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)

Medroxyprogesterone acetate injections (Depo-Provera) were given to 625 women at 3 monthly intervals involving 693 episodes. Ages at entry to the study ranged from 15-51 years with the majority in their 20s and a mean age of 30. Length of exposure ranged from 3-168 cycles. 4 women have received more than 160 continuous cycles of DMPA. Of the medication-induced reasons for discontinuing DMPA, bleeding was the most common with an incidence of 10.5% followed by depression (1.4%), weight gain (1.4%), and loss of libido (1.6%). No patient ceased treatment because of headaches, recurrent vaginal infections, mastalgia, nausea, chloasma, hypertension, or other vascular illnesses. The 59 women who move away or were lost to follow-up accounted for 405 cycles of treatment. The solitary unplanned pregnancy occurred in a 28-year-old obese woman who had previously had other method failures, once with an IUD and once with oral contraceptives (OCs). No association was found with carcinoma of the cervix. Of 80 women ceasing treatment to become pregnant, only 1 women has required the assistance of chlomiphene and conceived 2 years after ceasing DMPA. Amenorrhea was the side effect most appreciated by the women using DMPA. Due to the problem of irregular bleeding, it is wise to warn prospective patients about the lack of bleeding control that they have 1 chance in 10 of having relative menorrhagia. Women using OC subject to frequent vaginal moniliasis had a marked reduction in episodes after switching to DMPA. Chloasma, 1 of the minor stigmas of OC, was not induced in any of the patients. DMPA is a safe and efficient reversible method of contraception for women who have various gynecological conditions or problems associated with using OCs.
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PMID:Medroxyprogesterone acetate as an injectable contraceptive. 296 70

Drug companies have been at work throughout the 1960s, 1970s, and 1980s trying to reduce the steroid content of their oral contraceptives (OCs). Researchers have been successful in reducing steroid content while maintaining effectiveness, thereby making OCs safer. In the 1st half of the natural menstrual cycle, a woman secretes estrogen as the dominant steroid product. In the 2nd half, estrogen is the principal reproductive hormone. Estrogens inhibit ovulation, possibly by inhibiting implantation, altering ovum transplant, or in some way preventing corpus luteum function, which is necessary to maintain early pregnancies and the endometrium. There are still only 2 estrogens and 6 progestins on the market today. They are probably the most thoroughly studied chemical ever seen in the history of pharmacy or medicine. 1 of the estrogens, mestranol, is really a drug of the past. In the body, mestranol is converted to ethinyl estradiol, the other estrogen on the market. Consequently, there is no reason to use mestranol itself. Within the dose range of 50-100 mcg, there's little difference in contraceptive effect. Progestins are the other active ingredient in the combination OC. Their principal action is the thickening of the cervical mucus, which prevents sperm penetration. Also, with sufficient progesterone, ovulation is inhibited, but this happens in only 40% of those patients taking, for instance, the "mini-pill" (which consists of progesterone only). The progestins and the estrogens work in concert to make OCs a highly effective contraceptive method. Recent surveys conducted by the Centers for Disease Control and National Cancer Institute looked into the relative effectiveness of OCs. Nordette had a use effectiveness failure rate of 3.5; Ovral, 3.6. Loestrin 1/20 -- norethindrone acetate, 1 mg, and estinyl estradiol, 20 mcg -- shows a failure rate of 4.5. This indicates that the threshold for an effective dose of estinyl estradiol in OCs is 30 mcg. For 1 mini-pill, Ovrette, the failure rate is 9.5 -- much higher. Depo-Provera has a failure rate of 0.7. The primary complaint from women taking OCs is spotting and breakthrough bleeding during the cycle. 30-50% of women given OCs stop taking them within a year. OC side effects include nausea, fluid retention, breast tenderness, leukorrhea, hypomenorrhea, headaches, spotting around the face, hypertension, and visual changes. 1 of the risks of birth control pills may be cervical dysplasia -- changes in the cells of the cervix. The relative risk of cervical cancer with OCs after 5-9 years is approximately 1.8. Clinical cases of deep vein thrombosis number 1/1000 per year among nonusers of OCs. Among users, the rate is 3 times as high: 3/1000. The most serious potential adverse effect is myocardial infarction. Of the excess deaths attributed to OCs (23.3 total per 100,000 users), 22.7 are due to myocardial infarctions and hemorrhage. The discussion also briefly reviews other methods of contraception -- Depo-Provera, male contraceptives, implants, the diapragm, and IUDs.
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PMID:Prescription contraceptives: countering the risks. 405 Jun 70

The contraceptive effect of Depo-Provera or medroxyprogesterone acetate, a long-acting injectable progestogen, has been mainly attributed to its ability to prevent ovulation through its action on the hypothalamic pituitary axis, reducing the levels of plasma gonadotropin, progesterone, and estradiol, and suppressing the midcycle surge of luteinizing hormone. Its other contraceptive effects are thickening of the cervical mucus, causing a barrier to spermatozoa, alteration in tubal ovum transport, and atrophy of the endometrium. A standard dose of 150 mg injected every 3 months is as effective as the combined oral pill and more effective than the progestogen-only pill or IUD. Contraindications to use are thrombophlebitis, liver dysfunctions, suspected breast or genital malignancy, and abnormal uterine bleeding. Reported discontinuation rates range from 7-80%. The World Health Organization (1977) reported a gross cumulative discontinuation rate of 23.4/100 women years in 8 centers. Depo-Provera has a long list of short-term (menstrual disorders, fluid retention, nausea, hair loss, and others) and long-term (delayed fertility return, congenital abnormalities, cancer others) disorders. Its advantages include: 1) convenience, 2) effectiveness, 3) no risk of infection or other side effects of the coil, 4) none of proven side effects or long-term hazards of estrogen, and 5) no inhibition of lactation. The safety of Depo-Provera has been a controversial issue which led to its banning in the U.S. Its carcinogenic potential has been reported in clinical trials with animals. Its greatest disadvantage is that it takes control of a woman's fertility firmly out of her hands into those of the doctor. Depo-Provera should not be used except as an absolute last resort. It should not be used as a long-term contraceptive in this country, and research monies should instead be channeled into the development of a safe, reliable contraceptive with no systemic side effects.
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PMID:Depo-Provera: an injectable contraceptive. 645 20

A 42-year-old woman was administered a cleansing enema to treat chronic constipation. Immediately after the procedure she developed intense pain in the abdominal region, nausea, vomiting, and rectal bleeding. The patient, who was in good general health, had been on contraceptive administration of Depo-Provera (150 mg each month) for 1 year. Radiological investigation, endoscopy and histopathological examinations revealed acute ischemic colitis. A left hemicolectomy was performed with colorectal anastomosis through laparotomy; the postoperative period was good and the patient was discharged in good health. The majority of cases of ischemic colitis occur in persons of advanced age, because of arteriosclerosis. In young female patients it is necessary to systematically investigate contraceptive use as a possible iatrogenic cause; surgery may be indicated in some cases.
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PMID:Ischemic colitis attributable to a cleansing enema. 725 Sep

We report the clinical course of eight patients with metastatic renal cell carcinoma (RCC) who were treated with recombinant gamma-interferon (Immuneron) as part of a phase II-III study comparing the safety and efficacy of gamma-interferon with that of medroxyprogesterone acetate (Depo-Provera). There were no objective responders among the eight patients treated with recombinant gamma-interferon at an i.v. dose of 1 mg/m(2) daily for five days every other week for four weeks then 1 mg/m(2) three times a week given every other week until there was documented disease progression or complete response (CR). Overall median survival was 17.3 months (range 1.4 to 184). The major side effects of treatment included fever/chills (75%), mild anorexia and fatigue (75%), nausea/vomiting (80%), leukopenia (38%), and abnormal liver function tests (25%). There were no life-threatening side effects observed. At our institution, in a random cohort of eight patients with metastatic RCC, recombinant gamma-interferon when given at a dose of 1 mg/m(2) per day given three times per week on an every other week schedule yields no clinical antitumor activity. A review of the literature on the use of gamma-interferon for metastatic RCC suggests that low-dose combination therapy with other cytokines may yield the best response-to-side effect ratio. Higher doses yield more responses but an added cost of more toxicity.
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PMID:Single institution experience with recombinant gamma-interferon in the treatment of patients with metastatic renal cell carcinoma. 861 Jun 39

To assess the contraceptive needs of induced abortion patients, a 3-month (1992-93) prospective study was conducted of 269 women presenting to a National Health Service clinic in London, England, for pregnancy termination. 163 women (62.6%) had been using contraception--primarily condoms--around the time they became pregnant, but 86 failed to use the method correctly. Another 81 women (31.2%) had used contraceptives in the past, but not at the time of the index conception. 73 of these women were former pill users and 39 had used condoms. 39.5% of these women had discontinued use because of contraceptive side effects, particularly nausea. Finally, 16 women (6.2%) had never used a contraceptive method. 15 of these women were from outside the UK and had difficulties speaking English. When asked what form of contraception they would like to use in the future, 48.8% of abortion patients identified the pill, 11.9% wanted Depo-Provera, 7.3% chose condoms, and 6.5% wanted the IUD. Chemists were a major source of contraceptive supplies for women in this study, and this trend may represent a way of avoiding discussions of sexual activity with health professionals. Among the recommendations emerging from this study are more widespread education about and availability of emergency contraception, health promotion education in pharmacies, enhanced training of general practitioners in pill prescribing criteria and counseling, efforts to prevent repeat unwanted pregnancies, and the preparation of educational materials for non-English speaking family planning clients.
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PMID:Use of contraception in women who present for termination of pregnancy in inner London. 939 68

A case report documents a Hispanic adolescent, 17 years of age, with pseudocyesis, who became amenorrheic using Depo-Provera to prevent a second pregnancy. Pseudocyesis includes classic symptoms of pregnancy such as nausea, breast enlargement and pigmentation, abdominal distention, and amenorrhea in nonpregnant women. It demonstrates the to control one's physical aspect at the level of hypothalamus. The involvement that contributed to her pseudocyesis--in this case, of her mother and boyfriend -- was not unusual. The abrupt resolution was brought on by normal menstrual period that began after she voluntarily missed her Depo-Provera injection. However, her ambivalence about a pregnancy became clear after she and her family received counseling. While the agenda had been to help her prevent a pregnancy, hers had not been as clear and uncomplicated. Her subsequent conception was a very positive one for her and her family, which helped to resolve the situation.
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PMID:Pseudocyesis in an adolescent using the long-acting contraceptive Depo-Provera. 1047

Since the last in a series of childbirth education classes discusses contraception, educators must know about various family planning methods. Oral contraceptives (OCs) comprise combined OCs, phasic OCs, and minipills. Combined OCs inhibit secretion of gonadotropin-releasing hormone, which in turn keeps the follicle-stimulating hormone from inducing the ovarian follicle to grow and keeps luteinizing hormones from activating ovulation. They also thicken cervical mucus. Minipills also thicken cervical mucus and render the endometrium unreceptive to fertilized egg implantation. They do not always inhibit ovulation, however. OCs can induce side effects, such as nausea, hypertension, increased risk of atherosclerosis, and fatigue. The IUD prevents pregnancy either by inhibiting implantation of a fertilized egg or by an inflammatory reaction of the endometrium resulting in a release of macrophages which may destroy sperm. The no-longer-produced Dalkon Shield IUD increased the risk of pelvic inflammatory disease and damaged the reputation of other IUDs. Rare IUD complications are uterine perforation, salpingitis, tubal scarring, pelvic inflammatory disease, and infertility. Diaphragms, cervical film, and condoms serve as barriers between the egg and sperm. The main problem with barrier methods is the increased risk of developing toxic shock syndrome. Spermicide increase the effectiveness of diaphragms, cervical caps, and condoms. Vasectomy keeps sperm from arriving at storage sites. Shortterm side effects are swelling, discomfort, and occasional rejoining of the cut ends of the vas. Research hints at a link between vasectomy and prostate cancer. Some complications of tubal ligation are urinary tract infections, accidental electrical burns, and pelvic infections. Natural family planning methods include withdrawal, the rhythm method, and the sypto-thermal method. Controversial injectable contraceptives are Depo-Provera (medroxyprogesterone acetate) and Noristerate (norethisterone enanthate).
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PMID:Birth control update for childbirth educators. 1234 29

Molar pregnancies represent an uncommon yet important obstetric problem with potentially fatal outcomes. Patients typically present with signs and symptoms of early pregnancy, and physicians most often suspect nonmolar pregnancy complications initially; however a hydatidiform mole should be included in the differential diagnosis of a woman with a positive pregnancy test and abnormal vaginal bleeding irrespective of the use of contraception. Our case is that of an adolescent female on Depo-Provera injectable contraceptive with increased vaginal bleeding, abdominal pain, nausea, and vomiting who was incidentally found to be pregnant and subsequently diagnosed with a molar pregnancy despite persistent denial of having initiated sexual intercourse. Though gestational trophoblastic disease is uncommon with an incidence of about 1-2 cases per 1,000 pregnancies, a clinician has to display a high index of suspicion when dealing with patients at extremes of age in order to avoid potentially life-threatening outcomes.
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PMID:Incidental Finding of Persistent Hydatidiform Mole in an Adolescent on Depo-Provera. 2811 90