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)

Antiemetics of known efficacy have been shown to block mainly one of three neurotransmitter receptors in the brain. A combination of antiemetics, designed specifically for outpatient use and consisting of metoclopramide, thiethylperazine, diphenhydramine, dexamethasone, and diazepam, is capable of blocking multiple sites in the emesis pathway. Eighty-four patients receiving highly emetic chemotherapy (85% received cisplatin) completed 200 trials of this five-drug combination using two similar regimens. Complete control (i.e., no nausea or vomiting) was achieved in 45% and two or fewer episodes of vomiting was experienced in 72% of these 200 trials. The mean number of vomiting episodes was 1.65, the median 1.0, and the range 0-15. Sedation was nearly universal, although no serious toxicity was encountered. Thus, this antiemetic combination designed for outpatient use proved highly effective in controlling nausea and vomiting associated with highly emetic anticancer treatment.
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PMID:An effective five-drug antiemetic combination for prevention of chemotherapy-related nausea and vomiting. Experience in eighty-four patients. 369 69

This study documents our experience with labetalol administered by continuous intravenous infusion for severe hypertension. Infusions were performed in 14 hospitalized patients (15 infusions) with supine diastolic pressure greater than 125 mmHg or supine systolic pressure greater than 200 mmHg. Blood pressures were measured by intra-arterial recording or an Arteriosonde 1225 Doppler instrument standardized with a mercury sphygmomanometer. Patients initially received 2 mg/min continuous infusion; the infusion rate varied between 0.5 and 2.0 mg/min according to the protocol. The infusion was terminated when diastolic pressure decreased 30 mmHg or when 300 mg of the drug had been infused. Goal blood pressure was achieved in all but two infusions. Sedation was the most common adverse reaction, followed by nausea and diaphoresis. No patient required discontinuation or reduction in infusion rate secondary to side effects. We conclude that continuous intravenous infusion of labetalol offers an effective alternative to current parenteral therapy.
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PMID:Labetalol by continuous intravenous infusion in severe hypertension. 372 59

Patients with pain after operation received morphine hydrochloride intrathecally in doses of 0.02 mg kg-1 (n = 30) and 0.2 mg kg-1 (n = 30). The high-dose group showed slightly longer-lasting and more potent analgesia than the low-dose group. Sedation, decreases in heart rate and systolic arterial pressure, oliguria, nausea and urinary retention were more frequent in the high-dose group. Two patients of the high-dose group showed evidence of respiratory depression which appeared after a late change in posture (7 and 11 h). We conclude that postoperative analgesia with intrathecal morphine 0.02 mg kg-1 must be followed by a prolonged head-up posture and be performed in hospital units where the treatment of respiratory depression is competent.
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PMID:Postoperative spinal analgesia with morphine. 702 19

50% of hospitalized medical emergency cases are cardiological and respiratory emergencies. Myocardial infarction, cardiogenic shock, ventricular arrhythmias and left ventricular failure often cause sudden death occurring within 1 or 2 hours. Therefore immediate management is necessary already in the prehospital phase of cardiovascular events. This does also apply for acute respiratory failure due to obstructive ventilatory disorders. Acute exacerbations of chronic obstructive pulmonary disease frequently are masked and may be misinterpreted as encephalopathy or alcohol withdrawal syndrome. Sedation may be dangerous. Also neuroglucopenic syndrome and hyperosmolar coma are occasionally interpreted wrongly. Thyrotoxic crisis, adrenal crisis and hypercalcemia are characterized by lethargy, mental disturbance and weakness, by dehydration, myopathy, nausea, constipation, diarrhea or tenesms or arrhythmias. In this situation of varied symptoms the most important action is to think of endocrine emergency, which may have multiple etiologies.
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PMID:[Cardiovascular emergencies--endocrine and metabolic crises. Practical hints for the physician in emergency service]. 711 36

We investigated the antiemetic efficacy and safety of intravenous ondansetron infusion in the BMT setting. We conducted prospective randomized comparison trials between ondansetron at 2 dose levels and metoclopramide (MCP) plus droperidol for the prevention of chemotherapy-induced nausea and vomiting in 2 patient populations scheduled to undergo BMT. One patient population (n = 30) received CY alone, the other population (n = 30) received combination chemotherapy of Bu and CY. The CY alone group received ondansetron for 3 days, and the Bu/CY group received ondansetron for 7 days. The primary endpoints were emesis control and nausea. Secondary endpoints included acute (headache, diarrhea and sedation) and delayed (engraftment and regimen-related) side-effects. In both trials, ondansetron provided better emesis control than did MCP plus droperidol during CY administration (P = 0.009, 3-day trial; P = 0.0022, 7-day trial). There was a wide interpatient variation in serum ondansetron levels, although group averages were proportional to the dose administered. Intrapatient day-to-day variation was 10-30% and did not change significantly with concurrent CY administration. Antiemetic efficacy did not correlate with ondansetron serum levels at the doses tested. Headache incidence was similar in all groups. Sedation was highest in the MCP plus droperidol group (P = 0.048, 3-day trial; P = 0.016, 7-day trial). No statistically significant differences in engraftment or regimen-related toxicities were observed between groups in either trial. Ondansetron appears to be a safe and efficacious antiemetic during conditioning for BMT.
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PMID:Antiemetic efficacy and pharmacokinetics of intravenous ondansetron infusion during chemotherapy conditioning for bone marrow transplant. 758 Nov 39

In a randomly allocated double blind study of 54 primigravidae, we examined the relative efficacy of the addition of diamorphine 3 mg to either an initial bolus or an infusion of bupivacaine. Both groups received an initial bolus of 10 ml of bupivacaine 0.25% followed by an infusion of bupivacaine 0.1% at 10 ml.h-1. Group 1 received diamorphine 3 mg in the bolus and group 2 received diamorphine 3 mg in the initial 100 ml of infusion solution. Both groups had comparable total bupivacaine requirements. Analgesia, assessed by visual analogue scores, was superior at 7h in group 2, but was similar at all other times. Sedation scores were significantly lower in group 2 for the first 3h and the incidence of nausea was significantly lower in group 2. The addition of diamorphine, whether as a bolus or added to an infusion of bupivacaine, results in similar quality of analgesia, but there is a reduction in side effects when diamorphine is administered in an infusion.
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PMID:Epidural diamorphine. A comparison of bolus and infusion administration in labour. 770 36

Ipsapirone is a partial 5-HT1A agonist which appears promising for the pharmacologic treatment of anxiety. In this four-week, double-blind, 19-center study, 249 outpatients with generalized anxiety disorder were randomized to one of four treatments: ipsapirone, 5 or 10 mg t.i.d., diazepam 5 mg t.i.d., or placebo. Both active treatments were significantly superior to placebo in reducing anxiety symptoms, although response to ipsapirone was not significant until week 2 while diazepam had a more rapid onset. Five mg t.i.d. was the optimal ipsapirone dose. At 10 mg t.i.d. adverse experiences prompted more patients to discontinue treatment. Adverse experiences that were reported significantly more often for ipsapirone than placebo included asthenia, nausea, dizziness, paresthesias and sweating. Sedation was the most common diazepam-related side effect. The results of this study when combined with others suggest that 5 mg t.i.d. of ipsapirone is an effective and well-tolerated anxiolytic without many of the risks of benzodiazepine therapy. Dosage escalation by patients is unlikely because of an increased risk of side effects.
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PMID:A placebo-controlled double-blind multicenter trial of two doses of ipsapirone versus diazepam in generalized anxiety disorder. 790 26

We compared analgesia and sedation provided by one of four different opioids in combination with midazolam during gastrointestinal endoscopy. Patients were given 1-3 mg midazolam and meperidine 50-100 mg, fentanyl 50-100 micrograms, sufentanil 5-10 micrograms, or alfentanil 150-300 micrograms, plus additional opioid and/or midazolam if needed. No untoward effects (i.e., O2 saturation < 85%, nausea, vomiting, severe bradycardia) occurred. Sedation and analgesia were comparable in the upper gastrointestinal groups. The number of patients with amnesia for the examination was highest in the meperidine group. Recovery time generally was shorter with alfentanil and sufentanil. Recovery time of the lower gastrointestinal patients was significantly longer in the meperidine group than in the other groups; analgesia scores for sufentanil were significantly lower than for meperidine. Sedation scores for these patients were highest in the meperidine group. The number of patients given meperidine who were amnesic was significantly greater than for the other opioids. Meperidine was better than the other opioids with regard to patient comfort and amnesia during colonoscopy.
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PMID:Sedation and analgesia for gastrointestinal endoscopy. 809 40

Sixty children (7 months-20 yr; mean 6.5 yr, median 7-8 yr, mode 1-2 yr) undergoing major surgery received a balanced technique of general anaesthesia combined with bupivacaine as a single injection extradural or peripheral nerve block. Postoperative analgesia consisted of a subcutaneous infusion of morphine 1 mg kg-1 body weight in 20 ml of normal saline [corrected] at a rate of 0.3-0.5 ml h-1, controlled by the nursing staff in the surgical ward. Monitoring included SpO2, pain, sedation and nausea/vomiting scores. Infusions were used for a mean of 38.8 h (range 17-80 h). Ninety-seven percent of recordings of SpO2 were greater than 94% and only one recording in 2361 was less than 90%. Ninety-four percent of pain scores indicated either no pain or slight pain; 1% indicated severe pain. On the order of the medical staff, seven children had the rate of infusion of morphine increased to 0.6 ml h-1 [corrected] because of high pain scores. Sedation scores compatible with children being either awake or asleep but rousable by speech alone were recorded on 99.7% of occasions. No child at any time was unrousable. Of 1248 nausea/vomiting scores, only 2.8% indicated the presence of these side effects; in only two children were they thought to be troublesome. As a result of this audit, nursing staff have been permitted to increase the rate of infusion of morphine to 0.6 ml h-1 [corrected] if required.
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PMID:Postoperative analgesia in children using continuous s.c. morphine. 825 Dec 94

Esophagogastroduodenoscopy is most commonly performed for evaluation of epigastric pain, severe heartburn, chronic nausea and other dyspepsia syndromes that are not relieved by medical therapy. It should not be performed as an in-office procedure in patients with unstable angina, respiratory failure, active upper gastrointestinal bleeding or hemodynamic instability. Although office esophagogastroduodenoscopy is safe for low-risk patients, the risks associated with anesthesia and the need for postprocedure observation may require other patients to undergo the procedure in a hospital setting. Use of a local anesthetic throat spray reduces the gag response that occurs when the endoscope is swallowed. Sedation is commonly achieved with intravenous administration of a benzodiazepine plus a narcotic, and the effects of these drugs can be rapidly reversed. Complications are rare and most frequently result from medications rather than from the procedure itself.
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PMID:Esophagogastroduodenoscopy for the family physician. 827 10


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