When addressing anticipatory guidance about adverse effects of chemotherapy, which is the most common adverse effect?

• A. Pruritus
• B. Nausea and vomiting
• C. Altered glucose metabolism
• D. Confusion

Answer: (B)

Nausea and vomiting are the most common adverse effects of chemotherapy. Chemotherapy agents trigger the body's vomiting pathways, with serotonin release from the gut signaling the brain’s chemoreceptor trigger zone and vomiting center, leading to nausea (often acutely and sometimes delayed). Because this is so prevalent, anticipatory guidance emphasizes proactive prevention and management from the start: using antiemetic regimens that target multiple pathways (such as a 5-HT3 blocker plus a neurokinin-1 blocker and a corticosteroid), along with hydration, small frequent meals, and avoiding triggers. Other adverse effects like pruritus, altered glucose metabolism, or confusion can occur but are less common across most regimens.