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)

Forty cancer patients receiving parenteral chemotherapy were assessed for characteristics associated with the development of anticipatory nausea and vomiting (ANV). The patients who developed ANV were more likely to have increased pretreatment anxiety (p less than 0.05), greater posttreatment dizziness/lightheadedness (p less than 0.01), more severe postchemotherapy vomiting (p less than 0.01), and a delayed onset of postchemotherapy nausea and vomiting (PCNV) compared to the patients who developed neither ANV nor PCNV. However, when patients who did not develop PCNV were excluded from the analysis, the difference between the ANV and non-ANV patients remained significant only for postchemotherapy dizziness/lightheadedness (p less than 0.05). In an attempt to identify a group of variables that better predict the development of ANV, we analyzed the data for combinations of variables. Two indices were found to correctly classify ANV and non-ANV patients 71% of the time (p less than 0.05). Index A refers to the presence of at least two of the following variables, pretreatment anxiety, posttreatment dizziness/lightheadedness, and latency of PCNV. Index B refers to the presence of at least two of the following variables: pretreatment anxiety, severity of nausea, and severity of vomiting. The identification of characteristics associated with the development of ANV could lead to new intervention strategies.
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PMID:Variables contributing to anticipatory nausea and vomiting in cancer chemotherapy. 159 Feb 83

Recently, it has been shown that changes in gastric electrical rhythm can be connected with clinical syndromes characterized by nausea and vomiting, among these the nausea of pregnancy. We studied gastric electrical activity during the first trimester of pregnancy in nine women with nausea and vomiting (study group) by means of cutaneous electrogastrography. Recordings were made before and after a standardized meal in the 6th-8th wk of gestation, and 2 months after voluntary interruption of pregnancy (VIP). The control group consisted of eight pregnant women without a history of nausea and vomiting. In the women in the study group there was more unstable cutaneous electrogastrographic (EGGc) activity and a reduced increase in postprandial power during pregnancy than after VIP, when a normal pattern with regular 3-cpm EGGc waves was reestablished. The coefficient of variation of gastric frequency during pregnancy was significantly higher than after VIP (p less than 0.01), whereas the postprandial to preprandial power ratio was lower (p less than 0.01). During the recording sessions, none of the subjects had clear episodes of tachygastria or bradygastria, and none of them had nausea, vomiting, or epigastric discomfort. Comparison of the EGGc data for the pregnant women in the study and control groups revealed a similar pattern of gastric electrical activity in the two, the only exception being the power ratio, which was lower in the study group (p less than 0.01). We conclude that pregnant women without symptoms of nausea and vomiting at the time of EGG recordings have normal 3-cpm myoelectrical activity, and that EGGc activity is more unstable and less responsive to the ingestion of food during pregnancy than after VIP. Furthermore, in pregnant women with a history of nausea and vomiting, EGGc activity is less responsive to the ingestion of food than it is in symptom-free pregnant women.
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PMID:Gastric myoelectrical activity in the first trimester of pregnancy: a cutaneous electrogastrographic study. 159 Mar 1

Postoperative recovery after induction with either propofol or thiopentone has been compared in forty ASA I unpremedicated day surgery patients undergoing surgical extraction of third molar teeth under relaxant general anaesthesia. Mean recovery times in the propofol group, required for patients to sit out of bed (44.8 minutes; SD 18.6) and meet discharge criteria (113.1 minutes; SD 34.5) were significantly (P less than 0.05) shorter than those in the thiopentone group (59.7 minutes; SD 21.4 and 133.5 minutes; SD 34.5). Fewer patients in the propofol group were treated in the recovery room for nausea and vomiting and the incidence of mild nausea not requiring treatment was less in the propofol group, but these differences were not statistically significant. Postoperative mental performance, measured by the FAST index, a new test of mental speed, was reduced on average by 1.7% of preoperative levels, during the recovery period tested, with no significant difference between the groups.
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PMID:Double-blind comparison of patient recovery after induction with propofol or thiopentone for day-case relaxant general anaesthesia. 159 51

In a recent editorial, Kapur described perioperative nausea and vomiting as "the big 'little problem' following ambulatory surgery."257 Although the actual morbidity associated with nausea is relatively low in health outpatients, it should not be considered an unavoidable part of the perioperative experience. The availability of an emesis basin for every patient in the postanesthesia recovery unit is a reflection of the limited success with the available therapeutic techniques.257 There had been little change in the incidence of postoperative emesis since the introduction of halothane into clinical practice in 1956. However, newer anesthetic drugs (e.g. propofol) appear to have contributed to a recent decline in the incidence of emesis. Factors associated with an increased risk of postoperative emesis include age, gender (menses), obesity, previous history of motion sickness or postoperative vomiting, anxiety, gastroparesis, and type and duration of the surgical procedure (e.g., laparoscopy, strabismus, middle ear procedures). Anesthesiologists have little, if any, control over these surgical factors. However, they do have control over many other factors that influence postoperative emesis (e.g., preanesthetic medication, anesthetic drugs and techniques, and postoperative pain management). Although routine antiemetic prophylaxis is clearly unjustified, patients at high risk for postoperative emesis should receive special considerations with respect to the prophylactic use of antiemetic drugs. Minimally effective doses of antiemetic drugs can be administered to reduce the incidence of sedation and other deleterious side effects. Potent nonopioid analgesics (e.g., ketorolac) can be used to control pain while avoiding some of the opioid-related side effects. Gentle handling in the immediate postoperative period is also essential. If emesis does occur, aggressive intravenous hydration and pain management are important components of the therapeutic regimen, along with antiemetic drugs. If one antiemetic does not appear to be effective, another drug with a different site of action should be considered. With the availability of new antiserotonin drugs, the incidence of recurrent (intractable) emesis could be further decreased. Research into the mechanisms of this common postoperative complication may help in improving the management of emetic sequelae in the future. As suggested in a recent editorial, improvement in antiemetic therapy could have a major impact for surgical patients, particularly after ambulatory surgery. Patients as well as those involved in their postoperative care look forward to a time when the routine offering of an emesis basin after surgery becomes a historical practice.
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PMID:Postoperative nausea and vomiting. Its etiology, treatment, and prevention. 843 45

Twenty-eight elderly patients scheduled for urological surgery were randomly assigned to receive, in a double-blind study, subarachnoid hyperbaric bupivacaine 15 mg with 50 micrograms (group A, n = 7), 25 micrograms (group B, n = 7), or 12.5 micrograms (group C, n = 7) of fentanyl or 1 ml of saline (group D, n = 7) in a total volume of 4 ml. The pattern of breathing and the ventilatory response to CO2 were studied before and 90, 150 and 480 min after the subarachnoid injection. In group A, mild pruritus and sedation occurred in five patients, while nausea, vomiting and periodic breathing occurred in two. In group B, mild pruritus and sedation were observed in four patients, while nausea and vomiting occurred in two. No significant differences in minute ventilation, respiratory drive and respiratory timing were observed between the groups. Patients receiving fentanyl 50 micrograms showed a percentual change from baseline values as function of time (slope VE/PE'CO2) significantly below baseline at 90 and 150 min (p less than 0.05). However, the baseline values in this group reverted after 480 min. No side effects were observed in groups C or D. It is concluded that subarachnoid fentanyl 50 micrograms can cause an early respiratory depression and its use as a postoperative analgesic should be avoided in the elderly.
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PMID:Ventilatory effects of subarachnoid fentanyl in the elderly. 162 64

This study, carried out in three European countries, elicited the views and impact of three medical groups involved in patient care. Their views were compared with patients' perspectives of their condition. The main stage of the study was carried out by self-completion questionnaires by 300 patients across Italy, France and the U.K. The views of the medical profession were quantified via 150 hospital specialists, 75 cancer care nurses and 30 general practitioner interviews. Patients' symptoms most frequently seen by the medical profession were nausea, tiredness, loss of hair, vomiting, worrying and lack of appetite. On a scale of 1-4 (1 = not at all; 4 = very much) the frequency of these side effects were rated at 2.8 or over. Intensity of concern was highest for nausea and vomiting. These two symptoms was most frequently highlighted as one of the three highest concerns respectively for 74% and 54% of specialists, 64% and 60% of nurses and 50% of general practitioners. Patients on average reported a lower frequency of major symptoms. Most frequent were loss of hair, tiredness, lack of energy, nausea and decreased sexual interest. In terms of the impact of these problems, tiredness, nausea and loss of hair were the most frequently mentioned. Vomiting bothered them more than the frequency would suggest. 1 in 10 patients claim to have delayed their treatment because of previous experiences of side effects. The main impact on patient's quality of life related to the aspects of worrying and the effects on the family. In terms of communication, both the medical profession and the patients felt that patients were well informed about the disease and treatment. However, differences emerged between what patients claim to have been told about the disease and its treatment and what nurses and doctors claim to have said.
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PMID:The impact of cytotoxic chemotherapy--perspectives from patients, specialists and nurses. 162 6

In order to establish if anticholinergic drugs might influence postoperative nausea and vomiting, 100 ASA I-II adult patients scheduled for minor orthopaedic procedures, varicose vein stripping or inguinal herniorraphy were randomised to receive, in a double-blind fashion, either a premedicant and a reversal dose of 0.003 and 0.0075 mg/kg of glycopyrrolate or 0.006 and 0.015 mg/kg of atropine, respectively. Nitrous oxide, after thiopentone induction was used for anaesthesia with fentanyl and diazepam as supplements and pancuronium for relaxation. In the recovery room, up to 2 h after surgery, 28% of the patients in the glycopyrrolate group and 8% in the atropine group experienced nausea (P = 0.017). Thereafter, the patients complained of nausea at decreased and equal frequencies in both groups. The incidence of vomiting was not statistically significantly different. Droperidol was needed, to control persistent emesis, three times more often in the glycopyrrolate than in the atropine group. It is concluded that substitution of glycopyrrolate for atropine increases the likelihood of postoperative nausea, and continued use of atropine should be considered in patients at risk of postoperative emesis.
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PMID:Do anticholinergic agents affect the occurrence of postanaesthetic nausea? 163 67

In order to decide the administration method of metoclopramide for prevention or control of chemotherapy-induced nausea and vomiting in multidrug chemotherapy, with cisplatin 5-day continuous intravenous infusion (25 mg/m2/day) for patients with advanced lung cancer, a randomised crossover study of intermittent bolus infusion (1 mg/kg, 30 min, every 8 h, day 1-5) and continuous infusion (3 mg/kg/24 h, 120 h) of metoclopramide was performed. Both regimens included methylprednisolone and diphenhydramine given concurrently. The acute and delayed antiemetic effects were examined. 21 cases could be evaluated. There were 6 and 10 cases (P = 0.048), respectively, of no nausea and no vomiting; 14 and 18 cases (P = 0.048), respectively, of no vomiting; and vomiting episodes were seen 27 and 9 times, respectively (P = 0.042). Thus, metoclopramide continuous infusion was significantly superior in antiemetic effect compared to bolus infusion. Neither method had any serious side-effects and both were safe.
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PMID:Comparison of continuous and intermittent bolus infusions of metoclopramide during 5-day continuous intravenous infusion with cisplatin. 164 44

The reports of the effect of calcitonin on pituitary function are confusing and often refer to uncontrolled studies. We have now carried out a double-blind placebo-controlled trial of intravenous and subcutaneous salmon calcitonin on anterior pituitary function in 17 healthy volunteers. Visual analogue scores for the nausea and vomiting seen after salmon calcitonin correlated with the rise in ACTH and, secondarily, cortisol. Calcitonin had no effect on growth hormone, prolactin, thyrotrophin, luteinizing hormone or follicle stimulating hormone. It is concluded that the stimulation of ACTH secretion following a single dose of salmon calcitonin is probably the result of the stress of nausea rather than a direct effect on the pituitary.
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PMID:The effects on anterior pituitary hormone secretion of salmon calcitonin in healthy volunteers. 165 86

Dronabinol (Marinol, Roxane Laboratories, Columbus, OH) and prochlorperazine were tested alone and in combination in a randomized, double-blind, parallel group, multicenter study. Patients were randomized to receive either 1) dronabinol 10 mg every 6 hr plus placebo; 2) placebo plus prochlorperazine 10 mg every 6 hr; or 3) dronabinol and prochlorperazine, each 10 mg every 6 hr. Antiemetic treatment was begun 24 hr prior to and continued for 24 hr after the last dose of chemotherapy; all was given orally. Only 29% of patients in group 3 versus 47% in group 1 and 60% in group 2 experienced nausea after chemotherapy. In addition, the median duration per episode and severity of nausea were significantly less with combination therapy. Vomiting occurred after chemotherapy in 41%, 55%, and 35% of patients in groups 1, 2, and 3, respectively. The median duration per episode of vomiting was 1 min in group 3 versus two in group 1 and four in group 2. Side effects, primarily CNS, were more common in group 1 than in group 2; addition of prochlorperazine to dronabinol appeared to decrease the frequency of dysphoric effects seen with the latter agent. The combination was significantly more effective than was either single agent in controlling chemotherapy-induced nausea and vomiting.
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PMID:Dronabinol and prochlorperazine in combination for treatment of cancer chemotherapy-induced nausea and vomiting. 165 11


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