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)

Cough is an important defensive reflex of the upper airway and is also a very common symptom of respiratory disease. Cough after an upper respiratory virus infection is transient, and persistent cough is associated with a whole range of conditions such as asthma, rhino-sinusitis, gastro-oesophageal reflux. Treatment directed at these conditions may improve the associated cough. There is often a need, however, to control cough itself, whatever the cause. The most effective drugs in this class are the opioids, such as morphine, codeine or pholcodeine, but at effective doses they have side-effects such as drowsiness, nausea, constipation and physical dependence. Investigations into the cough reflex and into the potential mechanisms of sensitised cough reflex have uncovered several potential targets for novel drugs. New opioids such as k- and d-receptor agonists apart from m-agonists have been developed, in addition to non-opioid, nociceptin. Neurokinin receptor antagonists, bradykinin receptor antagonists, vanilloid receptor VR-1 antagonists may be beneficial by blocking effects of tachykinins, and sensory nerve activation. Local anaesthetics, blockers of sodium-dependent channels, and maxi-K CA2+-dependent channel activators of afferent nerves are inhibitors of the cough reflex. Some of these novel agents may act centrally or peripherally or at both sites as antitussives. Large scale trials of these novel compounds have not been tried in cough in man, but there is a serious need for more effective antitussives devoid of side-effects.
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PMID:Therapy for cough: active agents. 1209 88

Four cases of asthma (one adult, three children) developing acute adrenal crisis after introduction of high-dose inhaled fluticasone proprionate are presented. The three children, aged 7-9 yrs, had been prescribed inhaled fluticasone, dosage 500-2,000 microg x day(-1) and duration 5 months-5 yrs. All presented with convulsions due to hypoglycaemia (blood glucose 1.3-1.8 mM). The fourth case was a male of 33 yrs with difficult-to-control asthma and had been taking fluticasone propionate 1,000-2,000 microg x day(-1) for 3 yrs. He presented with fatigue, lethargy, nausea and postural hypotension. Acute adrenal crisis in each case was confirmed by investigations which included measurement of acute phase cortisol levels, short and long Synacthen stimulation tests and glucagon stimulation tests. Other cases of hypthoalamic-pituitary-adrenal axis suppression were excluded.
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PMID:Acute adrenal crisis in asthmatics treated with high-dose fluticasone propionate. 1210 82

The management of dementia patients encompasses pharmacologic, behavioral, and psychosocial intervention strategies. Before pharmacologic intervention is instituted, it is important that sources of excess disability and comorbidity be eliminated or reduced. Identification of comorbid medical and psychiatric conditions, such as depression and delirium, should be identified and appropriately treated. Providing caregivers with education, support, and practical advice is a critical component of the management of the demented patient. The current standard of care for pharmacologic management of the cognitive and functional disabilities of AD consists of the combination of a cholinesterase inhibitor and high-dose vitamin E. This standard is based on the results of large-scale, double-blind, placebo-controlled trials. Cholinesterase inhibitors are the only FDA-approved pharmacologic treatments for AD. Cholinesterase inhibitors have been shown to be effective in the treatment of the cognitive, behavioral, and functional deficits of AD. Large-scale placebo-controlled trials of tacrine, donepezil, rivastigmine, and galantamine have demonstrated moderate benefits in patients with mild to moderate AD. Donepezil, rivastigmine, and galantamine are the first-line choices in the treatment of AD because of their lack of hepatotoxicity, ease of administration, few significant drug-drug interactions, and mild to moderate side effects. There are few contraindications to the use of cholinesterase inhibitors. Known hypersensitivity to a specific drug or its derivatives is the only true contraindication. Cautious administration of cholinesterase inhibitors is advised in patients who have a previous history of allergy or adverse reactions to prior cholinesterase inhibitors, severe liver disease, preexisting bradycardia, peptic ulcer disease, current alcoholism, asthma, or chronic obstructive pulmonary disease. Nausea, vomiting, diarrhea, and anorexia are the most common side effects of cholinesterase inhibitors. These gastrointestinal side effects can be minimized by gradual dose increases, administration with food, adequate hydration, and judicious use of an antiemetic. Vitamin E has been demonstrated to slow the progression of AD in several small and one large placebo-controlled trials. Because of its low cost and safety, it is recommended in addition to a cholinesterase inhibitor for the treatment of AD. There are no FDA-approved treatments for DLB and VaD. One small placebo-controlled trial demonstrated that rivastigmine may be effective in the treatment of DLB. More large-scale placebo-controlled trials are needed to confirm the results of this study. Treatment of VaD focuses on the control, identification, and management of cerebrovascular disease and vascular risk factors. Although there are no peer-reviewed reports on the efficacy of cholinesterase inhibitors for VaD or mixed AD/VaD, early reports suggest that these agents may also be effective for mixed AD/VaD. The indications for the use of cholinesterase inhibitor drugs are eventually likely to broaden to include DLB, mixed AD/VaD, and AD in its more advanced stages.
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PMID:Pharmacologic treatments of dementia. 1217 Oct 61

During the period between 1992 and 1997, there was an increase in levels of methyl tertiary butyl ether (MTBE) in gasoline in the Philadelphia, Pennsylvania, area. In this study, the authors analyzed billing records from clinical practices that were extensions of the University of Pennsylvania. The authors based their selections on the International Classification of Diseases-9 diagnostic codes, which were determined from (1) previous studies of methyl tertiary butyl ether conducted by the Centers for Disease Control; (2) respiratory symptoms, including asthma and wheezing; and (3) symptoms associated anecdotally with methyl tertiary butyl ether levels in gasoline. The authors normalized all data by the total number of office visits. The incidences of headache, throat irritation, allergic rhinitis, cough, nausea, dizziness, upper respiratory infections, wheezing, otitis media, skin rash, anxiety, insomnia, palpitations, generalized allergy, and malaise were increased during the period studied. Large increases occurred during the winters of 1993-1994 and 1994-1995 (during which there were high levels of MTBE), but not in the preceding summers (during which there were low levels of MTBE). This was especially true for asthma and wheezing. During the summers of 1995, 1996, and 1997, the incidences of the aforementioned symptoms increased greatly.
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PMID:Visits to physicians after the oxygenation of gasoline in Philadelphia. 1219 59

(1) Dry mouth (xerostomia) is a frequent complication of radiation therapy for cancers of the ear nose and throat. Local measures such as saliva substitutes and anetholtrithione are either moderately effective, inadequately evaluated or little better than placebo. (2) Marketing authorization has been granted in France for an oral formulation of pilocarpine, an old parasympathomimetic agent, in the treatment of radiotherapy-induced xerostomia. (3) According to the results of two double-blind trials, pilocarpine (15-30 mg/day) improves symptoms in about 50 % of patients, compared to improvement in 25% of patients taking placebo. The drug is slow to take effect and has little impact on daily life. It is not known whether pilocarpine helps prevent the complications of xerostomia. (4) Most adverse effects of pilocarpine are due to its parasympathomimetic effects, such as sweating, urinary frequency, flushing, rhinitis and nausea. Pilocarpine must therefore be used with caution in patients with asthma, cardiac arrhythmia, iridocyclitis, and closed-angle glaucoma. (5) In France, this pilocarpine formulation costs 18 times more than a preparation of pilocarpine 2% eye drops used orally (off licence). (6) In practice, patients needing symptomatic treatment of xerostomia after radiotherapy may benefit from oral pilocarpine but, given its limited efficacy and its adverse effects, other local treatments should be tried first.
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PMID:Oral pilocarpine: new preparation. Xerostomia after radiation therapy: moderately effective but costly. 1219 76

Vomiting, the culminating sign of nausea, is primarily a protective reflex occurring in a wide variety of vertebrates. Even tough nausea and vomiting are among the most basic neural reflexes, they remain poorly understood. Poorly understood are the pathogenetic mechanisms from the anatomic receptor and neuroendocrine point of view. This is the reason why drugs are useful in some types of vomiting but not in others. The aim of this paper is to summarize current knowledge about anatomy of vomiting reflex, neurotransmitter receptor subtypes, agonists and antagonists of serotonin and substance P. Particularly in the treatment of post-chemotherapy and postoperative vomiting. It is pointed out that nausea an vomiting may be field of neurochemical and neuropharmacological research. Finally, in clinical research drugs for vomiting therapy may be useful in other pathologies (migraine, rheumatoid arthritis, bronchial asthma).
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PMID:[Vomiting]. 1220 99

Zafirlukast, a competitive cysteinyl leukotriene receptor antagonist, is a new class of asthma medications. It has shown an adverse event profile similar to that of placebo. Herein, we present a 69-year-old female patient who suffered from general malaise, poor appetite, nausea and jaundice after 3 months of zafirlukast therapy for asthma. She had no past history of liver disease, nor history of alcoholism, herb medication, blood transfusion, acupuncture, tattoo or recent traveling history. Liver biochemistries revealed elevated serum alanine aminotransferase and aspartase aminotransferase levels up to 481 U/L and 212 U/L, respectively. Moreover, peak serum total bilirubin level was elevated to 34.8 mg/dL during admission. Serum viral hepatitis marker, antinuclear antibody, anti-mitochondrial antibody and anti-smooth muscle antibody were all negative. Her general condition and liver biochemistries improved gradually after zafirlukast was discontinued. Roussel Uclaf causality assessment for adverse drug reaction confirmed the diagnosis of drug-induced liver injury. This case reminds us that zafirlukast is a potentially hepato-toxic drug. If clinical manifestations of hepatitis develop, patients should be managed cautiously and closely monitored for liver biochemistries. If drug-induced hepatitis is suspected, medication should be discontinued immediately to prevent further liver injury.
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PMID:Zafirlukast-induced acute hepatitis. 1258 21

From 1994 to June 2001, 15 parturients weighing more than 100 kg underwent cesarean section at our institution. Their medical and anesthetic records were reviewed retrospectively. They consisted of 10 primiparous and 5 multiparous patients. Mean body weight was 108.4 +/- 6.3 kg (mean +/- SD) and body mass index (weight in kilograms/[height in meters]2) was 41.6 +/- 2.8 kg.m-2 (min 36.6, max 49.7). Maternal complications included preeclampsia (n = 7, 46.7%), diabetes mellitus (n = 6, 40%) and asthma (n = 1). Of 15 patients, cesarean section was performed under spinal anesthesia in 11 patients and under epidural anesthesia in 4, and none received general anesthesia. All the patients gave live births. Intraoperative complications included hypotension (n = 6) and nausea (n = 3). All of them were free from the morbid postoperative complications except wound dehiscence occurring in four patients.
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PMID:[Anesthesia for 15 morbidly obese parturients undergoing cesarean section]. 1264 69

Cough is an important defensive reflex of the airway and a common symptom of respiratory disease. After an upper respiratory tract virus infection, cough is transient, but is more persistent with conditions such as asthma, rhinosinusitis, gastroesophageal reflux, chronic obstructive pulmonary disease (COPD) and lung cancer. Treatment directed at these conditions may improve cough, but there remains a need to control cough directly. The most effective antitussives are opioids, such as morphine, codeine or pholcodeine, but they produce side effects including drowsiness, nausea, constipation and physical dependence. Opioids such as k- and d-opioid receptor agonists, non-opioids such as nociceptin, neurokinin and bradykinin receptor antagonists, vanilloid receptor VR(1) antagonists, blockers of sodium-dependent channels, and maxi-K calcium-dependent channel activators of afferent nerves may all represent novel antitussives and this needs to be confirmed in clinical trials.
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PMID:Current and future prospects for drugs to suppress cough. 1291 74

Two randomized, placebo-controlled, double-blind studies have shown clinical benefit with omalizumab (Xolair), a recombinant humanized monoclonal anti-immunoglobulin E (IgE) antibody, at a dose of 300 mg every 3 or 4 weeks in patients with seasonal allergic rhinitis. The present open-label, 12-week study was designed to assess the safety and tolerability of retreatment with omalizumab in 287 patients previously treated with this agent in one of the latter studies. Omalizumab, 300 mg, was administered subcutaneously every 4 weeks (three injections) to patients with IgE levels < or = 150 IU/mL (n = 182) and every 3 weeks (four injections) to patients with IgE levels > 150 IU/mL (n = 105) at screening before retreatment. Reported adverse events were monitored and blood samples were analyzed for laboratory safety (hematology and serum chemistry) and IgE levels. Urinalysis also was completed as part of the laboratory safety evaluation. The overall incidence and pattern of adverse events were similar to those reported in the primary study. There were no severe or serious adverse events related to omalizumab treatment and no anti-omalizumab antibodies were detected in any patient. Two patients withdrew from treatment because of adverse events (skin rash and nausea; facial erythema and edema) related to study treatment. Free IgE levels decreased to the levels associated with symptom reduction in the core study. In summary, retreatment during a second pollen season with omalizumab, 300 mg every 3 or 4 weeks, was well tolerated and was not associated with any significant immunologic reactions.
Allergy Asthma Proc
PMID:Tolerability of retreatment with omalizumab, a recombinant humanized monoclonal anti-IgE antibody, during a second ragweed pollen season in patients with seasonal allergic rhinitis. 1461 32


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