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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We conducted a 10-center, double-blind trial to compare the efficacy and toxicity of four antiepileptic drugs in the treatment of partial and secondarily generalized tonic-clonic seizures in 622 adults. Patients were randomly assigned to treatment with carbamazepine, phenobarbital, phenytoin, or primidone and were followed for two years or until the drug failed to control seizures or caused unacceptable side effects. Overall treatment success was highest with carbamazepine or phenytoin, intermediate with phenobarbital, and lowest with primidone (P less than 0.002). Differences in failure rates of the drugs were explained primarily by the fact that primidone caused more intolerable acute toxic effects, such as nausea, vomiting, dizziness, and sedation. Decreased libido and impotence were more common in patients given primidone. Phenytoin caused more dysmorphic effects and hypersensitivity. Control of tonic-clonic seizures did not differ significantly with the various drugs. Carbamazepine provided complete control of partial seizures more often than primidone or phenobarbital (P less than 0.03). Overall, carbamazepine and phenytoin are recommended drugs of first choice for single-drug therapy of adults with partial or generalized tonic-clonic seizures or with both.
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PMID:Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures. 392 35

We conducted a pilot study of fluzinamide in 15 adults with refractory partial seizures. After a baseline period, fluzinamide was added to the existing regimen of phenytoin and carbamazepine and increased to maximum tolerated dose. Common side effects included dizziness, diplopia, ataxia, headache, nausea, and rash, resulting in patient withdrawal in six cases. Seizures became less frequent in four of the nine patients who completed the 8-week trial.
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PMID:Pilot study of fluzinamide (N-methyl-3-[3-(trifluoromethyl)phenoxy]-1-azetidinecarboxamide) in refractory partial seizures. 402 65

Sulfites are widely used as preservatives in the food and pharmaceutical industries. In the United States more than 250 cases of sulfite-related adverse reactions, including anaphylactic shock, asthmatic attacks, urticaria and angioedema, nausea, abdominal pain and diarrhea, seizures and death, have been reported, including 6 deaths allegedly associated with restaurant food containing sulfites. In Canada 10 sulfite-related adverse reactions have been documented, and 1 death suspected to be sulfite-related has occurred. The exact mechanism of sulfite-induced reactions is unknown. Practising physicians should be aware of the clinical manifestations of sulfite-related adverse reactions as well as which foods and pharmaceuticals contain sulfites. Cases should be reported to health officials and proper advice given to the victims to prevent further exposure to sulfites. The food industry, including beer and wine manufacturers, and the pharmaceutical industry should consider using alternative preservatives. In the interim, they should list any sulfites in their products.
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PMID:Adverse reactions to sulfites. 405 97

At least 25 different drugs have been implicated in drug-induced pancreatitis. For some drugs the evidence is strong, but for many a contradictory or incomplete association exists between their administration and the occurrence of pancreatitis. To our knowledge, carbamazepine has not been associated with pancreatitis. We report a case of a 73-year-old female on carbamazepine 200 mg bid for partial complex seizures who developed nausea, fatigue, anorexia, malaise, headache, and increased thirst. After carbamazepine discontinuation, the patient noted an almost immediate decrease in all symptoms. Her seizures are now treated successfully with phenytoin.
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PMID:A possible case of carbamazepine-induced pancreatitis. 408 52

The pharmacology, side effects, and possible drug interactions of metrizamide, a water-solulbe contrast medium for myelography, are reviewed. Metrizamide concentration in the brain reaches maximal levels two to six hour after lumbar injection, depending on dose and patient positioning, and is largely (55-96%) excreted from the body after 24 hours. Its lower neurotoxicity, compared with other water-soluble contrast agents, can be attributed in part to its undissociated, non-ionic nature. Common side effects, which include headache, nausea, and vomiting, occur to the same degree as with other myelographic contrast media. Reported data suggest that convulsions, which have occurred in a very small percentage of patients, are related to the amount of contrast medium reaching the brain which, in turn, is largely a factor of dose and examination technique. Although the risk of seizures is small, it is recommended that drugs that lower the seizure threshold (phenothiazine derivatives, butyrophenones, tricyclic antidepressants, and MAO-inhibitors) should be avoided 48 hours before metrizamide administration (if possible), should not be used to control nausea, and should not be resumed for 24 to 48 hours after the myelographic procedure. The value of premedication (e.g., with diazepam) to prevent seizures has not been established and is not recommended.
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PMID:Metrizamide: a review with emphasis on drug interactions. 610 72

Two cases of severe beta-blocker overdose are presented that were treated successfully with glucagon therapy. The effects of glucagon in reversing the cardiovascular depression of profound beta-blockade, including its mechanism of action, onset and duration of action, dosage and administration, cost and availability, and side effects are reviewed. Medical complications of beta-blocker overdose include hypotension, bradycardia, heart failure, impaired atrioventricular conduction, bronchospasm and, occasionally, seizures. Atropine and isoproterenol have been inconsistent in reversing the bradycardia and hypotension of beta-blocker overdose. Glucagon increases heart rate and myocardial contractility, and improves atrioventricular conduction. These effects are unchanged by the presence of beta-receptor blocking drugs. This suggests that glucagon's mechanism of action may bypass the beta-adrenergic receptor site. Because it may bypass the beta-receptor site, glucagon can be considered as an alternative therapy for profound beta-blocker intoxications. The doses of glucagon required to reverse severe beta-blockade are 50 micrograms/kg iv loading dose, followed by a continuous infusion of 1-15 mg/h, titrated to patient response. Glucagon-treated patients should be monitored for side effects of nausea, vomiting, hypokalemia, and hyperglycemia. The high cost and limited availability of glucagon may be the only factors precluding its future clinical acceptance.
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PMID:Glucagon therapy for beta-blocker overdose. 614 98

Iohexol containing 180 mg I/ml was used in 80 patients for myelography by lumbar injection. By using an adequate volume, between 10 and 20 ml, satisfactory films were obtained in all cases. Minor adverse effects occurred in 12 patients (15%) and were more frequent in women than men; they were headache (5), nausea (3), vomiting (2), back or limb pain (5), and skin rash (1) and were of minor degree in 10 cases, moderate in the other two and lasted more than 24 h in only one case. There was no change in vital signs or neurological examination related to the studies. No patient suffered difficulty with concentration, personality change or seizures. Electroencephalograms performed on 21 patients before and during the 24 h after iohexol showed no seizure or focal activity or any significant change. Repeat lumbar punctures were performed on ten patients during the 24 h following myelography. One of these, a patient with symptoms due to disc prolapse, whose CSF was abnormal prior to the myelogram, showed a slightly increased cellular response. There was no significant change in any other case. Iohexol is a very satisfactory contrast medium for myelography and compares favourably with other non-ionic contrast media.
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PMID:Clinical trial of iohexol for lumbar myelography. 634 11

Among patients with renal failure, there have been impressive modifications of both the duration and quality of life as a result of dialysis, renal transplantation, and improved medical management. However, patients who have renal failure continue to manifest a variety of neurologic disorders. Patients with chronic renal failure who have not yet received dialytic therapy may develop a symptom complex progressing from mild sensorial clouding to delirium and coma, with tremor, asterixis, multifocal myoclonus, and seizures. Even after the institution of otherwise adequate maintenance dialysis therapy, patients may continue to be afflicted with more subtle nervous system dysfunction, including impaired mentation, generalized weakness, and peripheral neuropathy. The central nervous system disorders of both untreated renal failure and that persisting despite dialysis are referred to as uremic encephalopathy. The dialytic treatment of end stage renal disease has itself been associated with the emergence of two distinct, new disorders of the central nervous system: Dialysis dysequilibrium and dialysis dementia. The dialysis disequilibrium syndrome consists of headache, nausea, muscle cramps, obtundation and seizures, and is a consequence of the initiation of dialysis therapy in some patients. Dialysis dementia is a progressive, generally fatal encephalopathy which affects patients on chronic hemodialysis. This disease also appears to be a complication of the therapy for renal failure.
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PMID:Pathogenesis of dialysis encephalopathy. 636 3

In a comparative randomized double-blind study, 73 patients underwent myelography using iopamidol (36 patients) or metrizamide (37 patients) as contrast medium. The overall diagnostic adequacy of iopamidol myelography was found to be comparable to that of metrizamide myelography. The incidence of examinations graded as superior (64%) or adequate (36%) with iopamidol was equivalent to that with metrizamide (57% superior, 43% adequate). Adverse reactions after iopamidol myelography were fewer, less severe, and generally of shorter duration than those associated with metrizamide. In the iopamidol group, adverse reactions occurred in nine (25%) patients, all of whom experienced mild or moderate headache, one with nausea, vomiting, and fatigue. In the metrizamide group, adverse reactions occurred in 17 (46%) patients, all of whom experienced mild or moderate headache, six with nausea and vomiting and four with back and leg pain. Of nine individuals who underwent myelography using 300 mg 1/ml metrizamide injected via lateral C1-C2 puncture, three experienced a toxic encephalopathy with confusion, dysphasia, headache, nausea, and vomiting, and a fourth individual suffered severe nausea, vomiting, fever, and irregular pulse. Encephalopathy was not observed in any of the 11 patients in whom myelography was performed via lateral C1-C2 puncture with a similar concentration of iopamidol. No seizures were encountered, and no clinically significant changes in laboratory studies were observed with either contrast medium.
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PMID:Iopamidol and metrizamide for myelography: prospective double-blind clinical trial. 638 81

Twenty-four adult outpatients with poorly controlled complex partial seizures were treated with valproic acid. Previous therapy with antiepileptic agents was continued to maintain stable plasma drug levels. Initially 12 patients experienced greater than 50% seizure reduction. Only five patients maintained longterm benefit. In the other seven patients a tolerance developed to valproic acid's efficacy. Duration of seizure control seemed to be a function of initial seizure frequency. Toxic effects were generally mild. No hepatotoxic effect was noted and no hematological abnormalities developed. Weight changes occurred in 17 patients (14 gained weight) and five patients experienced a postural tremor. Eighteen patients experienced nausea.
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PMID:Valproic acid therapy for complex partial seizures. Its efficacy and toxic effects. 640 1


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