Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Japan began oral contraceptive (OC) clinical studies after 1987 when the government requested studies of 2400 menstrual cycles and a minimum of 100 patients for 12 cycles and 20-30 patients for 24 cycles. 3 monophasic, 1 biphasic, and 4 triphasic drugs were tested from 6 companies and all contained ethinyl estradiol with different progestins (norethindrone, levonorgestrel, or desogestrel). In phase I, the purpose was to examine the pharmacological effects and shortterm safety of all 8 drugs among a small number of healthy volunteers and a comparison of results with Western women. Phase II was eliminated. Phase III involved examination of toleration of the drug, dropout rate, effects on cycle control such as bleeding patterns, metabolism, and effects on hormone secretion. In phase I, Ortho Novum 7/7/7 was administered at 3 dose levels for 1 menstrual cycle and the results were toleration and minimal side effects. Some experienced bleeding, spotting, and breakthrough bleeding. Suppression of ovulation was successful. In phase III, 40 medical schools, 174 hospitals, and 200 investigators enrolled 648 patients of which 117 withdrew. Interim results among women 22-42 years show no adverse effects either in self- reports or laboratory tests. There were nuisance side effects such as nausea, weight gain, and headache, and some amenorrhea and bleeding during different cycles. There is a high continuation rate and patient satisfaction. Results from the full sample are still pending.
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PMID:The current status of oral contraceptive clinical development in Japan. 257 51

A young woman with acute intermittent porphyria is described. She was admitted in a prolonged attack and had developed a flaccid quadriplegia. During the course she showed various manifestations of the autonomic nervous system, including pupils, gastrointestinal tract, cardiovascular system and others. On admission her pupils were equally mydriatic, and reacted to light sluggishly. Dilation of the pupils was seen when cocaine was instilled, but not when adrenalin. It was suggested that the parasympathetic control of pupils was disturbed. She complained repeatedly abdominal pain, nausea, vomiting, and constipation. However, diarrhea was rarely found. Radiological examinations revealed that her bowel movements were markedly impaired. Sinus tachycardia and elevation of blood pressure were frequently observed with attacks, and they correlated with the clinical course. With tachycardia the coefficient variance of R-R interval was markedly decreased, and large dose of atropine failed to accelerate the heart rate. These indicate that the vagal function was markedly impaired with attacks. The effects of isoproterenol and of propranolol on the heart rate were normal. Phenylephrine and phentolamine changed the blood pressure normally. From these it was concluded that the sympathetic nervous function was not so impaired at the time examined. However, with the elevation of blood pressure plasma and urinary noradrenaline were markedly increased. Other autonomic and related manifestations observed during the course included disorders of sweating, loss of sphincter control, fever of unknown cause and amenorrhea.
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PMID:[Autonomic dysfunctions in acute intermittent porphyria]. 258 92

Primary hypothyroidism may be associated with enlargement of the sella turcica, due to thyrotroph hyperplasia, in its turn due to the lack of feedback control by thyroid hormones. It may develop independently of the severity or of the duration of thyroid failure. A 42-year-old woman was referred to us. She presented us with a CT scan compatible with a pituitary microadenoma, in the left part of the sella. The patient showed obvious signs of myxedema, due to subtotal thyroidectomy which had been performed 14 months before, because of the presence of multinodular goiter. After operation, the patient has been discontinuously and inappropriately treated with desiccated thyroid. She complained of headache, nausea, galactorrhea without amenorrhea. Serum T4 (0.8 micrograms/dl), serum T3 (47 ng/dl) and TSH (174.5 +/- 60.1 mU/l: M +/- SD of 4 assays) were compatible with primary hypothyroidism as confirmed by TSH hyper-response to i.v. TRH (200 micrograms) and i.v. domperidone (10 mg), and by the normal TSH decrease after orally administered 2.5 mg bromocriptine or 90 min continuously infused 800 micrograms GHIRH. Moreover, an abnormal GH response to TRH was observed, whereas basal and appropriately stimulated PRL levels were normal. Serum alpha-subunit was marginally high (5.92 ng/ml), but alpha-subunit/TSH molar ratio fell within the normal range (0.1 molar ratio). Complete suppression of basal and TRH stimulated TSH values was achieved after a 14-day L-T3 (120 micrograms per day) and 4-month L-T4 (200 micrograms per day) administration. L-T4 treatment, first administered at suppressive doses (200 micrograms per day for 4 months) and subsequently at substitutive doses (150 micrograms per day for 2 months), induced complete remission of symptoms along with normalization of the CT scan picture.
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PMID:Pituitary enlargement in post-surgical hypothyroidism misdiagnosed as thyrotroph neoplasia. Report of a case. 262 26

Four multicentre clinical trials on interruption of early pregnancy (less than or equal to 49 days of amenorrhea) using RU 486 have been conducted in China, including 2321 subjects. The data from trials 1, 2 and 4 are presented here. RU 486 (600 mg as a single dose) was given to 299 women. A further 422 women were given RU 486 (600 mg) plus a vaginal suppository containing the Chinese domestic prostaglandin PGO5 (1 mg) 36-60 hours later. Complete abortion was achieved in 63.5% of patients receiving RU 486 alone and in 94.1% of patients receiving RU 486 plus PG (p less than 0.001). RU 486 given alone showed decreasing efficacy as the duration of amenorrhea increased. However, RU 486 combined with PG was equally effective at all time points studied (less than or equal to 35 days of amenorrhea: 98.1%, 36-42 days: 92%, 42-49 days: 87.4%). When compared with RU 486 alone Ru 486 + PG also produced a shorter bleeding time and a lower volume of blood loss (n = 21, 52 ml vs n = 13, 117 ml). Two patients from the RU 486+PG group and 4 given RU 486 alone suffered heavy bleeding, necessitating emergency curettage. No transfusions were required. The time elapsed between RU 486 intake and expulsion of the conceptus was significantly shorter in the RU 486+PG group (n = 97, 31 days) than that in the RU 486 alone group (n = 95, 4.4 4.4 days). Main side effects, nausea/vomiting and headache/dizziness, were mainly due to RU 486. PG increased the incidence of diarrhea and uterine cramp.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:RU 486 (mifepristone): clinical trials in China. 269 37

A combination of the antigestagen mifepristone (RU 486) and a synthetic prostaglandin analogue, gemeprost, was used to induce therapeutic abortion in 100 women in early pregnancy. Local family planning services and general practitioners in Edinburgh referred women of less than 56 days' amenorrhea who had requested abortion. Pregnancy was confirmed by measurement of the serum level of human chorionic gonadotropin. Group I (n=20) received 150 mg mifepristone orally each day for 4 days. Groups II (n=30), III (n=30), and IV (n=20) received a single oral dose of mifepristone, 400 mg, 500 mg, or 600 mg, respectively. Samples of peripheral blood were collected at recruitment for measurement of the concentration of hemoglobin, urea, electrolytes, cortisol, and HCG and for liver function tests. Blood also was taken for estradiol and progesterone essay from women in Groups II, III, and IV. Each woman recorded symptoms in a diary from the day prior to the start of treatment. Study participants were reviewed 1, 2, and 4 weeks after treatment and discharged from followup after the onset of the next menstrual period. The effectiveness of the 4 treatment regimens was similar. Only 10 (14%) of the 74 women who received half a gemeprost pessary required the 2nd half. 95 of the women aborted completely; 5 women needed surgical intervention. Data were pooled for analysis because there was no significant difference between the 4 groups in the onset of bleeding and pain, requirement for analgesia, side effects, duration of bleeding, measured blood loss, and the time until the next menstrual period. The 94 women who experienced pain became aware of pelvic discomfort 46.6 hours after the initiation of treatment. No patient needed analgesia during the first 48 hours of treatment. After insertion of the pessary, 44 women received an oral analgesic drug and 9 an intramuscular opioid. 47 women did not need an analgesia. There was no significant difference in the frequency of nausea before and during treatment, but there was a significant increase in the incidence of vomiting and of diarrhea. 30 women vomited after the pessary was inserted compared with 13 the day before treatment; 10 women had diarrhea compared with 3 before treatment. No women had clinical evidence of pelvic infection. Liver function tests and cortisol levels were similar prior to and following treatment. Levels of HCG, and estradiol and progesterone decreased significantly after treatment. There were no significant differences in the results between those who needed evacuation and those who did not.
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PMID:Induction of therapeutic abortion in early pregnancy with mifepristone in combination with prostaglandin pessary. 289 91

Medroxyprogesterone acetate injections (Depo-Provera) were given to 625 women at 3 monthly intervals involving 693 episodes. Ages at entry to the study ranged from 15-51 years with the majority in their 20s and a mean age of 30. Length of exposure ranged from 3-168 cycles. 4 women have received more than 160 continuous cycles of DMPA. Of the medication-induced reasons for discontinuing DMPA, bleeding was the most common with an incidence of 10.5% followed by depression (1.4%), weight gain (1.4%), and loss of libido (1.6%). No patient ceased treatment because of headaches, recurrent vaginal infections, mastalgia, nausea, chloasma, hypertension, or other vascular illnesses. The 59 women who move away or were lost to follow-up accounted for 405 cycles of treatment. The solitary unplanned pregnancy occurred in a 28-year-old obese woman who had previously had other method failures, once with an IUD and once with oral contraceptives (OCs). No association was found with carcinoma of the cervix. Of 80 women ceasing treatment to become pregnant, only 1 women has required the assistance of chlomiphene and conceived 2 years after ceasing DMPA. Amenorrhea was the side effect most appreciated by the women using DMPA. Due to the problem of irregular bleeding, it is wise to warn prospective patients about the lack of bleeding control that they have 1 chance in 10 of having relative menorrhagia. Women using OC subject to frequent vaginal moniliasis had a marked reduction in episodes after switching to DMPA. Chloasma, 1 of the minor stigmas of OC, was not induced in any of the patients. DMPA is a safe and efficient reversible method of contraception for women who have various gynecological conditions or problems associated with using OCs.
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PMID:Medroxyprogesterone acetate as an injectable contraceptive. 296 70

Menopausal women receiving 0.625 mg/day conjugated oestrogen continuously for 6 mth were also given either 10 mg/day dydrogesterone continuously or 20 mg/day for the first 12 days of each calendar month in order to evaluate both the efficacy and the tolerance of each regimen. The following parameters were assessed: subjective symptoms, bleeding patterns, lipid metabolism, glycaemia, weight and blood pressure. Of the 81 patients who entered the study, 60 opted for the continuous treatment and 21 for the cyclic treatment. Seven (7) patients dropped out, 6 for administrative reasons and 1 because of nausea. The two groups were comparable with regard to all parameters, with the exception of the duration of pretreatment amenorrhoea, which was longer in the continuous-treatment group (40.6 vs. 19.1 mth), and the initial lipid profile levels, which were higher in the same group. The subjective symptoms were influenced rapidly and positively by both treatments. The other parameters remained unchanged, except for a clinically insignificant rise in triglycerides in both groups. Both treatments were quite satisfactorily accepted by the patients, in spite of a 70% rate of withdrawal bleeding in the cyclic group and a 40% rate of spotting in the continuous-treatment group. Sixty-two (62) patients remained free of side effects, while mastodynia was reported in 9 cases.
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PMID:Comparison of two equine oestrogen-dydrogesterone regimens in the climacteric. 304 26

RU-486 (or mifepristone developed by Roussel-Uclaf, France) is an antiprogesterone drug. Similar compounds have been introduced by Schering AG, Germany: ZK 98.734 and ZK 98.299. Epostane (Sterling- Winthrop, UK) is a progesterone synthesis inhibitor blocking the 3- beta-hydroxysteroid dehydrogenase enzyme system. In a WHO study 37 women at amenorrhea of 42 days or less were given 25, 50 or 100 mg mifepristone twice/day for 4 days: 22 patients had a complete abortion and 11 had an incomplete abortion. Success rate varied between 82.4% and 88.5% with a daily dose of 100 or 150 mg; 83% with 100 or 200 mg daily; and complete abortion occurred in 39% with 200 mg. 400 mg daily for 2 days produced complete abortion in 85%. 200 mg epostane 4 times/day for 7 days terminated pregnancy in 73%. 30 mg of ZK 98.734 given sc for 2 days induced complete abortion in guinea-pigs vs. 7 of 9 and 4 of 9 animals with equal doses of ZK 98.299 and mifepristone, respectively. Sequential therapy with 25 mg mifepristone twice/day produced regular uterine contractions. In administration of sulprostone (16-phenoxy-tetranor PGE2 methyl sulphonylamide); 1 mg of gemeprost (16, 16-dimethyl-trans-delta2-PGE1 methyl ester) given vaginally after mifepristone treatment; and vaginal administration of 10 mg PGE2 following 300-600 mg epostane daily for 5 days showed similar effects. In a clinical trial 25 mg mifepristone twice/day for 4 days followed by .25 mg sulprostone in injection led to complete abortion in 32 (94%) of 34 patients. All 5 women treated with 300, 400 or 600 mg doses of epostane and PGE2 daily for 5 days had abortion. Bleeding lasted 1-2 weeks in successful cases after mifepristone with blood loss of 87 +or- 9 ml and excessive bleeding in 0-5.6% of cases. Side effects were mild. Nausea occurred more often with 800 mg/day epostane than with 50 or 100 mg mifepristone. In a recent study 20 patients with 16-18 weeks of pregnancy were given 200 mg mifepristone before extra-amniotic infusion of PGE2, and the time needed to induce abortion and the total PGE2 dose required was reduced significantly.
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PMID:Anti-progesterones for the interruption of pregnancy. 306 65

This article serves as a summary of the principles of prescription, hormone content, minor side effects, prescriptions for atypical individuals and significant drug interactions for oral contraceptives. There are 5 principles for prescribing oral contraceptives: the lowest possible dose should be given that is effective and produces the least side effects: adequate instructions should be given about the mode of action, taking the medication and possible side effects; adequate instructions about managing missed pills should be given; adequate supervision and explanations should be given if side effects occur; remember that each woman is different and idiosyncratic reactions to different formulations can occur. Possible side effects include: breakthrough bleeding, amenorrhoea, dysmenorrhoea, breast fullness and tenderness, nausea, chloasma, depression, acne, migraines and weight gain. Certain individuals such as epileptics, diabetics, women over 35 and women who have recently given birth need special care. Rifampicin, the phenytoins and barbiturates can all decrease the effectiveness of oral contraceptives. Oral contraceptives may effect the action of anticoagulants, antidiabetic agents and imipramine.
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PMID:Choosing an oral contraceptive. 307 12

To evaluate the safety and effectiveness of Minulet, a new low-dose combination oral contraceptive (OC) containing 75 mcg of gestodene and 30 mcg of ethinyl estradiol, a multicenter trial involving 239 women was conducted in Switzerland. Of the 239 subjects, 187 (78%) were monitored for 6 cycles of OC use and 24 (10%) were followed for 3 cycles, yielding a total of 1265 cycles for observation. No pregnancy occurred during the study period, despite the fact that 1 or more pills had been forgotten in 17.1% of cases. Cycle length and the intensity and duration of bleeding were favorably affected by Minulet use, especially in women with a prior history of prolonged, heavy bleeding. Spotting occurred in 8.2% of subjects by cycle 3, but this rate was reduced to 5.9% by cycle 6. Breakthrough bleeding alone occurred in 2.1% of the cycles. The amenorrhea rate was 1.6% after cycle 6. There were no serious side effects, and symptoms such as headache, depression, breast tenderness, acne, nervousness, and dizziness were actually reduced as a result of OC use. Most notable was the decrease in dysmenorrhea, from 40% before beginning OC use to 13% after 3 months and 8% after 6 months. No significant effects on systolic or diastolic blood pressure were recorded among study participants, nor were there significant weight changes. Of the 17 women who terminated the trial due to side effects, metrorrhagia accounted for 17% of the terminations, depression for 14%, nausea for 14%, and headache for 13%. The findings of this trial, in terms of reliability, cycle control, and tolerability, suggest that Minulet has considerable potential as a new contraceptive choice.
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PMID:Clinical experience in Switzerland with the new monophasic oral contraceptive Minulet (75 mcg gestodene, 30 mcg ethinyl oestradiol). 307 5


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