Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A double-blind random study compared the effects of lorazepam and pantopon an intra-muscular premedication in healthy women for uterine curettage (D & C). Anxiety, as assessed by a self-rating test by the patient and by a trained observer, showed a significant reduction at one and one-half hours after lorazepam and a smaller reduction after pantopon, which was not significant. Sedation was satisfactory with no significant difference between the two drugs in the change before and after the premedication. Lorazepam showed much more amnesia than pantopon (p less than 0.001). The patients who had lorazepam required higher doses of thiopentone for the operation, and this, in part, led to longer intervals in recovery times after lorazepam. However, it is suggested that lorazepam itself was partly responsible for the longer recovery. Pantopon was followed by more nausea, vomiting and headaches, than lorazepam. The intra-muscular injection of lorazepam hurt more patients than did pantopon, but other local complications were negligible and comparable in both groups. The results of this study show that lorazepam produces better reduction of anxiety and much more amnesia than pantopon, with comparable sedation and much less nausea and vomiting. The only disadvantage of lorazepam is the lack of analgesia and, therefore, the need for more anaesthesia during the operation. The conclusion is that lorazepam is a very satisfactory premedication and warrants more use as such.
 ...
PMID:Lorazepam as a premedication. 0 77

Three hundred and forty-six nulliparous women with pregnancy-induced hypertension prior to term were monitored in a high-risk pregnancy unit while awaiting fetal maturity. Management included ambulation as desired, regular hospital diet without salf restriction, blood pressure measured 4 times daily, weight and urine protein determined 3 times each week, creatinine clearance determined weekly, and serial sonography to monitor fetal growth. Sedation and antihypertensive agents were not prescribed. Delivery was delayed until term unless hypertension persisted or recurred following an initial salutary response. Factors other than hypertension that contributed to the decision to effect delivery were 1) rapid weight gain, 2) decreasing creatinine clearance, 3) appearance of significant proteinuria, 4) suspected fetal growth retardation, and 5) the development of severe headache or scotomata. With this method of management the perinatal mortality rate was 9/1000. Only 5 infants developed the respiratory distress syndrome and all survived. There were 26 women who left the unit against medical advice. Severe hypertension subsequently developed in 7 of these women and 4 of their fetuses were stillborn. The perinatal mortality rate among this group of patients was 154/1000. It is concluded that the nulliparous patient with pregnancy-induced hypertension prior to term can be safely managed by hospitalization and close observation as a viable alternative to prompt delivery.
 ...
PMID:Management of pregnancy-induced hypertension in the nullipara. 94 68

Ondansetron is a selective 5-HT3 antagonist with significant antiemetic properties in patients receiving cytotoxic chemotherapy. Patients who had suffered severe vomiting on carboplatin alone (23 patients with ovarian carcinoma) or in combination (two patients with testicular cancer) despite intensive antiemetic regimens were treated with ondansetron, given as 8 mg immediately prior to carboplatin followed by 8 mg orally, 8 hourly for 5 days. Twenty-five patients received 58 courses of ondansetron. In the first 24 h after the first course of chemotherapy with ondansetron, 17 patients (68%) experienced no vomiting, five patients (20%) had almost complete control and the other three patients had partial control. During the subsequent 4 days slightly lesser control was achieved. Nausea was similarly controlled in most patients. Twenty-two patients stated a preference for ondansetron with future chemotherapy. Fourteen patients received additional chemotherapy with ondansetron and in only three patients did the efficacy of therapy lessen. Toxicity was mild and transient with headache and constipation predominant. No extrapyramidal reaction was seen. Sedation was absent. Ondansetron is highly effective in refractory vomiting associated with carboplatin chemotherapy. It may be particularly beneficial when an extrapyramidal reaction has occurred on previous antiemetics and when sedation is unacceptable.
 ...
PMID:Reduction of carboplatin induced emesis by ondansetron. 182 54

Animal studies and the original study comparing buspirone with diazepam and placebo indicated that sedative-hypnotic side effects and impairment in psychomotor function would be less with buspirone than with diazepam. This was borne out by the present double-blind study in which almost 700 patients received buspirone. Mean daily doses were buspirone, 20 mg; diazepam, 20 mg; and clorazepate, 24 mg. Sedation, lethargy, and depression were significantly less with buspirone than with diazepam or clorazepate and were comparable to placebo. There was no indication that other types of side effects would differ significantly from those seen with the benzodiazepines. Nervousness, headache, and dizziness were experienced more frequently with buspirone than with placebo.
 ...
PMID:The side effect profile of buspirone in comparison to active controls and placebo. 613 65

Loratadine is a long-acting antihistamine agent, exhibiting partial selectivity for peripheral histamine H1-receptors. To date, loratadine has been evaluated in allergic rhinitis, urticaria and, to a limited extent, in asthma. In several large controlled comparative clinical studies, loratadine was superior to placebo, faster acting than astemizole and as effective as azatadine, cetirizine, chlorpheniramine (chlorphenamine), clemastine, hydroxyzine, mequitazine and terfenadine in patients with allergic rhinitis and chronic urticaria. The clinical effectiveness of loratadine in asthma is at present unclear. Loratadine is well tolerated. At dosages of 10 mg daily, commonly reported adverse events were somnolence, fatigue and headache. Sedation occurred less frequently with loratadine than with azatadine, cetirizine, chlorpheniramine, clemastine and mequitazine. Serious ventricular arrhythmias, as reported with some other second generation histamine H1-receptor antagonists, have not been observed with loratadine to date. Thus, loratadine, with its attributes of once daily administration, fast onset of action and essentially nonsedating properties, would appear to be an appropriate first-line agent for the treatment of allergic rhinitis or urticaria.
 ...
PMID:Loratadine. A reappraisal of its pharmacological properties and therapeutic use in allergic disorders. 752 33

We investigated the antiemetic efficacy and safety of intravenous ondansetron infusion in the BMT setting. We conducted prospective randomized comparison trials between ondansetron at 2 dose levels and metoclopramide (MCP) plus droperidol for the prevention of chemotherapy-induced nausea and vomiting in 2 patient populations scheduled to undergo BMT. One patient population (n = 30) received CY alone, the other population (n = 30) received combination chemotherapy of Bu and CY. The CY alone group received ondansetron for 3 days, and the Bu/CY group received ondansetron for 7 days. The primary endpoints were emesis control and nausea. Secondary endpoints included acute (headache, diarrhea and sedation) and delayed (engraftment and regimen-related) side-effects. In both trials, ondansetron provided better emesis control than did MCP plus droperidol during CY administration (P = 0.009, 3-day trial; P = 0.0022, 7-day trial). There was a wide interpatient variation in serum ondansetron levels, although group averages were proportional to the dose administered. Intrapatient day-to-day variation was 10-30% and did not change significantly with concurrent CY administration. Antiemetic efficacy did not correlate with ondansetron serum levels at the doses tested. Headache incidence was similar in all groups. Sedation was highest in the MCP plus droperidol group (P = 0.048, 3-day trial; P = 0.016, 7-day trial). No statistically significant differences in engraftment or regimen-related toxicities were observed between groups in either trial. Ondansetron appears to be a safe and efficacious antiemetic during conditioning for BMT.
 ...
PMID:Antiemetic efficacy and pharmacokinetics of intravenous ondansetron infusion during chemotherapy conditioning for bone marrow transplant. 758 Nov 39

Traditional centrally acting antihypertensives have been associated with a high incidence of adverse effects and are no longer recommended as first-line therapy. The newer imidazoline receptor agonists must overcome this reputation if they are to gain recognition as potential first-line agents for hypertension. Methyldopa, a centrally acting alpha(2)-agonist, is characterized by a number of serious adverse reactions that limit its use. Although unpredictable idiosyncratic or hypersensitivity reactions are uncommon, these include hepatitis, myocarditis, and hemolytic anaemia. Less serious problems such as abnormal liver function tests, positive Coombs test, drug-induced fever, and pancreatitis also occur. Central side effects include drowsiness, fatigue, lethargy, sedation, depression, psychotic reactions, nasal stuffiness, impotence, and exacerbation of Parkinsonism. In hypertensive men, methyldopa is less well tolerated than either captopril or propranolol, and up to 20% of patients discontinue therapy because of adverse effects. Clonidine acts primarily as an alpha(2)-agonist but also acts as an agonist at imidazoline receptors in the rostroventrolateral medulla. It is equipotent to most other antihypertensives but is considerably less well-tolerated in comparative trials. The principal adverse effects of clonidine are drowsiness, sedation, lethargy and dry mouth. Reserpine acts primarily by depleting central catecholamine neurotransmitter stores. It was very extensively used in early hypertension trials, but its central side effects of sedation, nasal stuffiness, and severe depression are now considered so undesirable that the drug is seldom prescribed. The imidazoline (I1) agonists moxonidine and rilmenidine act selectively and have very little central alpha(2)-agonist activity. In comparative studies against placebo and other reference antihypertensives, the only adverse effect consistently associated with these drugs was dry mouth (approximate placebo-corrected incidence 10%). Sedation was not pronounced. Withdrawal syndromes are complex pathophysiologic processes and occur with a variety of antihypertensive drugs. Cessation of therapy with clonidine and, to a lesser extent, methyldopa may result in a severe withdrawal syndrome characterized by restlessness, sweating, anxiety, tremor, palpitations, and headache. There may be a rapid rise in blood pressure, often with a true "rebound" to higher than pretreatment levels. Plasma and urinary catecholamine levels are increased, and fatalities have been reported. It is important to stress that such a syndrome has not been recorded, in animal or human studies, with either moxonidine or rilmenidine.
 ...
PMID:Aspects of tolerability of centrally acting antihypertensive drugs. 887 99

A meta-analysis of clinical trials of antihistamines was performed to assess the risk-benefit ratio of this therapeutic class in asthma. Double-blind randomized placebo-controlled trials assessing lung function changes under repeated use of antihistamine in adult asthma were selected, and the quality of studies was scored. Morning peak expiratory flow rate (PEFR) was the primary outcome: an effect size was computed for each study, with a 95% confidence interval (95% CI), and a mean effect size was computed, combining all studies. Effect sizes were also determined for secondary outcomes: evening PEFR, forced expiratory volume in one second (FEV1) and daily use of inhaled beta-agonists. Nineteen studies were included in the meta-analysis. Mean quality score of studies was 59.4%; asthma was generally uncontrolled at study inclusion. Altogether, 582 antihistamine-treated and 557 placebo-treated asthma patients were evaluable. Antihistamines had little effect on airway calibre (mean increase in morning PEFR: 13 L x min(-1); 95 CI: 8-18 L x min(-1)) and on use of inhaled beta-agonists (mean reduction in daily use: 0.4 doses; 95% CI: 0-0.8 doses). Sedation occurred more often with antihistamines than with placebo (p<0.001); additional side-effects were mentioned, including weight gain, altered taste, headache and dry mouth. Respiratory and systemic effects observed after repeated use of antihistamines do not support the use of these medications in the treatment of asthma; better designed studies could affect this appraisal.
 ...
PMID:Effects of antihistamines in adult asthma: a meta-analysis of clinical trials. 938 43

The objective of this study was to determine whether analgesia-sedation improved patient acceptance of day-case herniorrhaphy and to evaluate the extent of patient morbidity. A total of 98 patients (mean age 34 years, range 17-75 years) were studied before and after herniorrhaphy to determine their response to the procedure. All patients were unpremedicated and underwent herniorrhaphy using a Bassini repair technique with a standard local anaesthetic block. Sedation was obtained with titrated intravenous midazolam(Hypnovel, Roche Products Ltd.) without narcotic analgesia. Patients were evaluated with a simple questionnaire after surgery. The maximum dose of midazolam used was 5 mg (median dose 3.5 mg). Monitoring of vital signs with pulse oximetry during the operative period was routine though oxygen therapy was not required. All patients were able to walk without assistance and were discharged under responsible supervision. Operative morbidity was low (5%). Adverse reactions to the procedure such as nausea, vomiting and headache were not seen. In conclusion, conscious sedation allows amnesia to be achieved with low morbidity in the majority of patients undergoing local anaesthetic procedures. This should result in increased patient acceptance.
 ...
PMID:Analgesia-sedation for day-case inguinal hernia repair. A review of patient acceptance and morbidity. 1094 57

The present study evaluated self-reported subjective complaints (29 single items and 11 scales) at precessation, on quit day, and on Days 1, 2, 3, 7, 14, 21, and 28 after cessation in 46 healthy quitters who remained abstinent for the first month after cessation (biochemically confirmed). Also tested on the same schedule were 29 nonsmokers matched for age and gender. Specific criteria were set for transient and offset effects based on the direction, magnitude, and time course of changes in symptoms after cessation. Results indicated that single-item anger, anxiety, depression, difficulty concentrating, irritability, restlessness, dizziness, and nausea, and the Shiffman-Jarvik Stimulation/Sedation Subscale, the Perceived Stress scale, and the POMS anger, confusion, and tension subscales met the criteria for transient effects, and that single-item desire to smoke, cough, and headache, and the Shiffman-Jarvik Psychological Subscale met the criteria for offset effects. These findings help to clarify which subjective complaints after smoking cessation are transient effects and which are offset effects, a distinction with important implications for understanding nicotine dependence and for designing pharmacological and nonpharmacological interventions for smoking cessation.
 ...
PMID:Self-reported abstinence effects in the first month after smoking cessation. 1143 24


1 2 Next >>