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

In two placebo-controlled, double-blind, multicentre studies, the efficacy and safety of single oral doses of ondansetron 4 mg, 8 mg and 16 mg were evaluated for the prevention of postoperative nausea and vomiting in female inpatients. For the total study populations, 26% (European study) and 32% (US study) of placebo-treated patients experienced no emesis compared with 54% (European study) and 52% (US study) of patients treated with ondansetron 16 mg, the most effective dose. Similarly, 22% (European study) and 19% (US study) of placebo-treated patients experienced no nausea compared with 42% (European study) and 34% (US study) of ondansetron 16 mg-treated patients. All ondansetron doses in both studies were statistically superior to placebo (emesis p < or = 0.007; nausea p < or = 0.033). Slightly lower percentage differences in complete response between placebo and ondansetron for both nausea and emesis were observed for patients with a previous history of postoperative nausea and emesis compared with patients with no previous history, with ondansetron 16 mg being the most effective dose for both patient groups. In the US study, a slightly greater percentage of patients undergoing non-gynaecological surgery had no nausea and no emesis compared with patients undergoing gynaecological surgery in both the placebo and ondansetron treatment groups. Again, ondansetron 16 mg was the most effective dose in both surgery types. Ondansetron was well tolerated, with only headache being reported as a significant problem in both studies.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Single oral dose ondansetron in the prevention of postoperative nausea and emesis. The European and US Study Groups. 812 57

Ondansetron is a 5-hydroxytryptamine receptor antagonist which has shown activity in the prevention of emesis following cytotoxic and radiation therapy for cancer. We describe our experience using ondansetron in 25 patients undergoing fractionated total body irradiation (TBI) 12 Gy/3 days as conditioning for bone marrow transplantation. Antiemetic efficiency was investigated during the 3 days of TBI prior to high-dose cytotoxic chemotherapy. Twenty-two of the 25 patients (88%) achieved sufficient emesis control with less than three emetic episodes whereas the remaining 12% experienced three to five emetic events during their worst 24-h period. Eleven patients (44%) had complete control with no vomiting at all. Of 75 'patient days', 52 (69%) were without any emesis, 20 (27%) were associated with one to two and only three (4%) with three to five emetic episodes. Headache occurred in four patients (16%). No other significant adverse effects were seen, in particular no extrapyramidal reactions due to ondansetron. Our data confirm that ondansetron plays a major role in the antiemetic management of patients undergoing TBI.
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PMID:Ondansetron for efficient emesis control during total body irradiation. 820 86

Ondansetron is the first selective antagonist of the 5-hydroxytryptamine receptors (type 3) marketed for the prevention of emesis induced by antineoplastic agents. Ondansetron has been shown to be more active and less toxic than high-dose metoclopramide in patients submitted to cisplatin chemotherapy. Furthermore, when dexamethasone was added to ondansetron, its antiemetic efficacy increased significantly. In the prevention of emesis induced by a high single dose of cisplatin or by repeated low doses, ondansetron combined with dexamethasone has been shown to be the more efficacious and less toxic antiemetic treatment. However, in the prevention of delayed emesis from cisplatin, its role is still to be defined. In patients submitted to moderately emetogenic chemotherapeutic agents, ondansetron has shown an efficacy superior or equal to standard doses of metoclopramide, but is less toxic. Moreover, when compared with dexamethasone, its antiemetic efficacy and tolerability is similar; in this group of patients ondansetron should be used only when steroids fail. Ondansetron toxicity is generally mild; in particular, it does not induce extrapyramidal reactions. The most frequent side-effects are headache and constipation.
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PMID:Ondansetron. 842 20

Thirty-one selected patients with various haematological malignancies who received a 10 Gy-4 h total body irradiation (TBI) at the Institut Gustave Roussy 24 h before high dose cyclophosphamide for bone marrow transplantation, were prospectively evaluated for gastrointestinal symptoms, body temperature, consciousness, headache, xerostomia, parotiditis, ocular symptoms, blood pressure, and respiratory and cutaneous signs for 24 h. In spite of prophylactic administration of various anti-emetic agents, 90% of the patients experienced nausea and 80% experienced vomiting. An almost constant body temperature peak--up to 40.8 degrees C--was registered 6 h after the start of irradiation. No drowsiness was reported since the introduction of the new anti-emetic agent Ondansetron. Nearly half the patients (42%) complained of headache. The proportion of patients experiencing early (during TBI) xerostomia was 61%. 74% of patients complained of parotiditis in the first 24 h. Although this low dose rate whole body irradiation is not likely to be exactly replicated in many accidental human exposures, the incidence rate and the time-course of the observed prodromal phase symptoms may prove helpful for early triage in the case of accidental irradiation.
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PMID:Prospective study of the clinical symptoms of therapeutic whole body irradiation. 844 18

Ondansetron hydrochloride is a new serotonin receptor antagonist that is effective in preventing emesis associated with cancer chemotherapy. The antiemetic effect appears to be exerted through a peripheral vagal blocking within the gastrointestinal tract, as well as an inhibitory effect within the chemoreceptor trigger zone (CTZ). Plasma concentrations of ondansetron peak 1 hour after an oral dose, and the tablet has an absolute bioavailability of 59%. Ondansetron undergoes extensive hepatic oxidative metabolism in the liver. The half-life of ondansetron is 3.5 hours in healthy volunteers; elderly patients have a slightly reduced clearance, and pediatric patients have increased clearance. Although less than 10% of ondansetron is recovered unchanged in the urine, most metabolites are eliminated by this route. The recommended dose of ondansetron is 0.15 mg/kg for three doses on the day of chemotherapy (30 minutes before chemotherapy and 4 and 8 hours afterward). An alternative regimen includes a single-day dose of 32 mg IV in adult patients before chemotherapy. The efficacy of ondansetron therapy for delayed emesis has not been determined. Ondansetron has proven to be appropriate as a single agent or as an addition to standard antiemetic therapy (ie, corticosteroids, benzodiazepines, neurotransmitter blockers) in preventing and treating acute chemotherapy-induced emesis (CIE). Initial results of clinical trials in prevention of radiotherapy-induced emesis and anesthesia-induced emesis appear positive. Ondansetron is well tolerated, with few adverse events (eg, headache, sedation).
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PMID:Ondansetron: a novel antiemetic agent. 848 93

Postoperative nausea and vomiting (PONV) are common side effects after surgery and have numerous patient factors and etiologies. Although self-limiting, PONV is not without risks and complications. In the past numerous antiemetics have been used successfully in the management of PONV; however, these drugs are associated with adverse effects. Ondansetron is a serotonin receptor antagonist that is effective in preventing and treating PONV. It is believed that ondansetron binds at the serotonin receptor both in the vagal afferents of the gastrointestinal tract and in the chemoreceptor trigger zone. The reported side effects from ondansetron are minor compared with those of the more commonly used antiemetics such as droperidol and metoclopramide and include headache, dizziness, musculoskeletal pain, drowsiness and sedation, and shivers.
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PMID:Ondansetron: perioperative use of a serotonin receptor antagonist for the prevention and treatment of nausea and vomiting. 863 70

The new antiemetic ondansetron is effective for the prophylaxis and treatment of postoperative nausea and vomiting (PONV), but has been subject to limited comparative evaluation in surgical inpatients. Two hundred and seventy women having abdominal gynaecological surgery were investigated for 24 hours postoperatively in a randomized, double-blind, placebo-controlled study of intraoperative intravenous ondansetron 8 mg (n = 83), droperidol 2.5 mg (n = 89) or saline placebo (n = 87). Patients receiving either ondansetron or droperidol remained likely to vomit, although the incidence was significantly reduced compared with placebo (72% and 83% versus 91%, P < 0.01). Both drugs also resulted in significantly fewer vomiting episodes (P < 0.001), lower nausea scores (P < 0.05) and a lower incidence of patients requiring treatment for PONV (P < 0.01). Compared with droperidol, the risk of vomiting after ondansetron was less (odds ratio 0.5, CI 0.3-1.0). Ondansetron resulted in fewer vomiting episodes (P < 0.05) and a higher percentage of patients free of nausea after six hours postoperatively (P < 0.05). In patients with a past history of PONV, both drugs had a similar short-lived antiemetic effect, reducing the incidence of vomiting and the need for treatment while in the recovery room, but not thereafter. Droperidol was associated with significantly less headache (P < 0.05), but higher early sedation scores (P < 0.05). Although, compared to placebo, both droperidol and ondansetron administered intraoperatively reduced vomiting after major abdominal gynaecological surgery, the incidence during the first 24 postoperative hours was very high in all groups. Ondansetron reduced the risk of experiencing nausea after six hours postoperatively and the risk of vomiting, with respect to the total number of episodes, in the first 24 hours. It was no better than droperidol, however, in reducing the incidence of vomiting or the need for antiemetic treatment during the first postoperative day, whether or not patients had a past history of PONV. It was no better than droperidol, however, in reducing the incidence of vomiting or the need for antiemetic treatment during the first postoperative day, whether or not patients had a past history of PONV.
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PMID:Single-dose prophylaxis for postoperative nausea and vomiting after major abdominal surgery: ondansetron versus droperidol. 878 52

Six children developed severe daily migraine-type headaches during cancer treatment. In addition to chemotherapy drugs, all received daily doses of ondansetron, a 5-hydroxytryptamine type 3 receptor antagonist. 5-Hydroxytryptamine is considered to play a central role in migraine pathogenesis, and ondansetron may have caused headaches by producing 5-hydroxytryptamine dysfunction in the brain. All six children had either a personal or a family history of migraine, and this may be a risk factor for developing ondansetron-associated migraine-type headaches. Ondansetron-induced headaches respond to withholding the drug and to standard antimigraine medications, but further study of a larger group of patients is required to confirm this impression.
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PMID:Migraine-type headaches in children receiving chemotherapy and ondansetron. 1258 31

We investigated the effect of serotonergic agonists and antagonists injected intrathecally by direct punction of the spinal cord at the lumbar level (between L5-L6) on peripheral inflammatory edema. Edema was induced by carrageenan injected subcutaneously in one hindpaw 30 min after spinal treatments. Serotonin (0.1, 1, 10 pmol) caused a graded-inhibition of the inflammatory paw edema. The corticosteroid inhibitor aminoglutethimide (100 mg/kg, p.o. 1.5 h before spinal treatment) did not modify this effect. The 5-HT1A agonist buspirone and the 5-HT1B/1D agonist sumatriptan (0.1, 1.0 and 10 nmol) also inhibited paw edema. The 5-HT1,2 antagonist methysergide (10 and 100 pmol) enhanced edema, but higher doses ( 4 and 8 nmol) diminished edema. NAN-190 (5-HT1 antagonist; 1 and 10 nmol) increased paw edema, while ritanserin (5-HT2 antagonist; 1 nmol) inhibited paw edema. Ondansetron (5-HT3 antagonist; up to 10 nmol) did not affect edema, but metoclopramide (5-HT3 antagonist / 5-HT4 agonist; 5, 10 and 30 pmol) inhibited edema. These data suggest that a tonic release of serotonin in the spinal cord may occurs during ongoing peripheral inflammation, modulating the neurogenic component of edema either by an inhibitory action on 5-HT1 receptors or by a stimulatory action on 5-HT2 receptors. A disfunction in such mechanism may be involved in the pathophysiology of certain types of headaches or migraine, which seem to depend on neurogenic vasodilation, and may also help to explain the therapeuthic effectiveness of some serotonergic agents in these conditions.
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PMID:Evidence for a spinal serotonergic control of the peripheral inflammation in the rat. 1574 28


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