Initial management options A. bulk laxative B. bisphosphonate C. centrally acting anti emetic D. corticosteroid E. stimulant laxative F. opioid analgesic G. prokinetic anti emetic agent H. rehydration 1. A 68 years old man has widespread metastatic disease from a bronchial carcinoma requires regular opioid analgesia. he is suffering from nausea and vomiting. 2. A 58 years old man with inoperable gastric carcinoma has severe anorexia. 3. A 70 years old woman has vomiting and increasing confusion. initial tests show packed cell volume of 55% and hypercalcaemia.