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)

In a pilot study a combination of metoclopramide and dexamethasone was administered to 29 patients receiving emetogenic chemotherapy. Metoclopramide was given intravenously (IV) at a dose of 0.5 mg/kg one-half hour before the start of chemotherapy, and then given at the same dose orally two, five, and eight hours after chemotherapy. Dexamethasone was given at a dose of 10 mg IV immediately following the first dose of metoclopramide, then given at a dose of 8 mg orally six, 12, and 18 hours after chemotherapy. The chemotherapy regimens most commonly used were standard FAC, FAM, and BACOD regimens. Twenty-six of 29 patients received outpatient treatment. Complete protection against both nausea and vomiting was seen in 69% (20/29) patients; six others (21%) experienced mild nausea but no vomiting, resulting in 90% (26/29) of the patients having total emetic protection with combination metoclopramide and dexamethasone. Eighty-eight percent (15/17) of the patients with no prior chemotherapy had no nausea or vomiting, one (6%) had only mild nausea, and the remaining patient (6%) had one emesis. Forty-two percent (5/12) of the patients with prior chemotherapy had complete antinausea and emetic protection, five (42%) had nausea without vomiting, and the remaining two patients experienced one or two emesis. Side effects were minimal when present and included mild drowsiness (five patients), akathisia (three patients), diarrhea (one patient), and hot flashes (one patient). Combination metoclopramide and dexamethasone therapy can effectively prevent emesis in 94% of patients receiving potentially emetogenic chemotherapy and can prevent nausea and emesis in 88% of untreated patients. Studies defining the optimal dose and scheduling needed to maintain such antinausea and antiemetic protection are necessary.
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PMID:Combination metoclopramide and dexamethasone: an effective antiemetic regimen in outpatients receiving non-cisplatin chemotherapy. 647 Jul 55

Sixty-one patients undergoing treatment with cis-platin-containing regimens were given prophylactically either metoclopramide or methylprednisolone, in order to reduce the gastrointestinal side effects. Vomiting occurred in 79% of the cycles (128/162), and had a distressing intensity in 39.5% of cycles (64/162). No significant differences were observed between metoclopramide and methylprednisolone with respect to number and duration of vomiting episodes and duration of nausea and anorexia. Two of 6 patients benefited from substitution of metoclopramide for methylprednisolone; only 1/11 benefited from the substitution of methylprednisolone for metoclopramide. Metoclopramide and methylprednisolone, at the dosage and schedule used, were well tolerated and moderately active in preventing nausea and vomiting induced by cis-platin; their use in combination could further improve these results.
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PMID:Comparison of methylprednisolone and metoclopramide in the prophylactic treatment of cis-platin-induced nausea and vomiting. 653 68

In a study of the effectiveness of high intravenous doses of metoclopramide as an antiemetic, 41 patients with advanced cancer who were being treated with cisplatin were entered into two double-blind trials. In the first trial patients were randomly assigned to receive either metoclopramide or placebo, and in the second trial they received either metoclopramide or prochlorperazine. Patients given metoclopramide had significantly fewer episodes of emesis than patients given placebo (medians, 1.0 vs. 10.5; P = 0.001) or prochlorperazine (medians, 1.5 vs. 12.0; P = 0.005). Metoclopramide was superior to placebo and to prochlorperazine in reducing the volume of emesis (P = 0.001 and P = 0.022, respectively) and was more effective than placebo in shortening the duration of nausea (P = 0.042) and vomiting (P = 0.028). Side effects from metoclopramide were minor, with mild sedation frequently observed; one patient had a brief extrapyramidal reaction. We conclude that metoclopramide in high intravenous doses has greater antiemetic activity than placebo or prochlorperazine in patients receiving cisplatin chemotherapy.
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PMID:Antiemetic efficacy of high-dose metoclopramide: randomized trials with placebo and prochlorperazine in patients with chemotherapy-induced nausea and vomiting. 702 7

Ten patients with diabetic gastroparesis were selected for a randomized, double-blind, controlled trial of metoclopramide. Each patient had longstanding insulin-requiring diabetes mellitus and symptoms of gastric stasis. The patients were evaluated for the symptoms of gastric stasis and radionucleotide gastric emptying was measured before the patients entered the study and after they were given either metoclopramide or placebo treatment. Metoclopramide, 10 mg orally, stimulated an increase in the rate of gastric emptying (56.8% +/- 7.4%) in contrast to the response to placebo (37.6% +/- 7.7%) (p less than 0.01). The overall symptoms and symptoms of vomiting were markedly reduced during metoclopramide treatment in contrast to those during placebo treatment. Before the study five patients were constipated (less than three bowel movements per week); during metoclopramide treatment the patients' bowel habits were improved. There was a poor correlation between improved gastric emptying and decreased symptoms. Metoclopramide may improve symptoms of diabetic gastric stasis through two mechanisms: its peripheral effect on gastric smooth muscle, which increases gastric emptying; and its central effects on the chemoreceptor vomiting zone, which decrease nausea.
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PMID:Metoclopramide to treat gastroparesis due to diabetes mellitus: a double-blind, controlled trial. 706 59

One hundred and fifty patients with migraine attacks attending the Copenhagen acute migraine clinic were treated either with metoclopramide 10 mg i.m. metoclopramide 20 mg as suppository or placebo in a double blind trial. All patients simultaneously or 30 minutes later received paracetamol 1 g and diazepam 5 mg orally. The nausea was relieved in 71% of the patients by placebo and bed rest, but metoclopramide was significantly (p = 0.04) more effective and relieved nausea in 86% of the patients. Metoclopramide did not by itself reduce the pain, but enhanced the effect of the analgesic or sedative medication. This effect, however, just failed to be statistically significant (p = 0.06).
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PMID:A double blind study of metoclopramide in the treatment of migraine attacks. 737 38

Fifty-five patients with delayed gastric emptying and the symptoms of nausea, vomiting, postprandial bloating and early satiety were treated with metoclopramide. Obstruction was excluded by upper endoscopy and standard upper gastrointestinal series. None were on medication known to retard gastric emptying. All patients had an abnormal barium burger radiologic study. Twenty-one patients had had previous vagotomy and drainage procedure, five had diabetic gastroparesis and 29 had idiopathic delayed gastric emptying. Metoclopramide significantly decreased the symptom scores of the surgical and idiopathic patients. When all patients were analyzed together, there was a significant improvement in both the metoclopramide and placebo treated patients. When, however, the improvement on metoclopramide was compared to the improvement on placebo, there was a significant metoclopramide effect beyond the placebo effect. Thus, metoclopramide is an effective agent in treating the symptom-complex of patients with delayed gastric emptying.
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PMID:Metoclopramide therapy in fifty-five patients with delayed gastric emptying. 746 58

The prophylactic antiemetic efficacy of intravenous (i.v.) ondansetron, droperidol, perphenazine, and metoclopramide was evaluated in a prospective, double-blind study of 360 ASA physical status I-III patients undergoing total abdominal hysterectomy (TAH). Subjects were randomized to receive i.v., one of ondansetron 4 mg, droperidol 1.25 mg, perphenazine 5 mg, metoclopramide 10 mg, or placebo prior to induction of anesthesia. Hypotension immediately after administration of metoclopramide was observed in two patients and four patients given ondansetron developed profound systolic hypotension at induction of anesthesia. Twenty-two percent of patients receiving droperidol became sedated. Postoperatively, patients developing severe nausea, retching, or vomiting, defined as severe emetic sequelae (SES), were deemed to have failed antiemetic prophylaxis and received antiemetic rescue. A significantly larger number of patients who received i.v. ondansetron (63%), droperidol (76%), and perphenazine (70%) were free of SES when compared to placebo (43%); P < 0.05. Metoclopramide was ineffective. Although ondansetron, droperidol, and perphenazine were effective in providing antiemetic prophylaxis, only i.v. perphenazine was free of side effects. Hence, we conclude that perphenazine is the best choice for antiemetic prophylaxis after TAH.
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PMID:The efficacy of prophylactic ondansetron, droperidol, perphenazine, and metoclopramide in the prevention of nausea and vomiting after major gynecologic surgery. 759 43

Lignocaine has been shown to reduce the incidence of pain on injection of propofol. Metoclopramide, a weak local anaesthetic and commonly used antiemetic, was combined with propofol and the mixture compared, in a prospective, randomized trial, with a lignocaine-propofol combination. The incidence of injection pain was similar in both groups, as were recovery times and incidence of vomiting. The metoclopramide-propofol group experienced a lower incidence of nausea. One patient in the metoclopramide-propofol group had a minor extrapyramidal reaction. No adverse local or haemodynamic effects were seen.
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PMID:Propofol injection pain: comparing the addition of lignocaine or metoclopramide. 781 61

Metoclopramide is an active antiemetic against cisplatin-induced acute emesis. However, the optimal administration method (continuous infusion versus intermittent short infusion) for metoclopramide has not yet been clearly defined. We have conducted a randomized crossover study to compare the antiemetic efficacy of continuous infusion of metoclopramide with that of intermittent short infusion of metoclopramide in 54 evaluable patients. Patients were stratified according to sex and were randomized to receive either a continuous-infusion regimen (regimen A) or an intermittent-short infusion regimen (regimen B). Patients were switched to the alternate therapy in the second course. In regimen A, metoclopramide at 3 mg/kg i.v. was given before cisplatin, and then metoclopramide at 4 mg/kg was infused intravenously over 7.5 hours. In regimen B, metoclopramide at 3 mg/kg i.v. was followed by 2 mg/kg i.v. for two doses. Dexamethasone and diphenhydramine were given intravenously in both regimens. There was no significant difference between two regimens in their ability to prevent emesis. Complete protection (no episode of emesis) and major protection (< or = 2 episodes of emesis), respectively, were obtained by 67% (95% confidence interval: 53-79%) and 85% (95% confidence interval: 73-93%) of all patients given regimen A and by 59% (95% confidence interval: 45-72%) and 81% (95% confidence interval: 68-91%) of those given regimen B. The two regimens were also equally effective in controlling nausea. However, male patients showed better control of nausea and vomiting than did female patients, regardless of treatment regimen. Toxicity was mild in both regimens and was well tolerated. Our findings indicate that both continuous-infusion metoclopramide and intermittent-short infusion metoclopramide are effective in controlling cisplatin-induced acute nausea and vomiting.
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PMID:Continuous infusion versus intermittent short infusion of metoclopramide for cisplatin-induced acute emesis. 809 15

The occurring frequency of 14 most common chemotherapy and anti-nausea drug side-effects was examined. The studies were performed on 29 women with ovarian cancer treated by total number of 125 chemotherapy courses (schedule PAC and Acy) and additionally, in order to eliminate nausea caused by the chemotherapy, by anti-nausea drugs (Zofran, Solu-Medrol, Droperidol, Metoclopramide + Fenactil, Torecan). Zofran caused the fewest number of side-effects, solu-medrol inhibited nausea and vomiting significantly, however it caused many side-effects such as flush on a face, restlessness, incitement and headaches. Torecan did not prevent patients from vomiting. The greatest number of side-effects was observed after droperidol and metoclopramide + fenactil treatment.
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PMID:[Side effects of drug treatment for ovarian cancer after administration of antiemetic drugs]. 814 54


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