Which chemo agent causes delayed nausea and vomiting?

• A. Etoposide
• B. Cisplatin
• C. Vincristine
• D. Bleomycin

Answer: (B)

Delayed nausea and vomiting refers to symptoms that begin more than 24 hours after chemotherapy and can last several days. The drug most strongly linked to this delayed phase is cisplatin. It has one of the highest emetogenic potentials, with a pronounced delayed N/V component that often persists beyond the first day. The acute phase (within 24 hours) is largely driven by serotonin release, but the delayed phase involves additional pathways (like neurokinin-1 signaling), which is why regimens targeting both 5-HT3 and NK1 receptors plus dexamethasone are used for cisplatin. Other drugs in the list can cause nausea, but they are not as strongly associated with a prominent delayed component as cisplatin.