cannabis toxicity.