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)

Neuronal 5-hydroxytryptamine3 (5-HT3) receptors mediate the excitatory effects of 5-HT. They are located in pain- and nausea-modulating areas in the central nervous system and on C-fibre primary afferents in the peripheral nervous system. Consequently, these receptors mediate the painful and emetic effects of 5-HT. Selective and potent 5-HT3 receptor antagonists have been shown to block inflammatory and 5-HT induced and potentiated "vascular pain". Based on the hypothesis that 5-HT3 receptor antagonists may block neurogenic dural inflammation in the distribution area of the trigeminal nerve and, thus, could potentially prevent migraine (pain), four highly selective and potent 5-HT3 receptor antagonists have been tested in both the acute and prophylactic treatment of migraine. Unfortunately, except for a clear anti-emetic effect, none of these drugs has shown unequivocal efficacy in the treatment of migraine. This may be partly due to the complex (bell-shaped) dose-response relationship of these compounds, making exact titration of the correct dose difficult. Moreover, most 5-HT3 receptor antagonists have proved to be toxic in man on chronic administration thereby preventing further trials in migraine with adjusted doses. Short-term treatment for cytotoxic drug-induced emesis so far appears to be the only proven indication for 5-HT3 receptor antagonists.
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PMID:5-HT3 receptor antagonists and migraine therapy. 204 32

A 20 year old male naval crew-member suffering from sea sickness was treated with transdermal scopolamine (TS). After 5 months of continuous treatment, he developed scopolamine intoxication followed by the appearance of recurrent classic migraine attacks. He had never suffered from headache or migraine prior to TS intoxication. The migraine attacks comprised a prodrome of apathy, bad mood and loss of appetite lasting several hours. An aura of scintillating spots, left arm numbness and paresthesias lasting several minutes was followed by a severe throbbing unilateral headache with photophobia, sonophobia and nausea. After one year of repeated follow-up examination, he continued to suffer from the attacks once every 10 to 14 days, with no identified precipitating factors. We are not aware of similar cases in the medical literature. Although it is not possible to establish TS intoxication as a causal effect of the appearance of classic migraine in our patient, the temporal association and clinical course are very supportive of this assumption. Central nervous system neurotransmitter imbalance of cardiovascular alterations may possibly be implicated.
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PMID:Recurrent classic migraine attacks following transdermal scopolamine intoxication. 207 97

In an open multicentre study in Switzerland, the dihydroergotamine nasal spray was studied for its efficacy and tolerability in the treatment of acute migraine attacks (common and classical migraine--one attack each patient) in a total of 904 patients. In the global assessment, 76.8% of all the patients reported good efficacy (freedom from pain, less pain or shorter duration of pain). When the nasal spray was used already in the prodromal phase, good efficacy could be obtained by 90 (63%) of 143 patients. 18.1% of all the patients treated--more frequently those who obtained no beneficial effect and/or who took additional medication during the migraine attack--reported one or more--minor side-effects such as local nasal irritation (congestion, burning or stinging), nausea, dizziness and vomiting. 3.9% of the patients said they would not use the spray again because of the side effects.
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PMID:[Dihydroergotamine as a nasal spray in the therapy of migraine attacks. Efficacy and tolerance]. 220 27

Based on recent epidemiologic studies of functional intestinal disorders, we have attempted to answer the following two questions: a) what is the prevalence of functional intestinal disorder in the Western world, b) are there epidemiologic variations in the different modes of symptomatic presentation of functional intestinal disorders? The overall prevalence of functional intestinal disorders in the Western world ranges between 17 and 23 percent according to the country considered, and is between 14 and 18 percent for the irritable bowel syndrome and 4 to 8 percent for painless constipation. The "irritable intestine" group is characterized by a sex ratio of close to one, a median age near 40, a strong influence of stress on symptoms, and the frequency of complaints such as nausea, vomiting, migraine, and pyrosis. The syndrome is seen in active subjects, who believe that they are "sick", and as such, seek medical advice often. Anxiety and depression are frequently encountered. Patients are often athletes, smokers, and have diarrhea. On the other hand, "painless constipation" is characterized by a high prevalence of women and age over 50. Often these subjects do not have any active professional activity. Stress-related and extradigestive symptoms are rare. They do not consider themselves "sick" and do not seek medical advice very often. Conversely, they use laxatives frequently. Individualization of epidemiologically different groups suggests that the pathophysiology may differ between the two groups and perhaps that there are specific therapeutic and diagnostic approaches accordingly.
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PMID:[Epidemiology of the irritable bowel syndrome]. 221 Jan 92

1. This study examined the ability of a bioimpedance method to detect the delay in gastric emptying which occurs during attacks of migraine. 2. In 64 non-migraineur control patients and 46 migraine patients outside an attack, gastric emptying rates were within the predicted normal range. 3. In contrast, rates in 14 migraineurs during 20 attacks were delayed during severe or moderate attacks and were significantly correlated with the intensity of headache, nausea and photophobia. 4. The epigastric impedance method was generally well tolerated by patients and appears to merit further investigation as a clinical method of monitoring gastric emptying of liquids.
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PMID:A correlation between severity of migraine and delayed gastric emptying measured by an epigastric impedance method. 222 19

The characteristics of common migraine are not unique, they also appear in other forms of benign headaches. As there are no laboratory tests and biological signs enabling the diagnosis of migraine and its differentiation from the headache due to muscle contractrion, clinical criteria which are simplified and easy to comprehend should be used. We compared the symptoms in 29 patients of both sexes, suffering from common migraine, as well as 29 patients with headache due to muscle contraction (chronic daily headaches). In common migraine the following symptoms appear in greater percentage (statistically significant): nausea, vomiting, unilateral localization of pain, pulsating pain, photophobia and phonophobia. Bad headache is more frequent in patients with common migraine than in those suffering from chronic headache. We should accept Solomon's and Cappa's attitude who suggest at least two of the following five criteria: 1. nausea with or without vomiting, 2. unilaterality, 3. pulsating pain, 4. photophobia or phonophobia, and 5. provocation by menstruation or positive family history. Besides the above mentioned criteria the authors also mention and emphasize the existence of free interval in migraine when the patient has no difficulties and feels well.
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PMID:[Common migraine--diagnostic criteria]. 226 10

The correlation of specific headache attack characteristics derived from a standardized questionnaire was studied in a consecutive series of 392 patients attending a headache clinic. In patients reporting headache with aura such attacks tended to be infrequent, and the percentage of their headache attacks that were preceded by aura varied widely, many cases having very low percentages. Paresthesias as auras were uncommon and rarely occurred without visual aura. Unilateral headaches were associated with nausea to widely varying degrees. Most patients reported both unilateral headache and headache with tension characteristics. Definite history of hypertension was significantly correlated specifically with migraine with aura (classic migraine).
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PMID:Specific headache phenomena: their frequency and coincidence. 232 17

In the five year period 1972-1977, 27 patients aged 15-45 years were admitted to a neurological department in the Copenhagen area because of acute focal neurological deficits, lasting more than 24 hours and of presumably vascular origin i.e. stroke. In seven cases, the neurological deficits were of thromboembolic origin and in further seven cases the deficits occurred in relation to migraine with aura. Two cases were classified as migraine-equivalents. In the remaining eleven cases it was not possible to decide whether the persisting neurological deficits were of migrainous or thromboembolic origin. Nine of these 11 patients were women. Nine had headache and six had nausea/vomiting or photo/phonofobia. Cerebral angiography was performed in five of these 11 patients and in all the angiograms were normal. Migraine-aura was most probably the cause of the persisting deficits in some of these 11 patients. It is concluded, that migraine-aura is relatively often the cause of stroke in young adults.
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PMID:[Migraine aura as the cause of apoplexy in young adults]. 236 Feb 67

Two separate, but related, studies are described in which psychophysiological symptoms associated with chronic headache were examined. In the first study, the Psychosomatic Symptom Checklist (PSC) was administered to evaluate the presence of 15 different psychophysiological symptoms in 3 types of chronic headache patients (migraine, tension, and combined migraine and tension). Over 97% of these 438 patients reported at least one other symptom occurring at least monthly and 75% reported another intense symptom occurring at least once a week. The tension and combined headache groups reported significantly higher overall symptomatic distress than the migraine headache patients. The tension patients reported significantly higher scores on the backache and weakness items, while the migraine and combined headache patients reported significantly more nausea. The differences between the diagnostic groups is more a function of the intensity of the symptoms than the presence of the symptoms, since, for many individual symptoms, the percentage of patients reporting is nearly equal. In the second study, 150 patients from the original sample (50 from each diagnostic group) were reassessed using the PSC after psychological treatment of headache. There were significant decreases in total scores for all 3 groups with no significant differences between groups seen at post treatment. Different treatment effects were seen on the individual symptoms with 7 of the 15 showing significant reduction. Chronic headache does not occur in isolation and headache diagnostic groups do not differentiate well on other individual psychophysiological symptoms.
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PMID:Two studies of the occurrence of psychophysiological symptoms in chronic headache patients. 236 3

In a double-blind cross-over study we compared tolfenamic acid with paracetamol in out-patients with common migraine (migraine without aura). Each patient was treated during (at least) 4 attacks with one of the following alternatives: tolfenamic acid 200 mg, tolfenamic acid 400 mg, paracetamol 500 mg or paracetamol 1000 mg in a randomized sequence. The same sequence of treatments was applied to (preferably) 4 more attacks. Dosage was repeated after 2 h if the attack had not abated. Escape medication was allowed after 4 h if the treatment was inefficient. A total of 83 patients were admitted to the study, but 3 dropped out, while 10 completed less than 4 attacks. Seventy completed 4 attacks, and 58 completed all 8. The total number of attacks treated was 545. We found a significant superiority of tolfenamic acid over paracetamol with regard to effect on pain after 2 h (p less than 0.01), patients' global evaluation (p less than 0.001), and use of escape medication (p less than 0.02). The trend was the same for duration of attacks, confinement to bed during attack and nausea, but the results were not statistically significant. There was no significant difference between the smaller and the larger dose of either drug nor between the need for escape medication, although the trend favoured tolfenamic acid. Side effects were few. Tolfenamic acid is evidently valuable in treatment of migraine.
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PMID:Randomized double-blind comparison of tolfenamic acid and paracetamol in migraine. 237 49


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