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

Apart from sufficient experience on the part of the examining physician and adequate technical apparatus, proper premedication can facilitate the procedures for both patient and physician considerably. The paper reports on experience gained in 500 laparoscopies carried out under conditions which were deviated slightly from those hitherto recommended in the literature. The analgesic employed was Tilidine (in Germany: Valoron), and Diazepam was used as a sedative; both of these substances were given intravenously, the vein was kept open for the entire course of the examination. The Tilidine dose was normally 50-100 mg, but under exceptional circumstances as much as 150 mg. Tilidine showed good analgesic effectiveness and tolerance; no case or nausea or vomiting and no sign of respiratory depression of effects on smooth muscle were observed under the conditions stated. The fact that Tilidine is not subject to the restrictions imposed by the German narcotics law is also seen as an advantage. The Diazepam dose was 5-30 mg. Apart from its sedative effect Diazepam also diminishes the tonus of skeletal muscle (important in laparoscopy) and has a relatively long time of elimination (20-48 h). In addition to these two substances, 10-20 ccm of 1% Lidocaine solution with Epinephrine additive was given as a local anaesthetic. The investigators' experience with the above premedication procedure was found to be convincingly positive.
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PMID:[Premedication with valoron (Tilidin) in internal laparoscopy]. 13 78

Under randomized double-blind conditions, 1.00 to 1.67 mg of intravenous physostigmine (Antilirium) reversed sleep induced by administration of 0.102 to 0.238 mg/kg body weight of intravenous diazepam in eight healthy human volunteers. Awakening occurred 330 to 740s after initiation of the physostigmine infusion at a rate of 0.5 mg/min every 4 min. Diazepam plasma levels were not significantly different at the start of either the physostigmine or placebo infusion. Physostigmine did not effect plasma binding of diazepam. Six subjects experienced nausea, and one subject developed an arrhythmia. Physostigmine reverses diazepam-induced hypnosis but causes side-effects requiring cautious administration.
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PMID:Physostigmine reversal of diazepam-induced hypnosis. A study in human volunteers. 38 Apr 27

The series comprises 109 healthy females aged 14-49 years (mean age 28 years) hospitalized for legal abortion or diagnostic curettage. The patients were premedicated with morphine-scopolamine 0.4-0.7 ml i.m. (morphine 20 mg/ml, scopolamine 0.6 mg/ml) and atropine 0.01 mg/kg i.v. Ketamine 1.5 mg/kg was administered i.v. and immediately thereafter 2 ml of a coded solution i.v. consisting either of diazepam 10 mg or its solvent only. Supplementary doses of ketamine 0.2-0.4 mg/kg were administered when needed. Diazepam reduced the incidence of unpleasant dreams and experiences to a significant degree (p less than 0.01) according to the postanaesthetic interviews of the patients. Nausea occurred in the diazepam group in 2 per cent and in the placebo group in 17 per cent (p less than 0.01). In respect to the differences in opinion presented in literature the authors consider the time of administration of diazepam at induction to be of decisive importance and find prophylactic prevention of dreams justified as it cannot be predicted which of the patients will have unpleasant or even terrifying dreams. Dreams and/or experiences or their memories must be prevented at the stage at which the effect of ketamine commences. The authors do not, however, recommend ketamine anaesthesia for young adults, even when supplemented with diazepam. On the other hand, the authors consider the positive observations made during the study to be applicable to all other ketamine anaesthesias.
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PMID:Effect of diazepam on emergence from ketamine anaesthesia. A double-blind study. 76 May 87

Diazepam (0.21 mg/kg; group 1) and midazolam (0.03 mg/kg; group 2) was applied for sedation in two groups of urological patients (n = 10 in each) requiring transurethral resection (urine bladder, prostata) using spinal or peridural anaesthesia. Before anaesthetic procedure, 500 ml hydroxyethyl starch were administered for precluding severe vascular depression. Patients receiving midazolam began to sleep within one minute. Heart rate dropped in both groups after injection of both benzodiazepines which was considered a physiological sleeping effect. No hypotensive reactions were registered. Using this therapy maximum PaO2 values of 14.9 kPa in group 1 (diazepam) were registered and of 14.0 kPa in group 2 (midazolam). During the operation all patients were arousable. Side-effects such as nausea, vomiting and confusion were not observed.
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PMID:[The effect of diazepam and midazolam on the circulation and respiration during spinal and peridural anesthesia]. 208 5

Buspirone is an antianxiety compound that has been extensively evaluated in clinical trials: it has proved superior to placebo and comparable to diazepam in the treatment of patients with generalized anxiety disorder. In this study, 33 outpatients with generalized anxiety disorder were entered into a crossover study of 3 weeks each of placebo, buspirone 10 to 30 mg daily, and diazepam 10 to 30 mg daily. Psychiatrist and patient ratings were made, together with psychological tests and EEG and skin conductance measures before and after each treatment. Of the nine dropouts, six were on buspirone at the time of dropout. For the remaining 24 patients, the mean daily doses attained of buspirone and diazepam were both 20 mg. On most clinical ratings diazepam was superior to buspirone and placebo, which did not differ. Diazepam produced minor psychomotor changes and the expected major effects on the EEG. Buspirone was without effect. Side effects on buspirone were mainly nausea and giddiness and on diazepam, drowsiness. The lack of efficacy of buspirone is discussed in terms of the previous benzodiazepine exposure--23/24 patients had had previous exposure and only 10 were able to tolerate a pretrial placebo washout period. The implications are considerable for the introduction of any new antianxiety agent not cross-tolerant with the benzodiazepines into a chronically anxious group of patients with previous long-term benzodiazepine therapy.
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PMID:A comparison of buspirone, diazepam, and placebo in patients with chronic anxiety states. 288 44

Three placebo-controlled double-blind and crossover trials were carried out to analyze the effects of oral yohimbine (YOH) 0.8 mg/kg on mood and performance in 16 healthy students. Subjective assessments (visual analogue scales, side-effects on questionnaire) and objective measurements (digit symbols, flicker fusion, tapping, heterophoria) were done at baseline, and post treatment. YOH shifted the healthy subjects' mood towards feeling panicked, elevated systolic blood pressure and plasma prolactin concentrations, reduced digit symbol substitution, and induced drowsiness and passiveness. Caffeine (CAF) 10 mg/kg raised plasma cortisol and rendered the subjects slightly panicked. Muzziness, clumsiness, tremor, chills and nausea were common after both YOH and CAF. Diazepam (DZ) 0.3 mg/kg given at 60 min antagonized some effects of CAF but failed to antagonize YOH. Clonidine (CLO) 100 micrograms counteracted YOH effects on blood pressure but less the subjective and hormonal effects. CLO 200 micrograms partly antagonized the pressor, sedative but not the hormonal responses of YOH. DZ counteracted YOH effects on plasma cortisol on panic but not on other subjective measures or plasma prolactin. Since CLO did not abolish YOH-induced prolactin increase, it is suggested that these effects of YOH are mediated not only via adrenergic alpha 2-receptors; other mechanisms made important contributions.
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PMID:Anxiogenic effect of yohimbine in healthy subjects: comparison with caffeine and antagonism by clonidine and diazepam. 315 10

A survey was made of drug prescriptions written for all medical/surgical patients in a general hospital on a single weekday in 1978. Of these 348 patients, 195 were over the age of 60. In this elderly group, 62 (32 percent) were receiving psychoactive drugs. Flurazepam was the drug most commonly prescribed (in 63 percent of the patients). Diazepam was the most frequently prescribed nonhypnotic psychoactive drug (in 29 percent). Neuroleptic drugs and phenothiazine anti-emetics (in 52 percent) were not prescribed for psychosis but for augmenting analgesia and sedation and for reducing nausea. The average daily doses were about 20 percent of those used to treat psychotic young adults. All antidepressants (in 9.7 percent) had been prescribed before admission. No monoamine oxidase inhibitors were used, and doses of tricyclic antidepressants were half to one-third lower than those used to treat younger depressed adults. Antidepressants, which pose a risk to the elderly patient, were overprescribed and underdosed.
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PMID:Psychotropic drug prescriptions for elderly patients in a general hospital. 610 Dec 83

This paper presents the usage of psychotropic drugs by all general inpatients of a Boston teaching and referral hospital on a randomly chosen weekday. Of all surveyed inpatients, 42.8% were receiving at least one psychotropic medication. Sleep medications were the most frequently prescribed class of psychotropic drugs and flurazepam was the most commonly prescribed of all drugs. Phenothiazine and neuroleptics were given to control agitation, pain, or nausea, rather than psychosis. Antidepressants were prescribed without notated justification in the medical record, and if given for depression, were underdosed. Diazepam was the most frequently prescribed antianxiety drug and was the most frequently prescribed psychotropic drug after flurazepam. Psychotropic drug polypharmacy was common, with the average patient receiving seven different drugs. Remedial approaches to this widespread problem are recommended.
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PMID:Psychotropic drug use and polypharmacy in a general hospital. 611 14

Forty-one patients with advanced squamous cell lung cancer and no prior chemotherapy were entered in a prospectively randomized trial comparing dianhydrogalactitol plus Adriamycin (DA) versus DA plus cis-dichlorodiammineplatinum(II) (DAP). The DAP regimen was superior to the DA regimen in regression rate (53% versus 27%), median regression duration (255 versus 122 days), median time to tumor progression (approximately 175 versus 58 days), and median survival time (185 versus 126 days). Patients who were greater than 60 years old responded particularly well to the DAP regimen and accounted for most of the survival advantage. Nausea, vomiting, and myelosuppression were more frequent and severe with the DAP regimen. This study seems to indicate a role of cis-dichlorodiammineplatinum(II) in patients with advanced squamous cell lung cancer. The particular advantage noted for older patients needs further evaluation.
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PMID:A role of cis-dichlorodiammineplatinum(II) in squamous cell lung cancer. 699 Nov 7

Diazepam has been used empirically for the relief of vertigo and, in addition, there are animal studies to suggest that this drug suppresses the vestibular system. One might anticipate therefore that diazepam would be an effective antimotion sickness drug. To study this, motion sickness was generated in four groups of normal subjects by having the subject make controlled head movements while rotating at constant velocity. Every subject was subjected (using a double-blind technique) to four different drug states, namely no drug, placebo, dimenhydrinate, and diazepam. Each group of subjects received the drug state at a different time interval (i.e. 30, 60, 90, and 120 min) prior to the motion sickness exposure. Motion sickness endpoints were measured subjectively using a nausea scale and objectively using a sweat sensor. The results showed significant antimotion sickness properties for both dimenhydrinate and diazepam as compared to the placebo. For the time intervals studied, the maximum effect was obtained at 120 min for both drugs.
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PMID:Diazepam as an anti-motion sickness drug. 713 36


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