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

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

Low dose estrogen tablets, containing less than 50 mcg of ethinyl estradiol, were formulated because of the recognized dose response relationship with the steroid content of the tablet and side effects. These new oral contraceptives (OCs) are as effective as the older high-dose OCs, and available evidence reports fewer side effects. This discussion reviews pharmacology of these new OCs, the mechanism of action, contraindications, side effects, and problems with the low-dose estrogen OC. Ethinyl estradiol is the only estrogen used in the low-dose combination OC. There are several synthetic progestins: norethindrone, norethindrone acetate, norgestrel, levonorgestrel, and ethynodiol diacetate. These progestins have different potencies so the pharmacologic activity cannot be accurately predicted based on the amount present in the tablet. The synthetic steroids in OCs are absorbed in the small intestine, metabolized in the liver, excreted in the bile and feces with a half-life of 24 hours. The low-dose estrogen combination preparation is taken 3 out of every 4 weeks. Its contraceptive effect is primarily a result of hypothalamic mediated gonadotropin suppression with subsequent inhibition of ovulation. Contraindications to taking the low-dose OC are the same as for the higher dose OC: thromboembolic or cardiovascular disease, estrogen dependent neoplasia, markedly impaired liver function, undiagnosed genital bleeding, congenital hyperlipidemia, pregnancy, and women over age 30 who smoke. Relative contraindications include hypertension, diabetes mellitus, migraine headaches, uterine myomas, and epilepsy. The often quoted 2-5-fold increased incidence of thromboembolic disease, myocardial infarction, and stroke is based on large epidemiologic studies involving patients taking the older higher dose OCs. Current data from patients taking the newer low-dose medication demonstrate minimal if any increased incidence of these problems in young women who do not smoke. The low-dose estrogen OCs have minimal effect on lipid levels. Early reports of patients using the low-dose OC have shown little if any increased incidence of hypertension. The low-dose contraceptives have little effect on glucose tolerance, and there is no evidence to show an increased incidence of overt diabetes in OC users. There is no evidence that use of the combination OC causes an increase in cancer of the cervix, uterus, or ovaries. Clinical complaints of nausea, breast discomfort, chloasma, weight changes, and depression are reduced with the low-dose estrogen preparation. Hypomenorrhea while taking the OC occasionally occurs because the lower dose of estrogen is insufficient to stimulate the endometrial growth in face of the predominant progestin-atrophy effect.
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PMID:Oral contraceptives in 1984. 649 Mar 38

To verify if bicarbonate dialysis actually improves the dialytic tolerance of acetate intolerant patients, we have measured the incidence of dialysis with side effects such as headache, nausea, vomiting, hypotension, post-dialytic fatigue at 180 days interval in 2 groups of patients. The first with a good tolerance to acetate, the other with a bad tolerance acetate but put meanwhile for 90 days on a bicarbonate dialysis. While the incidence of side effects did not change in the first group, it decreased by 75% in the second, in spite of a greater weight loss. Thus bicarbonate improves the dialytic tolerance in patients intolerant to acetate as well as ultrafiltration.
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PMID:[A hemodialysis bath with bicarbonate improves comfort and ultrafiltration]. 666 27

Twenty-three patients with advanced solid tumors received 9-hydroxy-2N-methyl-ellipticinium acetate at a single daily i.v. dose of 15-80 mg/m2 for 5 consecutive days, repeated every 3 weeks. One partial and one minor response were achieved in two patients with breast cancer. Dryness of the mouth was dose-related and dose-limiting. Local phlebitis was also dose-related and frequently severe at the highest dose levels. Other non-hematologic toxic effects were essentially mild to moderate and included nausea, vomiting, diarrhea, stomatitis, fever, weakness, transient renal and hepatic impairment, alopecia and chest pain. Minimal myelosuppression was encountered. It appears that 60 mg/m2/day is the maximum tolerated dose with a five-day schedule. According to our findings, this schedule does not seem to offer any advantage over the previously tested weekly administrations.
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PMID:Phase I clinical study of 9-hydroxy-2N-methyl-ellipticinium acetate (NSC-264137) administered on a 5-day i.v. schedule. 688 28

A review of the composition, usage, and side effects of hormonal contraceptives is presented. The estrogens ethinyl estradiol, mestranol, ethinyl estradiol sulfonate, and quinestrol, as well as the gestagens chlormadinon acetate, norethindrone acetate, and d-norgestrel, are used in combination, sequential, and depot preparations, mini-pills, and morning-after pills. The failure rate of combination preparations is 1/100 women-years and of sequential preparations is 1-5/100 woman-years. Gestagen-intensive preparations can be used for women showing symptoms of gestagen deficiency (e.g. hypermenorrhea, endometriosis), while estrogen-intensive preparations are indicated for women with e.g. hypomenorrhea, acne, or hirsuitism. Preparations containing chlormadinon acetate are indicated for women with signs of androgen imbalance or for women who sing or use their voices professionally. Control check-ups of patients using hormonal contraceptives should occur every 6 months. Women who still want to bear children should discontinue hormonal contraceptive use for a certain period every 2 years. Hormonal contraceptives can be prescribed to adolescents 2 years after menarche and after one year of regular menstruation. The side effects of hormonal contraceptive use are listed. Subjective side effects such as nausea and headaches are frequently reported. Hormonal contraceptives can cause menstrual irregularities; spottings or break-through bleedings during hormonal contraceptive use indicate a reduced contraceptive effectiveness. Hormonal contraceptive use causes increases in laboratory values, e.g. SGOT, SGPT; lipid metabolism and carbohydrate metabolism are also affected by hormonal contraceptives. Hormonal contraceptives have been shown to cause an increase in blood pressure and affect the circulatory system, liver and gall bladder function, and blood coagulation. Neoplasms may be affected positively or negatively by hormonal contraceptive use. Relative and absolute contraindications for hormonal contraceptive use as well as indications for discontinuing hormonal contraceptive use are listed.
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PMID:[Hormonal contraception--side effects and surgical aspects (author's transl)]. 701 44

Since it has been clearly established that multiple drug chemotherapy is more effective than the use of a single drug for advanced carcinoma of the breast, the latter is not commonly used today. However, upon failure of one of two combinations of drugs, if any of these drugs are then tried singly they are rarely useful, and valuable time is lost. It is at this point that megestrol acetate, a potent progestin, was found to be effective in 30 per cent of a series of 161 patients with advanced carcinoma of the breast. This drug was given orally, 40 milligrams, after each meal and at bedtime, without any toxicity or any undesirable reactions, except a weight gain--not fluid retention--in patients less than 55 years of age. The average duration of response was 8.1 months from onset of megestrol acetate therapy and for the group classified as unchanged, 5.2 months. This drug is at least as effective as any steroid or cytotoxic compound but has the advantage of not producing toxicity and, with the exception of weight gain in patients less than 55 years, no undesirable reactions of any kind, such as bone marrow depression, alopecia, nausea, vomiting or diarrhea. Hence, it can be properly administered by the patient's physician or surgeon. Since oncologists known that medroxyprogesterone therapy had not shown promising use for advanced carcinoma of the breast, it was assumed that megestrol acetate also had little activity, and hence, it was not used. However, those who did give it a trial found it a valuable compound in the management of advanced carcinoma of the breast, even after failure of all hormonal or cytotoxic combination trials. It proved to serve as an important addition to our armamentarium in the management of advanced carcinoma of the breast.
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PMID:Clinical results with megestrol acetate in patients with advanced carcinoma of the breast. 714 70

Changes in pH and blood gases were studied during hemodialysis with both acetate and bicarbonate dialysates. During acetate dialysis, PaO2 and PaCO2 decreased significantly (P less than 0.05) from 101 +/- 2 to 93 +/- 3 mmHg and from 34.4 +/- 1.0 to 31.8 +/- 0.9 mmHg, respectively, whereas during bicarbonate dialysis neither parameter changed significantly. The final pH was 7.45 +/- 0.01 during acetate dialysis and 7.50 +/- 0.02 during bicarbonate dialysis. Plasma bicarbonate rose immediately and progressively from 18.9 +/- 0.8 to 26.8 +/- 0.9 mmol/L with bicarbonate dialysis, whereas the increase was moderate, from 19.6 +/- 0.6 to 22.3 +/- 0.5 mmol/L, with acetate dialysis. These data indicate that dialysis-induced hypoxemia was prevented and correction of acidosis was more adequate with bicarbonate dialysis. During a two-year period on bicarbonate dialysis, total cholesterol, HDL-cholesterol, and triglycerides did not change significantly when compared to acetate dialysis. The most striking change was the increased tolerance to dialysis with bicarbonate dialysis, which included a 50% reduction in hypotensive episodes and muscle cramps and an almost complete absence of headache, nausea, and vomiting.
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PMID:Effect of bicarbonate-containing dialysate on chronic hemodialysis patients: a comparative study. 716 57

Cyproterone acetate (100 mg daily on the 5th-14th days of the normal cycle) together with ethinyl estradiol (0.05 mg daily on the 5th-25th days) was used for the treatment of hirsutism in 23 women for six months. This treatment caused a significant decrease in the severity of the hirsutism after only three months, the effect being maximal after six months. Sixty per cent of our patients reported being subjectively satisfied with the results. A relapse occurred, however, within three months of the end of the treatment in half the patients. The serum testosterone was significantly decreased after three months of treatment, but the changes in serum testosterone did not follow the changes in the clinical picture of hirsutism, suggesting that one facet in the favorable action of cyproterone acetate is an inhibition of the action of androgen on target cells. Various side effects, such as nausea, headache, loss of libido and depression, were reported very frequently, which undoubtedly limits the large scale use of this treatment, at least with the doses used in this study.
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PMID:Cyproterone acetate in the treatment of hirsutism. 728 7

During standard haemodialysis, cause of calcium and magnesium insoluble salts formation, the bicarbonate as a buffer has been replaced by the more soluble and stable acetate. But the new and more efficient dialytic systems cause an increase of intradyalitic bicarbonate loss and acetate gain the latter, by a direct calcium binding or by calcium displacement from the active sites, has been believed to be responsible for vasodilatation and myocardial contractility depression. Aim of this study is to verify if the bicarbonate dialysis versus acetate dialysis modifies left ventricular performance, investigated by non invasive tools (systolic time index and echocardiography). This work deals with twelve patients undergoing standard haemodialysis (three times a week) since 28 months on the average. Echocardiographic and systolic time index study was performed before and after the acetate dialysis and before and after the tenth bicarbonate dialysis observing the same interdialytic period. The echo has shown improvement concerning the fractional shortening (P less than 0.025) and the cardiac output (P less than 0.05) and only before the tenth bicarbonate dialysis. Systolic time index data have shown reduction of the ratio PEP/LVET (P less than 0.05) and LVET less negative than after acetate only in the end of the tenth bicarbonate dialysis (P less than 0.05). These results seem point out left ventricular performance improvement in accordance with the decrease of clinical intradialytic (nausea, vomiting, and hypotension) and interdialytic troubles (headache, asthenia and washed-out feeling) probably due to the bicarbonate more effective as a buffer in the acid-base and electrolytic balance.
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PMID:[Comparison of acetate and bicarbonate in hemodialytic treatment. Echocardiographic and polycardiographic study of the left ventricle]. 731 88

From 1971 to 1974 89 patients with advanced ovarian cancer (FIGO-stage III-IV), admitted to seven centers of the Swiss Group for Clinical Cancer Research (SAKK), were randomly allocated to three different treatment schedules: cyclophosphamide (CYT) alone or CYT in combination with either medroxyprogesterone acetate (GEST) or 5-fluorouracil (FU). Results in 71 evaluable patients (according to standardized group criterial) were as follows: 1. The overall remission rate was 48% (34 out of 71 patients) with no clear-cut statistical difference between the three treatment schedules but a firm trend towards higher remission rate with CYT + FU (58% as compared to 42% with CYT alone). 2. The scheduled "second-look" operations were performed in only 5 of 34 patients clinically judged to respond to therapy (PR), and does not allow objective surgical monitoring of therapeutic effects intraabdominally. 3. The median remission duration varied from 3 months (CYT alone) to 6 months (CYT + FU or CYT + GEST), again with only marginal statistical differences. 4. With regard to survival from initiation of chemotherapy, no treatment regimen was superior to another. The median survival ranged from 6.6 months (CYT) to 10.3 months (CYT + GEST). Patients responding to chemo-(hormone) therapy (CR + PR + NC) showed a significant prolongation of survival as compared to those with initial disease progression: median survival in "responders" was 11 months and in "non-responders" 2.9 months. A small group of 8-10% of all treated patients has survived in documented tumor remission for 4 years and more. 5. Toxicity was moderate and consisted mainly of mild temporary hematologic depression, tolerable nausea and transient alopecia, with equal distribution in the three treatment regimens. Hemorrhagic cystitis due to CYT was observed only in 3 cases. 6. Progress in remission induction and duration, as well as survival in advanced ovarian cancer, seems to depend on the inclusion of new effective agents (such as adriamycin, hexamethylmelamine and cisplatinum) and, most probably, on significantly more intensive treatment.
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PMID:[Chemo-(hormonal)-therapy of advanced ovarian neoplasms in FIGO stages III and IV. Prospective SAKK-study 20/71]. 742 63


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