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)

Ketoconazole action dosed as 400-600 g per day was studied in 12 patients with prostatic metastasizing carcinoma. The decrease in serum testosterone down on castration values was stated in one G1 cancer patient and another two G1, G2 patients approximated to this level. No more than two patients with well differentiated tumour showed the significant decrease in alkaline, acid and prostatic phosphatase down to normal values. No toxic manifestations were stated with only impaired tolerance to the drug in 9 patients from them its administration was discontinued for nausea, vomiting and dysorexia in 2 cases. The favourable clinical action has been signalized in only a half patients. The drug trial showed neither significant decrease in plasmatic testosterone, nor more promising treating results in comparison with current hormonal therapy with stilbenes.
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PMID:[Results of a clinical trial of ketoconazole in metastatic prostatic carcinoma]. 184 10

The antifungal drug ketoconazole has been shown to block testosterone synthesis. High dose ketoconazole therapy was given to 17 patients with previously untreated stage D2 prostatic cancer. Rapid relief of pain occurred in 15 patients with significant pain. Prostatic acid phosphatase levels normalized or decreased in all patients. Bone scan scores were stable or improved. Two patients remain on therapy for more than 30 months. The remainder have ceased treatment owing to subsequent progressive disease (5 patients), side effects (6) or noncompliance. Eleven patients who had relapse after previous endocrine ablative therapy were treated with ketoconazole. Subjective responses were frequent but long-term objective responses were rare. There was a high incidence of side effects, particularly nausea. Ketoconazole may have limited usefulness as initial therapy in patients with endocrine responsive advanced prostatic cancer. The drug can be palliative in some patients who have failed previous therapeutic modalities. Analogues of the drug should prove to have better efficacy and fewer side effects.
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PMID:Long-term experience with high dose ketoconazole therapy in patients with stage D2 prostatic carcinoma. 243 34

We have treated 48 cases of onychomycosis (of which 37 were caused by dermatophytes, 10 by yeasts and one by Scopulariopsis brevicaulis) with 200 mg ketoconazole daily. We obtained recovery in 65 p. 100 of the cases of onyxis caused by dermatophytes and in 80 p. 100 of the cases of onychomycosis due to Candida. The one patient presenting an infection with Scopulariopsis brevicaulis recovered in 13 months. The average duration necessary to obtain complete recovery was 6 1/2 months for onychomycosis of the hands due to dermatophytes and 12 1/2 months for those of the feet. Perionyxis due to Candida needed 2 months of treatment with this drug, however 6 months of treatment were necessary to obtain recovery for onycholysis due to Candida. Biological tests remained normal and the side-effects were minimal and essentially gastrointestinal in our study. Ketoconazole is an effective treatment for onychomycosis: it is active against the different mycotic agents infecting nails and well tolerated by the patient. Several minor effects such as itching, nausea, headache and more serious reactions such as erythrodermia and hepatitis have been reported. Regular control and biological tests are therefore necessary. Patients with other diseases should avoid the use of ketoconazole for treatment of onychomycosis.
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PMID:[Ketoconazole and onychomycosis]. 608 41

Ketoconazole, a new oral antifungal agent, was evaluated in the treatment of four patients with severe chronic mucocutaneous candidiasis refractory to standard antifungal therapy. Three had Candida esophagitis, and too had previously received intravenous amphotericin B. Initial ketoconazole dosage was 100 mg daily for patients weighing less than 30 kg and 200 mg daily for patients over 30 kg. All four patients showed dramatic improvement on the initial dose; three had complete clearing of mucous membrane and skin lesions within three weeks. Of the three patients with Candida esophagitis, one had complete clearing of esophagitis within one month and two were markedly improved. One patient required 400 mg daily to obtain complete clearing of skin and mucous membrane lesions. Two patients were maintained free of overt disease on one dose three times weekly but two patients relapsed and have required daily ketoconazole therapy to keep them free of Candida. The only side effects were mild nausea (two patients) occasional emesis at higher doses (two patients), and transient hypocholesterolemia (one patient). No adverse hematologic, gastrointestinal, or renal effects were noted. Ketoconazole appears to be a valuable oral antifungal agent for some patients with CMC.
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PMID:Successful treatment of chronic mucocutaneous candidiasis with ketoconazole. 625 9

Forty patients (22 males and 18 nonpregnant females) with tegumentary mycoses were treated with ketoconazole (R41,400). The group included 39 patients with dermatophytoses and one with tinea versicolor. Ketoconazole was administered in one dose per day taken with water 2 hr before or after breakfast for one month; patients weighing < 30 kg received 100 mg of ketoconazole per day, whereas those weighing > 30 kg received 200 mg per day. Twenty-one patients had complete clinical and mycologic cure, two responded clinically but the last culture was positive, eight had partial improvement, and three had no improvement at all. In six cases the treatment was stopped (in one because of gastric intolerance). The main adverse effect of ketoconazole was nausea; only one patient had vomiting. The results indicate that ketoconazole is a safe and effective drug for treatment of dermatomycosis.
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PMID:Treatment of dermatomycoses with ketoconazole. 625 34

Candida infection of the esophagus is a frequent occurrence in both symptomatic and asymptomatic patients. In the present study, 12 symptomatic consecutive patients with Candida esophagitis. were successfully treated with oral Ketoconazole in a single dose of 200 mg daily. Response to treatment occurred in 8 days or less, with complete resolution of symptoms and endoscopic clearing of lesions. We found Ketoconazole to be well tolerated except for one patient who developed nausea, vomiting, and facial flushing while on the drug, which seemed to have been precipitated by alcohol intake. No changes in liver function tests were noted. Ketoconazole in this study was universally effective. In addition, its ease of administration, cost effectiveness, and low toxicity make it, in our opinion, the initial therapy of choice for C. esophagitis.
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PMID:Ketoconazole treatment of Candida esophagitis--a prospective study of 12 cases. 630 14

Ketoconazole has only recently been recognized as a cause of hepatic injury, with most reports coming from outside the United States. In order to characterize more fully the U.S. experience, we undertook an analysis of 54 reports of alleged ketoconazole-induced liver injury submitted to the Food and Drug Administration from the time of initial marketing in 1980. Thirty-three reports were considered likely instances of ketoconazole-induced hepatitis. The majority of these cases occurred in women more than 40 yr of age. Jaundice was recorded in 27 individuals after therapy of 11-168 days with an average daily dose of 200 mg. Anorexia, malaise, nausea, and vomiting accompanied liver injury in one-third of cases. No instances of rash or eosinophilia were recorded. Serum transaminase and alkaline phosphatase values were consistent with acute hepatocellular injury in 18 patients, with primarily cholestatic injury in 5 patients, and with a mixed pattern in 9 individuals. Only one death seemed attributable to ketoconazole. In that patient, the drug was continued after the appearance of clinical and biochemical evidence of hepatic injury and massive hepatocellular necrosis was present at autopsy. The incidence of symptomatic, potentially serious hepatic injury appears to be very low, perhaps 1 in 15,000 exposed individuals. The presumed mechanism of injury is metabolic idiosyncrasy, although hypersensitivity has not been completely dismissed in some cases reported in the literature. The incidence of mild, asymptomatic, reversible elevations in serum transaminases occurring in ketoconazole recipients has been estimated to be 5%-10%. Periodic biochemical testing and monitoring for symptoms of hepatitis during ketoconazole therapy is recommended to help prevent the development of serious or fatal hepatic injury.
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PMID:Hepatic injury associated with ketoconazole therapy. Analysis of 33 cases. 631 20

Ketoconazole has been used with success to treat disseminated intravascular coagulation and acute spinal cord compression syndromes associated with metastatic prostatic adenocarcinoma. It effects prompt, reversible medical castration, making it especially useful as empiric therapy when histologic diagnosis is delayed but prostate cancer is suspected. Side effects are usually limited to asthenia, nausea, diarrhea, and gynecomastia, but a theoretical risk of adrenal suppression exists. We report a case of fulminant adrenal crisis precipitated by ketoconazole given on a 6-hour dosing schedule in a patient with nerve root compression secondary to prostatic metastases. Through a review of the literature, we attempt to provide a better understanding of the use and potential dangers associated with ketoconazole therapy.
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PMID:Ketoconazole-induced adrenal crisis in a patient with metastatic prostatic adenocarcinoma: case report and review of the literature. 914 92

The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, drug interactions, and dosage and administration of donepezil are reviewed. Donepezil is a synthetic noncovalent reversible inhibitor of acetylcholinesterase (AChE) for the treatment of mild to moderate dementia associated with Alzheimer's disease. In contrast to tacrine hydrochloride, the only comparable agent currently approved by FDA, donepezil exhibits a relatively high degree of selectivity for neuronal AChE as opposed to butyrylcholinesterase. It has a half-life of 60 hours in young adults and 104 hours in elderly patients. In clinical trials, donepezil has been associated with significant improvements in Alzheimer's Disease Assessment Scale-cognitive subscale and Clinical Interview-Based Impression of Change scores. The most common adverse effects associated with donepezil are nausea, diarrhea, anorexia, and vomiting, which are most likely to occur during dose initiation or adjustment. Hepatotoxicity, a dose-limiting adverse effect that sometimes requires discontinuation of tacrine, has not been reported with donepezil. Donepezil does not appear to interact with theophylline, cimetidine, warfarin, or digoxin. Ketoconazole and quinidine inhibit the metabolism of donepezil in vitro, but there is a lack of clinical data showing that these drugs decrease the clearance of donepezil. The initial recommended dosage is 5 mg daily before bedtime, with a dosage increase to 10 mg after four to six weeks according to the patient's response and tolerance. Donepezil appears to be preferable to tacrine as the initial agent for patients with mild to moderate dementia associated with Alzheimer's disease.
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PMID:Donepezil: an anticholinesterase inhibitor for Alzheimer's disease. 942 50

The newer antifungal agents itraconazole, terbinafine and fluconazole have become available to treat onychomycosis over the last 10 years. During this time period these agents have superseded griseofulvin as the agent of choice for onychomycosis. Unlike griseofulvin, the new agents have a broad spectrum of action that includes dermatophytes, Candida species and nondermatophyte moulds. Each of the 3 oral antifungal agents, terbinafine, itraconazole and fluconazole, is effective against dermatophytes with relatively fewer data being available for the treatment of Candida species and nondermatophyte moulds. Itraconazole is effective against Candida onychomycosis. Terbinafine may be more effective against C. parapsilosis compared with C. albicans; furthermore with Candida species a higher dose of terbinafine or a longer duration of therapy may be required compared with the regimen for dermatophytes. The least amount of experience in treating onychomycosis is with fluconazole. Griseofulvin is not effective against Candida species or the nondermatophyte moulds. The main use of griseo-fulvin currently is to treat tinea capitis. Ketoconazole may be used by some to treat tinea versicolor with the dosage regimens being short and requiring the use of only a few doses. The preferred regimens for the 3 oral antimycotic agents are as follows: itraconazole - pulse therapy with the drug being administered for 1 week with 3 weeks off treatment between successive pulses; terbinafine - continuous once daily therapy; and fluconazole - once weekly treatment. The regimen for the treatment of dermatophyte onychomycosis is: itraconazole - 200mg twice daily for I week per month x 3 pulses; terbinafine - 250 mg/day for 12 weeks; or, fluconazole - 150 mg/wk until the abnormal-appearing nail plate has grown out, typically over a period of 9 to 18 months. For the 3 oral antifungal agents the more common adverse reactions pertain to the following systems, gastrointestinal (for example, nausea, gastrointestinal distress, diarrhoea, abdominal pain), cutaneous eruption, and CNS (for example, headache and malaise). Each of the new antifungal agents is more cost-effective than griseofulvin for the treatment of onychomycosis and is associated with high compliance, in part because of the shorter duration of therapy. The newer antifungal agents are generally well tolerated with drug interactions that are usually predictable.
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PMID:A risk-benefit assessment of the newer oral antifungal agents used to treat onychomycosis. 1064 75


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