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

The purpose of this study was to assess the efficacy and side effects of morphine sulfate controlled-release (MSCR) in patients with cancer pain who had previously required narcotic analgesia. The study design included an attempt at conversion of 30 patients from the previously required narcotic analgesic to around the clock (ATC) 4-h dosing of morphine sulfate immediate-release (MSIR) that would provide satisfactory analgesia. All patients controlled on MSIR at 4-h ATC were then successfully converted to MSCR and had an appropriate dosage regimen established. The patients were subsequently maintained for 4 weeks on MSCR, with the majority of patients adhering to a 12-h schedule at two-thirds the total daily morphine dose of the q 4 h regimen. Twenty-four patients completed this dosage range study. Five dropouts were not related to use of MSCR, while one patient was discontinued because of nausea following administration of both MSIR and MSCR. Patients preferred the analgesic relief of MSCR over their previous narcotic regimen. Half the patients manifested fewer side-effects compared with their prestudy narcotics. No patients had greater side-effects with MSCR. These findings support the efficacy and safety of MSCR at appropriate dosage for the prolonged relief of cancer pain.
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PMID:Dosage range study of morphine sulfate controlled-release. 243 Apr 48

Indecainide, a new type Ic antiarrhythmic agent, and quinidine sulfate were compared in a randomized double-blind parallel study. Cardiac patients with greater than or equal to 30 ventricular premature complexes per hour hour received indecainide, 50 mg, or quinidine, 200 mg every 6 hours, and the doses were increased until more than 80% suppression was noted, adverse effects occurred or a maximal dose of 100 mg of indecainide or 400 mg of quinidine given every 6 hours. Efficacy was achieved in 8 of 10 taking indecainide (p less than 0.05) and 7 of 9 taking quinidine (p less than 0.05). At least 90% of episodes of ventricular tachycardia were suppressed in 4 of 7 patients taking indecainide and 1 of 4 taking quinidine. No adverse effects were observed in the 7 patients who responded to indecainide and the 4 who responded quinidine, resulting in short-term efficacy without adverse effects in 7 patients (70%) taking indecainide and 4 (44%) taking quinidine. The effective or maximal mean daily indecainide and quinidine doses were 190 +/- 32 mg and 1,022 +/- 291 mg, respectively; mean trough indecainide and quinidine concentrations were 617 +/- 247 ng/ml and 3.3 +/- 1.4 micrograms/ml, respectively. Indecainide prolonged mean PR and QRS intervals (p less than 0.05), but not QT and QTc intervals. Quinidine did not change PR or QRS intervals but prolonged QTc interval (p less than 0.05). During dosing, 1 patient discontinued indecainide treatment because of nausea; 3 discontinued quinidine because of gastrointestinal complaints.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Indecainide compared with quinidine for chronic stable ventricular arrhythmias secondary to coronary artery disease or to cardiomyopathy. 244 93

Recently a sustained-release morphine sulfate tablet (MS Contin [MSC]) was introduced in Canada. In a randomized double-blind crossover trial we compared MSC given every 12 hours with a morphine sulfate solution (MSS) given every 4 hours to 17 patients suffering from chronic severe pain. After titration of the morphine dosage to optimize the analgesic effect, each patient received 10 days of therapy with either MSC or MSS, then 10 days of therapy with an equal daily dose of the other formulation. Both preparations provided effective pain control, with minimal side effects. There was no significant difference between MSC and MSS in pain scores on a visual analogue scale (VAS), severity scores for tiredness and nausea, amount of supplemental morphine needed for break-through pain or patient preference. The plasma morphine concentrations tended to be greater during treatment with MSC. The study had an 89% probability of detecting a clinically significant difference in VAS pain scores. We conclude that an individualized, twice-daily regimen of MSC is as effective as MSS given every 4 hours for control of severe pain. The twice-daily regimen has several advantages: it provides for an uninterrupted night's sleep, it is substantially more convenient than the six doses per day required with MSS, and it should help reduce both medication errors and noncompliance.
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PMID:Control of severe pain with sustained-release morphine tablets v. oral morphine solution. 264 88

Oral morphine is increasingly recognized as the pharmacologic standard for cancer pain management. Yet for the primary care physician and oncologist alike, misconceptions of the safety and efficacy of oral morphine along with lack of recognized guidelines for use have often resulted in inadequate cancer pain therapy. Use of controlled-release oral morphine sulfate (MSC) requires additional guidelines for optimum analgesia. Proposed are ten principles of dosing oral morphine, especially MSC, which were followed in a clinical trial involving cancer patients. MSC dosed at 8-, 10-, and 12-hour intervals was compared with immediate-release morphine (IRMS) dosed every four hours, and with prestudy analgesics. Patients achieved satisfactory analgesia at daily doses (mean +/- SE) of 118.0 +/- 8.6 mg and 111.4 +/- 12.6 mg (P greater than .05) for IRMS and MSC, respectively. Dosing endpoints were determined by titration with IRMS and MSC to a minimal and equivalent amount of supplemental short-acting analgesic. Side effects were typical for opioids and tolerated except for one dropout on IRMS (nausea and constipation). The ten principles have been incorporated into a dosing scheme as a practical guide for MSC therapy.
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PMID:Principles of cancer pain management. Use of long-acting oral morphine. 264 96

A multicenter, 14-wk, double-blind, randomized, parallel group study of 60 patients with obstructive lung disease was performed to assess tachyphylaxis with inhaled atropine sulfate versus placebo. Forty patients completed the study; twenty-one were treated with placebo and nineteen were treated with atropine sulfate. Atropine and placebo groups were compared before and after inhaled atropine by spirometry at Weeks zero, 6, and 14. Medication side effects, other medication usage, and symptoms were recorded daily. Comparison of FEV1 response to atropine sulfate from baseline at Weeks zero, 6, and 14 did not show a statistically significant decrease. Inhaled atropine sulfate continued to be an effective bronchodilator in both placebo groups and atropine sulfate groups. There was no evidence of significant tachyphylaxis with atropine. Significant side effects in the atropine group when compared with placebo included dry mouth, dry skin, rapid heart rate, and nausea.
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PMID:Absence of tachyphylaxis to inhaled atropine in patients with chronic obstructive pulmonary disease. 267

The safety and efficacy of epidural morphine injected into the caudal space for control of postoperative pain following open cardiac surgery in children was studied. Thirty-two children between the ages of 2-12 yr for whom early postoperative tracheal extubation was anticipated were randomly assigned to control and study groups. Study subjects received a caudal injection of preservative free morphine sulfate (0.075 mg/kg) in preservative-free normal saline (5-10 ml) following completion of surgery, but prior to awakening and extubation of the trachea. Supplemental intravenous morphine administration and pain scores were recorded for 24 h. Patients in the study group received significantly less (P less than 0.03) morphine (0.32 mg.kg-1.24 h-1) and had significantly lower pain scores than did patients in the control group (0.71 mg.kg-1.24 h-1). The mean duration of complete analgesia in patients receiving caudally administered morphine was 6 h (range 2-12), but decreased analgesic requirements were noted for the entire 24 h. No respiratory depression was evident by clinical variables or repeated arterial blood gas values. Nausea without vomiting occurred in 4/16 patients in the study group. No patient described pruritus. The authors were unable to evaluate the occurrence of urinary retention because all patients had indwelling urinary catheters. They found caudal epidural morphine to be safe and effective in the treatment of postoperative pain in children following open heart surgery.
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PMID:Caudal epidural morphine for control of pain following open heart surgery in children. 292 90

Normally, if pentobarbital and then a toxin are injected after a rat drinks saccharin solution, a taste aversion produced by the pentobarbital summates with that produced by the toxin. An opposite effect is obtained after a preconditioning series in which pentobarbital is injected prior to a toxic dose of lithium or amphetamine in the absence of saccharin drinking: The pentobarbital attenuates the saccharin aversion normally produced by the toxin. Lett (1983) theorized that a conditioned antisickness response (CAR) to pentobarbital is responsible for this conditioned attenuation of saccharin aversion. It is reported here that this attenuation of taste aversion occurs even if the toxin paired with pentobarbital is different from the toxin used during saccharin aversion conditioning. Preconditioning pentobarbital with a high dose of amphetamine allows it to attenuate saccharin aversions produced by lithium and by gamma radiation (as well as by amphetamine itself). Preconditioning pentobarbital with a high dose of lithium allows it to attenuate aversions produced by amphetamine, gamma radiation, cisplatin, mechlorethamine, dactinomycin, and doxorubicin (as well as by lithium itself). This means that the CAR cannot be due to conditioned amelioration of specific effects of specific toxins (which would not be effective if the toxin were changed) and suggests a central alleviation of nausea, perhaps like the alleviation of pain by endogenous opiates. However, aversions produced by intraperitoneal copper sulfate were not attenuated by lithium-conditioned pentobarbital.
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PMID:Pairing pentobarbital with one toxin causes it to attenuate taste aversions produced by a different toxin: implications for conditioned antisickness theory. 302 68

Administration of lithium chloride and copper sulfate to adult monkeys caused marked elevations in plasma vasopressin (AVP) levels without significant increases in plasma oxytocin (OT) levels. Emesis was produced in five of the seven animals given these agents, in support of nausea as the main stimulus to AVP release. A similar pattern of AVP release without OT release was found after administration of cholecystokinin (CCK). Although most monkeys vomited in response to 10 micrograms/kg of CCK, a significant increase in plasma AVP levels also was produced with a dose of 1 microgram/kg, which did not produce emesis in any animal. These findings are in marked contrast with previous results in rats, which indicated that lithium chloride, copper sulfate, and CCK each stimulated OT rather than AVP release. Despite this interspecies difference, the significant neurohypophysial hormone secretion in response to both nausea-producing agents and CCK suggests that AVP secretion in monkeys, similar to OT secretion in rats, might reflect activation of central pathways mediating nausea and/or inhibition of food intake, even when overt illness is not produced.
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PMID:Vasopressin release in response to nausea-producing agents and cholecystokinin in monkeys. 303 8

Thirty-two workers in an electroplating plant accidently drank water contaminated with nickel sulfate and chloride (1.63 g Ni/liter). Twenty workers promptly developed symptoms (e.g., nausea, vomiting, abdominal discomfort, diarrhea, giddiness, lassitude, headache, cough, shortness of breath) that typically lasted a few hours but persisted 1-2 days in 7 cases. The Ni doses in workers with symptoms were estimated to range from 0.5 to 2.5 g. In 15 exposed workers who were tested on day 1 postexposure, serum Ni concentrations ranged from 13 to 1,340 micrograms/liter and urine Ni concentrations ranged from 0.15 to 12 mg/g creatinine. Ten subjects (with initial urine Ni concentrations greater than 0.8 mg/g creatinine) were hospitalized and treated for 3 days with intravenous fluids to induce diuresis, resulting in a mean elimination half-time (T1/2) for serum Ni of 27 hours (SD +/- 7 hour), which was significantly shorter (p less than .001) than the mean T1/2 of 60 hours (SD +/- 11 hours) in 11 subjects who did not receive intravenous fluids. Laboratory tests showed transiently elevated levels of blood reticulocytes (N = 7), urine albumin (N = 3), and serum bilirubin (N = 2). All subjects recovered rapidly, without evident sequellae, and returned to work by the eighth day after exposure.
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PMID:Acute nickel toxicity in electroplating workers who accidently ingested a solution of nickel sulfate and nickel chloride. 318 43

This study assesses the effect of oral iron therapy on the upper gastrointestinal tract and fecal occult blood testing. Fourteen healthy volunteers completed a checklist of gastrointestinal symptoms, underwent endoscopy and biopsy of the stomach and duodenum, and supplied a fresh stool sample for Hemoccult and HemoQuant testing. They then took ferrous sulfate 325 mg per os tid for two weeks and had the same evaluation repeated. Gastrointestinal symptoms were rated by the patients on a scale of 0-3, endoscopic findings were numerically scored (0-4), and the biopsies were graded blindly. Thirteen other healthy volunteers took ferrous sulfate 325 mg per os tid for one week and had Hemoccult testing of stool at days 0 and 7. All subjects developed dark stools, and significant nausea and diarrhea were noted (0.1 +/- 0.1 to 0.9 +/- 0.3, P less than 0.05 for both symptoms). Only 1/27 had a questionably trace-positive Hemoccult test (two observers disagreed) and no significant difference was seen in HemoQuant testing (1.4 +/- 0.5 to 1.8 +/- 0.7 mg Hb/g). A significant increase was seen in endoscopic abnormalities in the stomach (0.1 +/- 0.1 to 1.5 +/- 0.3, P = 0.003), consisting of erythema, small areas of subepithelial hemorrhage, and, in two subjects, erosions. Biopsies showed no significant change after iron therapy. We conclude that (1) oral ferrous sulfate rarely causes Hemoccult-positive stools, and patients with positive Hemoccult tests on iron therapy require further evaluation; and (2) oral iron may cause mild endoscopic abnormalities in the stomach which are of uncertain clinical significance.
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PMID:Effect of oral iron therapy on the upper gastrointestinal tract. A prospective evaluation. 325 37


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