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)

Metformin is an effective and commonly administered drug for controlling plasma glucose concentrations in patients with type 2 diabetes mellitus. Gastrointestinal adverse effects such as abdominal pain, nausea, dyspepsia, anorexia, and diarrhea are common and widely accepted when occurring at the start of metformin therapy. Diarrhea occurring long after the dosage titration period is much less well recognized. Our patient began to experience nausea, abdominal cramping, and explosive watery diarrhea that occasionally caused incontinence after several years of stable metformin therapy A trial of metformin discontinuation resolved all gastrointestinal symptoms. A review of the literature revealed two reports that suggest diarrhea occurring long after the start of metformin therapy is relatively common, based on surveys of patients with diabetes. Metformin-induced diarrhea is differentiated from diabetic diarrhea, which is clinically similar, except diabetic diarrhea is rare in patients with type 2 diabetes. Patients with type 2 diabetes who are taking metformin and experience diarrhea deserve a drug-free interval before undergoing expensive and uncomfortable diagnostic tests, even when the dosage has been stable over a long period.
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PMID:Metformin as a cause of late-onset chronic diarrhea. 1171 16

The aim of the study was to improve diagnosis and treatment of women suffering from clinical manifestations of urogenital atrophy in menopause: stress and urgent urine incontinence, disturbances of urination, recurrent infections of the lower urinary tracts. A total of 237 menopausal women were treated for urogenital atrophy for four years. The age of the patients ranged from 51 to 78 years (mean age 64.5 years). after treatment with ovestin they were followed up for 1 to 2.1 years. It was found that stress incontinence is more common in young women, older females suffer more frequently from urgent and imperative incontinence. Ovestin, as a local replacement therapy, relieved symptoms within the first several days of treatment, the complaints disappeared completely after 25 days of ovestin intake. Side effects (nausea, head ache, breast discomfort) occurred rarely, were mild and disappeared within the first two weeks of the treatment. The conclusion is made that urogenital atrophy is a common disease of postmenopausal women arising as a result of lacking estrogenization of the vagina and adjacent tissues. Urogenital atrophy manifests as stress and urgent urinary incontinence, disurea and recurrent infection of the lower urinary tracts. Ovestin therapy should be given for at least 1.5 months. In positive effect the duration of the treatment is not limited.
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PMID:[Long-term use of ovestin by postmenopausal women with urinary incontinence]. 1262 67

Stress urinary incontinence (SUI) is the accidental leakage of urine associated with physical activities such as running, jumping or lifting or with sneezing and coughing. For many patients it can be a very bothersome symptom, causing social isolation, loss of self-esteem and increased financial outlays. Although there is currently no medication approved worldwide for the treatment of SUI, a variety of off-label agents are sometimes prescribed. Duloxetine (LY-248686; Eli Lilly), a new centrally acting compound with dual activity as a serotonin and noradrenaline re-uptake inhibitor, offers a promising new approach for treatment. Due to its inhibition of presynaptic neuron re-uptake of serotonin and noradrenaline in the sacral spinal cord, duloxetine is believed to increase the strength of urethral sphincter contractions and thereby prevent accidental urine leakage by increasing urethral closure pressure. In three published trials in women with the predominant symptom of SUI, duloxetine significantly reduced the number of incontinence episodes compared to placebo. Adverse events were usually observed early in treatment, were mild-to-moderate in severity and were transient. Nausea was the most common reason for discontinuation.
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PMID:Duloxetine: a serotonin-noradrenaline re-uptake inhibitor for the treatment of stress urinary incontinence. 1294 99

Stress urinary incontinence (SUI) is the accidental leakage of urine associated with physical activities such as running, jumping or lifting, or with sneezing and coughing. Worldwide, SUI is a highly prevalent condition, both in young and elderly women, and is a condition fraught with social isolation, loss of self-esteem and significant financial burden. Most women with SUI assume that it is an inevitable part of aging and "suffer in silence", relying on absorbent pads or lifestyle changes to cope with their condition.Unfortunately, for those who do seek medical treatment, the absence of effective and well tolerated pharmacological treatments for SUI limits the clinician's choices to behavioural modification, biofeedback and surgery. Many of the nonsurgical approaches have low success rates, particularly in the elderly and more severely afflicted. Although most continence surgeries have been reported to produce very high cure rates, many women are willing to live with their condition rather than undergo such invasive options. In an attempt to help these patients, some physicians prescribe off-label agents, including tricyclic antidepressants such as imipramine, alpha- and beta-adrenoceptor agonists, and estrogen replacement therapy. The use of these therapies has been limited by unpredictable results and adverse reactions. In addition, acetylcholine receptor antagonists are often prescribed for SUI, despite the fact that these medications have never been shown to be effective in this condition. This lack of a reliable pharmaceutical agent led to the development of duloxetine, a balanced dual reuptake inhibitor of serotonin and norepinephrine that is also being studied for the treatment of major depressive disorder. Based on in vivo data in animals, duloxetine is believed to increase the strength of urethral sphincter contractions and, thereby, prevent accidental urine leakage by increasing urethral closure forces. In clinical trials in women with SUI, duloxetine has demonstrated efficacy in reducing incontinence episodes and increasing the quality of life with no serious adverse effects. Nausea was the most common adverse event; however, in most patients it was reported early in treatment, mild-to-moderate in severity and transient. A medication such as duloxetine, if approved, would go a long way towards expanding the available treatment options for patients with SUI.
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PMID:Pharmacotherapy for stress urinary incontinence : present and future options. 1571 22

Duloxetine is a potent and balanced dual serotonin and norepinephrine reuptake inhibitor (SNRI) that enhances urethral rhabdosphincter activity and bladder capacity in a cat irritated bladder model. Whether this is beneficial in women suffering from stress urinary incontinence (SUI) has been investigated in one phase 2 and three phase 3 placebo-controlled clinical trials with very comparable inclusion and exclusion criteria and outcome variables. In addition, one phase 3 study was performed in women with SUI awaiting incontinence surgery. These trials involved investigational centers in 5 continents: North America, Europe, Australia, South America and Africa. Duloxetine 80 mg per day (40 mg twice daily) decreased the frequency of incontinence episode frequency (IEF) and improved incontinence-related quality of life (I-QOL) independent of baseline incontinence severity and also in patients awaiting surgery. In the trial in patients awaiting surgery, onset of action was closely monitored and all patients who responded to duloxetine did so within 1-2 weeks. The decrease in IEF and improvement in I-QOL were not due to more frequent voiding, as the mean time between voids increased. Nausea was the most common treatment emergent adverse event. This was mostly experienced early after the start of duloxetine (usually within the first few days) and was usually mild or moderate and non-progressive in severity. The majority of patients reporting nausea continued treatment with duloxetine and in most of these patients the nausea resolved within 1 to 4 weeks. It can, therefore, be concluded that duloxetine 40 mg twice daily is a new and promising pharmacological treatment approach for women with SUI.
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PMID:Duloxetine: a new approach for treating stress urinary incontinence. 1530 67

Options for the repair of parastomal hernias include contralateral transposition or in situ repair. The latter can be accomplished either primarily or with prosthetic mesh. Concerns with mesh include possible gut erosion and infection. Recurrence rates in the literature are dismal regardless of technique. We retrospectively reviewed our experience with this problem focusing on in situ repairs. We identified 9 patients who underwent 10 in situ repairs. Of these, 6 were women, average age was 69.4 years, and stomas had been constructed for cancer in 6, inflammatory bowel disease in 2, and incontinence in 1. Eight patients had colostomies; one had an ileostomy. All patients were symptomatic from their hernias. Repairs were performed an average of 8 years after stoma construction. Hernia repair was performed transabdominally in four and through a parastomal incision in six. Complications included hematoma formation requiring evacuation in one and delayed resumption of oral intake secondary to nausea and cramps in three. Of the 9 initial repairs, 1 recurred (11%) and was repaired without subsequent failure. No mesh erosions or wound infections have occurred. This technique is safe and may be preferable to contralateral placement of the stoma.
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PMID:In situ mesh repair of parastomal hernias. 1532 4

Trospium chloride is an orally active, quaternary ammonium compound with antimuscarinic activity. It binds specifically and with high affinity to muscarinic receptors M(1), M(2) and M(3), but not nicotinic, cholinergic receptors. It is hydrophilic and does not cross the normal blood-brain barrier in significant amounts and, therefore, has minimal central anticholinergic activity. Peak plasma trospium chloride concentrations are attained approximately 5-6 hours after oral administration, which should occur before meals as concurrent food ingestion significantly reduces trospium bioavailability. Trospium chloride undergoes negligible metabolism by the hepatic cytochrome P450 system; few metabolic drug interactions are known. While trospium chloride dosage adjustments based on age or sex appear unwarranted, such adjustments may be needed in patients with severe renal impairment. Direct comparative studies in patients with overactive bladder indicate that trospium chloride is at least as effective as oxybutynin and tolterodine. Placebo-controlled studies have also confirmed the efficacy of trospium chloride in terms of improved urodynamic parameters; small-scale, noncomparative studies have documented significant trospium chloride-induced improvements in patients with reflex neurogenic bladder, postoperative bladder irritation and radiation-induced cystitis; and observational studies including >10,000 patients have also revealed favourable findings for trospium chloride, including a marked decrease in incontinence episodes and substantial improvement in health-related quality of life. Trospium chloride is generally well tolerated, and significantly more so than immediate-release oxybutynin. The most frequent adverse events, occurring in >1% of trospium chloride-treated patients, are dry mouth, dyspepsia, constipation, abdominal pain and nausea. Available for many years in several countries outside North America, trospium chloride is likely to develop an important role in the management of overactive bladder following its approval in the US on 28 May 2004.
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PMID:Trospium chloride in the management of overactive bladder. 1548 1

Duloxetine is an orally administered, balanced, dual serotonin and norepinephrine (noradrenaline) reuptake inhibitor that increases neural input to the urethral sphincter, thereby relieving the symptoms of stress urinary incontinence (SUI). Duloxetine 40 mg twice daily for 12 weeks reduced the median incontinence episode frequency (IEF) to a significantly greater extent than placebo in women with predominant symptoms of SUI. In most studies, Incontinence Quality of Life (I-QOL) questionnaire total scores were significantly improved compared with placebo. In a dose-escalation study in women with severe SUI scheduled for continence surgery, duloxetine 80-120 mg/day for 8 weeks significantly reduced IEF and increased I-QOL total scores compared with placebo, and caused 20% of recipients to reconsider their willingness to undergo surgery. Duloxetine or duloxetine plus pelvic floor muscle training (PFMT) were more effective in reducing the median IEF than PFMT alone or no treatment in women with SUI. Mean I-QOL total scores suggested that combination therapy was more effective than either therapy alone. Nausea was the most frequent adverse event and was the main cause for discontinuing duloxetine therapy.
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PMID:Duloxetine: in stress urinary incontinence. 1551 54

Urinary incontinence is a public health problem, as more than three million women in France are concerned by this problem. The prevalence of stress urinary incontinence is about 40% among these women. Duloxetine is a molecule developed for the oral treatment of stress urinary incontinence. It is a serotonin and norepinephrine reuptake inhibitor, which acts by increasing urethral sphincter tone. In several phase III trials, duloxetine administered orally at a high dose of 80 mg per day, significantly reduced episodes of incontinence. Total scores on the Incontinence Quality of Life questionnaire (I-QOL) were more markedly improved by duloxetine than by placebo. Nausea was an adverse effect observed in more than 25% of cases and required discontinuation of treatment in some patients. However, the encouraging preliminary results of duloxetine in this indication must be confirmed during phase IV post-marketing clinical trials.
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PMID:[Place of duloxetine in the treatment of stress urinary incontinence]. 1645 87

Stress urinary incontinence (SUI) is the most common form of urinary incontinence and occurs more frequently in women than in men. Duloxetine is a balanced dual serotonin (5-HT) and norepinephrine (NE) reuptake inhibitor and shows no relevant binding affinity for histaminergic, dopaminergic, cholinergic, and adrenergic receptors. The efficacy of duloxetine in SUI is based on the inhibition of the presynaptic reuptake of 5-HT and NE in Onuf's nucleus of the sacral spinal cord, whereby it may increase the concentration of 5-HT and NE in the synaptic cleft. The effectiveness of duloxetine was studied in a cat model of acetic acid-induced bladder irritation. The results showed that in cats with previous irritated bladder function, there was a dosage-dependent improvement of bladder capacity and periurethral electromyography (EMG) activity. In women with SUI, it is assumed that the clinical efficacy of duloxetine is based on stronger urethral contraction and persistent sphincter tone during the storage phase. In clinical trials in women with SUI, duloxetine has demonstrated efficacy in reducing incontinence episodes and increasing quality of life. Nausea was the most common adverse event and the main cause for discontinuation. In summary, duloxetine appears to be a promising new option for the treatment of SUI.
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PMID:Duloxetine in the treatment of stress urinary incontinence. 1836 May 68


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