Journal Club

Efficacy of Crude Marijuana and Synthetic Delta-9-Tetrahydrocannabinol as Treatment for Chemotherapy-Induced Nausea and Vomiting: A Systematic Literature Review

Jayme Cotter

alternative therapies, nausea/vomiting
ONF 2009, 36(3), 345-352. DOI: 10.1188/09.ONF.345-352

Purpose/Objectives: To synthesize the research to determine whether oral delta-9-tetrahydrocannabinol (THC) and smoked marijuana are effective treatments for chemotherapy-induced nausea and vomiting (CINV) and to evaluate side effects and patient preference of these treatments.

Data Sources: Original research, review articles, and other published articles in CINAHL®, MEDLINE®, and Cochrane Library databases.

Data Synthesis: Cannabinoids are effective in controlling CINV, and oral THC and smoked marijuana have similar efficacy. However, smoked marijuana may not be accessible or safe for all patients with cancer. Also, these drugs have a unique side-effect profile that may include alterations in motor control, dizziness, dysphoria, and decreased concentration.

Conclusions: This synthesis shows that cannabinoids are more effective than placebo and comparable to antiemetics such as prochlorperazine and ondansetron for CINV.

Implications for Nursing: Nurses should feel supported by the literature to recommend oral synthetic THC as a treatment for CINV to their patients and physician colleagues. Nurses should be cognizant of the side-effect profile for this medication and provide appropriate patient education.

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    Carrieri-Kohlman, V., Lindsey, A.M., & West, C.M. (Eds.). (2003). Pathophysiological phenomena in nursing: Human responses to illness. St. Louis, MO: Saunders.
    Chang, A.E., Shilling, D.J., Stillman, R.C., Goldberg, N.H., Seipp, C.A., Barofsky, I., et al. (1979). Delta-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate. A prospective, randomized evaluation. Annals of Internal Medicine, 91(6), 819-824.
    Deglin, J.H., & Vallerand, A.H. (2001). Davis' drug guide for nurses. Philadelphia: F.A. Davis.
    Frytak, S., Moertel, C.G., O'Fallon, J.R., Rubin, J., Creagan, E.T., O'Connell, M.J., et al. (1979). Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy. A comparison with prochlorperazine and a placebo. Annals of Internal Medicine, 91(6), 825-830.
    Gullatte, M.M. (2001). Clinical guide to antineoplastic therapy: A chemotherapy handbook. Pittsburgh, PA: Oncology Nursing Society.
    Hall, W., Christie, M., & Currow, D. (2005). Cannabinoids and cancer: Causation, remediation, and palliation. Lancet Oncology, 6(1), 35-42.
    Itano, J.K., & Taoka, K.N. (2005). Core curriculum for oncology nursing. St. Louis, MO: Elsevier Saunders.
    Lane, M., Vogel, C.L., Ferguson, J., Krasnow, S., Saiers, J.L., Hamm, J., et al. (1991). Dronabinol and prochlorperazine in combination for treatment of cancer chemotherapy-induced nausea and vomiting. Journal of Pain and Symptom Management, 6(6), 352-359.
    Mechoulam, R., & Hanu, L. (2001). The cannabinoids: An overview. Therapeutic implications in vomiting and nausea after cancer chemotherapy, in appetite promotion, in multiple sclerosis, and in neuroprotection. Pain Research and Management, 6(2), 67-73.
    Meiri, E., Jhangiani, H., Vredenburgh, J.J., Barbato, L.M., Carter, F.J., Yang, H.M., et al. (2007). Efficacy of dronabinol alone and in combination with ondansetron versus ondansetron alone for delayed chemotherapy-induced nausea and vomiting. Current Medical Research and Opinion, 23(3), 533-543.
    Musty, R.E., & Rossi, R. (2001). Effects of smoked cannabis and oral delta-9-tetrahydrocannabinol on nausea and emesis after cancer chemotherapy: A review of state clinical trials. Journal of Cannabis Therapeutics, 1(1), 26-56.
    Orr, L.E., McKernan, J.F., & Bloome, B. (1980). Antiemetic effect of tetrahydrocannabinol. Compared with placebo and prochlorperazine in chemotherapy-associated nausea and emesis. Archives of Internal Medicine, 140(11), 1431-1433.
    Robson, P. (2001). Therapeutic aspects of cannabis and cannabinoids. British Journal of Psychiatry, 178(2), 107-115.
    Sallan, S.E., Zinberg, N.E., & Frei, E., III. (1975). Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. New England Journal of Medicine, 293(16), 795-797.
    Ungerleider, J.T., Andrysiak, T., Fairbanks, L., Goodnight, J., Sarna, G., & Jamison, K. (1982). Cannabis and cancer chemotherapy: A comparison of oral delta-9-THC and prochlorperazine. Cancer, 50(4), 636-645.
    Vinciguerra, V., Moore, T., & Brennan, E. (1988). Inhalation marijuana as an antiemetic for cancer chemotherapy. New York State Journal of Medicine, 88(10), 525-527.
    Voth, E.A. (2003). A peek into Pandora's box: The medical excuse marijuana controversy. Journal of Addictive Diseases, 22(4), 27-46.