Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty patients were studied in the early post-operative period after cardiac surgery with sternotomy. Buprenorphine was prescribed: 0.3 mg intra-muscularly after total recovery from anaesthesia (8th hour) then every 8 hours if requested during 72 hours. The patients auto-estimated their level of analgesia, the clinical effects were measured with regard to heart rate, systolic and diastolic arterial pressure, and respiratory rate, before, 2 and 4 hours after each injection. Buprenorphine administration produces an effective, long lasting (8 to 12 hours) analgesia. No significant changes in haemodynamic or respiratory parameters were noticed. Side effects occurred rarely: 5 cases of drowsiness, reversible by verbal stimulation, 2 of nausea and sweats, 2 retentions of urine (after vesical catheter withdrawal). Parenteral buprenorphine is satisfactory for treatment of severe thoracic pain due to sternotomy, although the oral route would be safer during effective anticoagulant treatment.
 ...
PMID:[The use of buprenorphine in the postoperative period in heart surgery. Evaluation of its efficacy and tolerance]. 273 Oct 59

Intravenous ciprofloxacin was administered to 54 patients who were either critically ill or in whom oral administration was not possible. The 31 males and 23 females ranged in age from 20 to 89 years (mean, 53.2 +/- 17.8 years). Patients had "difficult-to-treat" infections, i.e., respiratory infections (15), abscesses (four intraabdominal, three lung, two soft tissue, and one intrahepatic), deep soft tissue infections (10), chronic post-traumatic osteomyelitis in exacerbation (nine), upper urinary tract infection (five), malignant external otitis (two), catheter-related bacteremia (two), and infectious endocarditis (one). Thirty patients (56 percent) had serious associated medical problems. Pathogens included Pseudomonas aeruginosa (38 isolates), Acinetobacter species (10 isolates), Enterobacter cloacae (eight isolates), Escherichia coli (two isolates), Proteus mirabilis (one isolate), Kingella kingae (one isolate), Bacteroides fragilis (eight isolates), and Peptostreptococcus species (five isolates). Minimal inhibitory concentrations of ciprofloxacin ranged from 0.003 to 2 micrograms/ml. In 39 patients, the isolated microorganisms were multi-resistant; resistance included ceftazidime and amikacin in 32 patients. In 24 patients, ciprofloxacin was given exclusively by the intravenous route at a dose of 200 mg every 12 hours; in 30 patients, treatment was completed after discontinuation of the parenteral drug with the oral preparation of ciprofloxacin at a dose of 750 mg every 12 hours. The duration of parenteral treatment ranged from six to 40 days (mean, 14.9 days). A successful clinical response was observed in 49 patients (91 percent), while five (9 percent) failed to show a response. Bacteriologic outcomes were as follows: eradication of pathogen in 33 patients (61.1 percent), persistence in 18 (33.3 percent), and relapse in three (5.6 percent), with development of resistance to ciprofloxacin in nine patients (16.7 percent) and superinfection in two patients (3.7 percent). Side effects included vein irritation at the site of the infusion (three patients), abnormal elevation in liver enzyme levels (two patients), reversible renal failure (one patient), and nausea (one patient). Parenteral ciprofloxacin is a safe, well-tolerated, and effective therapy for the critically ill patient, and can be replaced with the oral form when clinically appropriate.
 ...
PMID:Use of intravenous ciprofloxacin in difficult-to-treat infections. 355 59

The epidural instillation of morphine for pain control has been utilized for some time, although primarily intraoperatively or for patients with chronic severe pain, as in terminal cancer. Long term indwelling catheter or subarachnoid administration of epidural morphine are both potentially hazardous. However, in relatively brief applications, up to a few days, the epidural administration of morphine sulfate Is effective, safe, and well tolerated when used according to a carefully controlled plan. We report the use of this method as an improved means for the control of post-lumbar surgery pain in 25 cases. These patients were compared with 25 others receiving standard doses of parenteral and oral narcotics. The two groups were quite similar preoperatively. However, patients receiving epidural morphine were more comfortable, had fewer side effects such as nausea and lassitude, and exhibited no respiratory depression. Further, they ambulated sooner, showed no definitive orthostatic hypotension and less ileus, and remained much more alert and cooperative during the initial 48 hours after operation. Hospitalizations were usually shorter by 1 or 2 days. The administration of very small doses (1.0 to 2.5 mg) of morphine every 12 to 24 hours was usually adequate for good to excellent postoperative pain control. Hydroxyzine was sometimes used to potentiate the analgesia between doses. The epidural catheters were routinely removed within about 72 hours. The technique for the intraoperative placement of the epidural catheter and drug administration are detailed. Precautions for catheter placement were carefully followed to prevent dural penetration or intrathecal injection.
 ...
PMID:Indwelling epidural morphine for control of post-lumbar spinal surgery pain. 663 31

Mild tail pinch (TP) in rats resulted in 72% of animals displaying ingestive behavior with 20% demonstrating gnawing behavior without food ingestion and 8% demonstrating licking behavior only. The animals ate steadily over 5 min with a maximum rate occurring at 1 min (0.5 +/- 0.2 g). There was a circadian rhythm of TP-induced behavior with the peak food ingestion occurring at 24 h. A mild increase in blood glucose occurred 120 s after commencement of TP (115 +/- 4 mg/dl). Common satiety signals such as stomach distension and glucose decreased food ingestion. Parenteral administration of glucagon, cholecystokinin-octapeptide, bombesin, and thyrotropin-releasing hormone resulted in suppression of TP-induced food ingestion. Chronic TP (12 5-min TP periods/day) resulted in a fall in spontaneous food intake with the total intake remaining similar to food intake prior to the chronic TP period. We suggest that TP serves as an excellent model for eating behavior because 1) it correlates well with starvation-induced eating; 2) it precludes the necessary deprivation of food and water to adrenalectomized animals; and 3) animals subjected to TP continue chewing in the face of decreased food intake allowing one to exclude the possibility that the effects of an anorectic are secondary to nausea.
 ...
PMID:Stress-induced eating in rats. 719 55

Migraine is caused by intermittent brain dysfunction. Attacks result in severe unilateral headache with nausea, vomiting, photophobia, phonophobia and general weakness. The prevalence of migraine is 12 to 20% in women and 8 to 12% in man. Treatment of an acute attack is done by antiemetics in combination with analgesics. Severe migraine attacks are treated with ergotamine or sumatriptan. Parenteral treatment is performed most efficiently and safely with i.v. ASA. Frequent and severe attacks require prophylaxis. Drugs of first choice are metoprolol, propranolol, flunarizine and cyclandelate. Substances of second choice are valproic acid, DHE, pizotifen, methysergide and magnesium. Homeopathic remedies are not superior to placebo. Nonpharmacological treatment consists of sport therapy and muscle relaxation techniques.
 ...
PMID:[Migraine--diagnosis, differential diagnosis and therapy]. 913 7

Iron overload caused by lifelong transfusion-dependent anaemias, such as beta-thalassaemia major, usually results in lethal cardiac toxicity in the second decade of life if not treated by iron chelation. There is no physiological mechanism for excreting the excess iron accumulated from blood transfusions and, unlike hereditary haemochromatosis, venesection is not an option. Therefore, chelation therapy is the only way to remove excess iron. This must be removed while not depriving cells of the essential iron needed for normal metabolism. Additionally, the iron chelator must prevent iron from participating in the generation of harmful free radicals. Parenteral chelation therapy with deferoxamine (desferrioxamine) is well established as promoting negative iron balance, reversing cardiac toxicity, and prolonging life expectancy well into the fourth decade of life and, most likely, beyond. Unfortunately, poor compliance with the rigours of parenteral treatment in a minority of patients limits its regular use, resulting in reduced life expectancy in these patients. Use of deferoxamine in excessive dosages may result in growth retardation, sensorineural ototoxicity and ocular toxicity, as well as bone deformities. These effects can be largely avoided if the dosage is adjusted to take account of the degree of iron overload (using the therapeutic index) and if the mean daily dose does not exceed 40 mg/kg. Nevertheless, it is recommended that patients be regularly monitored for such adverse effects. Deferiprone (L1; CP20) is an orally absorbed bidentate hydroxypyridinone iron chelator that can induce urinary iron excretion, promote negative iron balance and reduce hepatic iron levels in some transfusion-dependent patients, particularly in those who are markedly iron overloaded and have not received regular deferoxamine therapy. The long term efficacy and toxicity of deferiprone are the subjects of some controversy, and the published results of randomised controlled trials are awaited. Preliminary results suggest that when currently recommended dosages of deferiprone (75 mg/kg/day) are used, hepatic iron settles at levels that still put most patients at an increased risk from iron overload. A number of adverse effects may occur, and require cessation of therapy in up to 30% of patients. These effects include arthritis, nausea and (most seriously) agranulocytosis in 0.6 to 4% of patients. The risk of the latter complication means that frequent white blood cell counts are mandatory for patients taking this drug. There remains an urgent need to identify an orally active chelator regimen that is as effective as deferoxamine and has an acceptable degree of tolerability.
 ...
PMID:A risk-benefit assessment of iron-chelation therapy. 942 39

The anorexia-cachexia syndrome is a particularly frequent complication of advanced cancer. Parenteral nutrition must remain the exception in palliative medicine but enteral nutrition through feeding tubes or by a gastrostomy is an efficient method to provide an adequate long term nutritional support at home which can improve the quality of life of the palliative care patient. One must never forget all simple means to improve nutritional status. Since the cost benefit ratio of the medications stimulating the appetite, such as the corticosteroids and the progestatives, must still be demonstrated in palliative medicine. Hiccups therapy is essentially based on several non pharmacological means and on the administration of metoclopramide, antacids, haloperidol or chlorpromazine. Chronic nausea is an extremely frequent problem in palliative care, treated most often by metoclopramide, haloperidol and corticosteroids. Constipation is another extremely frequent problem which can lead to serious complication if left untreated. Besides general means, therapeutic means essentially comprise drugs such as lactulose and macrogol, bisacodyl, docusan and prokinetic agents like cipraside.
 ...
PMID:[Nutritional and digestive disorders in palliative care]. 980 66

Bowel obstruction may be an inoperable complication in patients with end-stage cancer. Scopolamine butylbromide (SB) and octreotide (OCT) have been successfully used with the aim of reducing gastrointestinal (GI) secretions to avoid placement of a nasogastric tube (NGT); however, there have been no comparative studies concerning the efficacy of these drugs. Furthermore, there is little information about the role played by parenteral hydration in symptom control of these patients. In a prospective trial that involved all 17 inoperable bowel-obstructed patients presenting to our services with a decompressive NGT, patients were randomized to OCT 0.3 mg/day or SB 60 mg/day for 3 days through a continuous subcutaneous infusion. Clinical data, survival time, and the time interval from the first diagnosis of cancer to the onset of inoperable bowel obstruction were noted. The intensity of pain, nausea, dry mouth, thirst, dyspnea, feeling of abdominal distension, and drowsiness were assessed by means of a verbal scale before starting treatment with the drugs under study (T0) and then daily for 3 days (T1, T2, T3). Moreover, daily information was collected regarding the quantity of GI secretions through the NGT, the oral intake of fluids, the quantity of parenteral hydration, and the analgesic therapy used. The NGT could be removed in all 10 home care and in 3 hospitalized patients without changing the dosage of the drugs. OCT significantly reduced the amount of GI secretions at T2 (P = 0.016) and T3 (P = 0.020). Compared to the home care patients, the hospitalized patients received significantly more parenteral hydration (P = 0.0005) and drank more fluids (P = 0.025). There was no difference in the daily thirst and dry mouth intensity in relation to the amount of parenteral hydration or the treatment provided (OCT or SB). Independent of antisecretory treatment, the patients receiving less parenteral hydration presented significantly more nausea (T0 P = 0.002; T1 P = 0.001; T2 P = 0.003; T3 P = 0.001) and drowsiness at T3 (P < 0.5). Pain relief was obtained in all 17 patients and only two patients required an increase in morphine dose at T1. All patients with inoperable malignant bowel obstruction should undergo treatment with antisecretory drugs so as to evaluate the possibility of removing the NGT. When a more rapid reduction in GI secretions is desired, OCT should be considered as the first choice drug. Parenteral hydration over 500 ml/day may reduce nausea and drowsiness.
 ...
PMID:Role of octreotide, scopolamine butylbromide, and hydration in symptom control of patients with inoperable bowel obstruction and nasogastric tubes: a prospective randomized trial. 1068 23

Nutrition support in gastroparesis begins with encouraging smaller volume, low-fat, low-fiber meals and, if necessary, liquid caloric supplements. There should be a low threshold for placing a jejunal feeding tube either by laparoscopy or mini-laparotomy. Parenteral nutrition should be used only briefly during hospitalization and not encouraged or sustained as an outpatient. Metoclopramide is now the prokinetic of choice for patients who can tolerate this agent; subcutaneous administration is an important method that allows for continued guaranteed absorption. Low-dosage erythromycin also has a prokinetic role alone or in combination with metoclopramide. Domperidone, a centrally acting antiemetic and prokinetic, is only be available to US citizens who can access sources in Canada or Mexico. Antiemetics should be used extensively because nausea is a very severe debilitating symptom, which is under-appreciated and under-treated by physicians. We recommend scopolamine patches to gain maximal absorption, in spite of vomiting and unpredictable oral intakes. The 5-hydroxytryptamine-3 (5-HT3) antagonists ondansetron and granisetron are the most powerful agents. Relief bands using the P6 acupuncture point are useful adjunct. Special vigilance should be paid to situations that can undermine medical therapy or result in breakthrough symptoms, such as hyperglycemic events in patients with diabetes, migraine headaches, cyclic nausea and vomiting, menstrual cycles, rumination syndrome (psychogenic vomiting), and elevated herpes simplex titers. Most excitingly, the era of gastric electrical stimulation has arrived for patients not responding to standard medical therapy. The dramatic improvement in nausea and vomiting, as well as a sustained evidence of improved quality of life, gastric emptying, nutritional status, and decreased hospitalizations by this device are documented by long-term follow-up of more than a year for patients in this country and world-wide.
 ...
PMID:Gastric Dysmotility and Gastroparesis. 1146 76

As death approaches, a gradual shift in emphasis from curative and life prolonging therapies toward palliative therapies can relieve significant medical burdens and maintain a patient's dignity and comfort. Pain and dyspnea are treated based on severity, with stepped interventions, primarily opioids. Common adverse effects of opioids, such as constipation, must be treated proactively; other adverse effects, such as nausea and mental status changes, usually dissipate with time. Parenteral methylnaltrexone can be considered for intractable cases of opioid bowel dysfunction. Tumor-related bowel obstruction can be managed with corticosteroids and octreotide. Therapy for nausea and vomiting should be targeted to the underlying cause; low-dose haloperidol is often effective. Delirium should be prevented with normalization of environment or managed medically. Excessive respiratory secretions can be treated with reassurance and, if necessary, drying of secretions to prevent the phenomenon called the "death rattle." There is always something more that can be done for comfort, no matter how dire a situation appears to be. Good management of physical symptoms allows patients and loved ones the space to work out unfinished emotional, psychological, and spiritual issues, and, thereby, the opportunity to find affirmation at life's end.
 ...
PMID:Pharmacologic pearls for end-of-life care. 2014 91


1 2 Next >>