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)

Eflornithine was offered as compassionate treatment of 33 episodes of Pneumocystis carinii pneumonia in 31 patients with acquired immunodeficiency syndrome who were intolerant of and/or unresponsive to conventional trimethoprim-sulfamethoxazole or pentamidine therapy. A full course of eflornithine consisted of ten days at 400 mg/kg/d but no more than 30 g/d in four divided intravenous doses, four days at 300 mg/kg/d in four divided intravenous doses, and then up to six weeks at 300 mg/kg/d in four divided oral doses where tolerated. Of 33 patient-episodes, 15 patients were discharged from the hospital without need for supplemental oxygen after receiving ten or more days of parenteral therapy and were classified as responders. Of the 16 episodes classified as treatment failures, death occurred within the first 10 days of therapy in 12, and supplemental oxygen could not be withdrawn in 4. The other two patients left the hospital without need of oxygen after receiving one and six days of treatment with eflornithine and were not considered evaluable for efficacy. The most serious adverse effect was thrombocytopenia, which occurred in 12 of 19 patients treated for ten days or more. Serious bleeding associated with thrombocytopenia was observed in two patients. Other common adverse effects were anorexia, nausea, and diarrhea. Prior to receiving eflornithine, 13 of 15 responders had received ten or more days of conventional therapy without demonstrating clinical improvement. Two had improved while receiving conventional therapy but were switched to eflornithine because of a treatment-limiting adverse effect of standard therapy. These results suggest that eflornithine may be useful as an alternative therapeutic agent for Pneumocystis carinii pneumonia. Studies designed to determine proper dosage, duration of therapy, and efficacy as primary therapy are warranted.
 ...
PMID:Eflornithine treatment of refractory Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome. 172 13

he safety and efficacy of oral transmucosal fentanyl citrate (OTFC) as a preanesthetic medication and the efficacy of droperidol as a prophylactic anti-emetic were evaluated in 100 children aged 2-8 yr undergoing general anesthesia for outpatient surgery. Patients were randomly assigned to one of four groups and managed in a double-blinded manner: 1) placebo lozenge 45 min preoperatively and placebo (normal saline) injected intravenously after induction of anesthesia; 2) placebo lozenge 45 min preoperatively and 50 micrograms/kg droperidol intravenously after induction; 3) 15-20 micrograms/kg OTFC lozenge 45 min preoperatively and placebo intravenously after induction; and 4) 15-20 micrograms/kg OTFC lozenge 45 min preoperatively and droperidol 50 micrograms/kg intravenously after induction. Anesthesia was induced and maintained with halothane and nitrous oxide in oxygen. Heart rate, respiratory rate, blood pressure, and hemoglobin oxygen saturation (SpO2) were monitored throughout the study. Scoring systems were used to evaluate sedation, anxiety, cooperation, and ease and quality of anesthetic induction. Emergence, recovery, and discharge times were recorded. Nausea, vomiting, and adverse effects were noted. Preoperatively, children receiving OTFC had significantly greater sedation, slower respiratory rates, lower SpO2, and less excitement during induction. Postoperative nausea and vomiting occurred significantly more frequently after OTFC than after placebo. Prophylactic droperidol did not significantly reduce the incidence of nausea and vomiting. The authors conclude that, in pediatric surgical outpatients, OTFC reliably induces preoperative sedation and facilitates inhalation induction of anesthesia, but it is associated with significant decreases in respiratory rate and SpO2 and a high incidence of postoperative nausea and vomiting that is not significantly reduced by prophylactic droperidol.
 ...
PMID:Oral transmucosal fentanyl citrate for preanesthetic medication of pediatric day surgery patients with and without droperidol as a prophylactic anti-emetic. 172 35

Forty-two surgical patients were given epidural tramadol for control of postoperative pain. They were randomly assigned to three groups: group 1 (n = 15), in which 25 mg of tramadol were given; group 2 (n = 13), in which 50 mg of tramadol were given; and group 3 (n = 14), in which 75 mg of tramadol were given. When the patients complained of wound pain, epidural tramadol was given. Heart rate, blood pressure, respiratory rate, oxygen saturation (SpO2), sedation scale, motor blockade, verbal rating scale, subjective grading, and visual analogue pain scale (VAPS) were measured and recorded before the tramadol administration, at 5 and 15 min, and at 1, 2, 4, and 8 h after the tramadol administration. Only 26.6% of the patients in group 1 had significant relief of pain. The rest of them needed at least one incremental dose of 25 mg of tramadol. The baseline VAPS of the patients in group 2 was 8.9 +/- 2.0. It became 5.46 +/- 3.0 (p greater than 0.05) 15 min after tramadol was given, and dropped further to 1.9 +/- 1.8 (p greater than 0.05) 2 h later. The average duration of pain relief was 12.0 +/- 5.9 h. In group 3, the initial VAPS was 8.14 +/- 1.9. It decreased to 4.28 +/- 1.8 (p greater than 0.05) 15 min, and further dropped to 1.7 +/- 0.9 (p greater than 0.05) 2 h following tramadol administration. The average duration of pain relief was 11.3 +/- 4.8 h. The common side effects of tramadol such as dizziness, nausea, and dry mouth, were most frequently found in group 3.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Epidural tramadol for postoperative pain relief. 175 61

One hundred and sixty-four patients scheduled for elective termination of pregnancy under general anaesthesia were randomly assigned to receive one of three different supplements to propofol and oxygen in nitrous oxide anaesthesia: 0.1 mg fentanyl, 0.5 mg alfentanil or placebo. Postoperative pain and nausea, as well as complications during anaesthesia were studied. There were no differences in complications or complaints by surgeons during anaesthesia, and no patient in any group reacted unsatisfactorily to surgery. The patients in the placebo group consumed significantly more propofol during the procedure (P less than 0.001). No differences were seen in time until hospital discharge between the three groups. Complaints about postoperative pain were significantly less frequent among patients receiving fentanyl (P less than 0.01). The number of patients requesting postoperative analgetics, however, did not differ. There was no difference in the frequency of nausea or vomiting, but postoperative pain was found significantly to increase complaints of nausea (P less than 0.01) and also time until hospital discharge (P less than 0.01). In conclusion, opioid supplementation lowered the amount of propofol needed for anaesthesia. Alfentanil 0.5 mg did not improve the postoperative course. Fentanyl 0.1 mg decreased the frequency of postoperative pain without increasing the time to hospital discharge.
 ...
PMID:Opioid supplementation to propofol anaesthesia for outpatient abortion: a comparison between alfentanil, fentanyl and placebo. 176 99

Desflurane's induction and recovery characteristics were compared to those of propofol-nitrous oxide in outpatients undergoing laparoscopic procedures. Ninety-two healthy patients were randomized to receive either: 1) propofol induction and propofol-nitrous oxide maintenance (control), 2) propofol induction and desflurane-nitrous oxide maintenance, 3) desflurane-nitrous oxide, or 4) desflurane alone for induction and maintenance of anesthesia. Inhalation induction with desflurane-nitrous oxide was faster than with desflurane alone (100 +/- 35 vs. 124 +/- 43 s). Inhalation inductions were associated with a high incidence of apnea (17 and 26%), breath-holding (26 and 39%), and coughing (30 and 22%) in groups 3 and 4, respectively. The emergence time after discontinuation of desflurane in oxygen (4.5 +/- 2.1 min.) was significantly less than that after propofol-nitrous oxide (7.3 +/- 3.9 min.). However, times from arrival in the recovery room until the patients were judged fit for discharge were similar for all four treatment groups. Digit-symbol substitution test results and sedation visual analogue scores also were similar during the first 2 h in the recovery room. A lower incidence of moderate-to-severe nausea was reported in group 1 (15% vs. 52, 52, and 59% in groups 2, 3, and 4, respectively). In conclusion, induction of anesthesia with desflurane was rapid but is associated with a high incidence of airway irritation. Emergence and recovery profiles after maintenance of anesthesia with desflurane compared favorably to a propofol-nitrous oxide combination. However, propofol was associated with a lower incidence of nausea than was desflurane after outpatient anesthesia for laparoscopic surgery.
 ...
PMID:Use of desflurane for outpatient anesthesia. A comparison with propofol and nitrous oxide. 183 Apr 62

The effect of nitrous oxide on postoperative nausea/vomiting and alertness were studied in 50 patients undergoing elective upper abdominal surgery. The study period lasted 20 h. Patients were randomly assigned to receive thiopentone-fentanyl-isoflurane-pancuronium anaesthesia with either 70% nitrous oxide-oxygen (Group I) or air-oxygen (Group II). There were no differences between the groups regarding age, sex, weight or amount or per- and postoperative analgetics given. The mean inspiratory isoflurane concentrations were 0.6% and 1.15% in Groups I and II, respectively. The postoperative alertness was tested by a visual analogue scale (0-10) for 6 h postoperatively. Omitting nitrous oxide did not decrease the frequency of postoperative nausea, although the symptoms were milder in the air group. The patients without nitrous oxide were alert earlier, in spite of a higher isoflurane concentration: VAS from 5 to 8.7 vs from 2.8 to 6.9 during the first 6 postoperative hours.
 ...
PMID:The role of nitrous oxide in postoperative nausea and recovery in patients undergoing upper abdominal surgery. 185 96

Arterial oxygen saturation (SaO2) was monitored continuously during and immediately after sputum induction in 41 HIV positive patients with respiratory symptoms and in 20 symptomless medical and nursing staff, who acted as control subjects. Arterial oxygen desaturation (defined as SaO2 less than or equal to 92%) occurred during sputum induction and persisted for up to 20 minutes after the end of the procedure in 11 of the 20 patients with Pneumocystis carinii pneumonia and in nine of the 21 patients with other respiratory diagnoses. None of the control subjects showed oxygen desaturation. Neither the severity of chest radiographic abnormalities, the alveolar-arterial oxygen gradient (both measured before sputum induction), nor baseline SaO2 prospectively identified the patients who developed oxygen desaturation. Two patients, one with pneumocystis pneumonia, developed dyspnoea and had a fall in arterial oxygen saturation to 84% within 10 minutes of starting sputum induction. The procedure was abandoned in both patients and in two further patients, who developed severe nausea and reaching but no oxygen desaturation. Sputum induction in HIV positive patients with respiratory symptoms may induce a fall in SaO2 that persists after this procedure. This may be important if other procedures are performed soon after sputum induction.
 ...
PMID:Arterial desaturation in HIV positive patients undergoing sputum induction. 185 86

Thyrotropin-releasing hormone (TRH) stimulates pituitary thyrotropin synthesis and release and also regulates autonomic nervous system functions by acting as a neuromodulator and neurotransmitter. In experimental animals a stimulation of ventilation by thyrotropin-releasing hormone was shown when applied at central nervous system sites that affect respiratory motor output. It was the goal of our study to investigate the respiratory properties of thyrotropin-releasing hormone on basal and stimulated (i.e. CO2-rebreathing) conditions following systemic thyrotropin-releasing hormone application in healthy humans. Thyrotropin-releasing hormone (200 micrograms, 400 micrograms intravenous) initiated a rapid short lasting rise of minute volume, ventilatory air-flow and alveolar oxygen tension under steady state breathing (P less than 0.001). Breathing frequency was less affected, heart rate rose concomitantly (P less than 0.001). While breathing with increasing concentrations of carbon dioxide, minute volume was higher under thyrotropin-releasing hormone than under placebo alone. Further effects (e.g. nausea, dizziness, palpitations) mostly appeared later than respiratory changes and thus may not be responsible for their initiation. Our findings prove systemic thyrotropin-releasing hormone to be a strong respiratory stimulant in man. Response in respiratory output was also accompanied by central nervous system-effects (e.g. dizziness, restlessness, augmented vigilance). The mode of thyrotropin-releasing hormone effects on respiration after peripheral administration is still speculative. An augmented sympathetic output or a direct receptor mediated action at central nervous system sites may be responsible, while a peripheral effect cannot be excluded.
 ...
PMID:Thyrotropin-releasing hormone has stimulatory effects on ventilation in humans. 190 74

There have been claims that the postoperative course of patients may be improved by presentation during general anesthesia of therapeutic suggestions which predict a rapid and comfortable postoperative recovery. This study evaluated the effectiveness of such therapeutic suggestions under double-blind and randomized conditions. A tape recording predicting a smooth recovery during a short postoperative stay without pain, nausea, or vomiting was played during anesthesia to about half the patients (N = 109), while the remaining, control patients were played a blank tape instead (N = 100). The patients were primarily undergoing operations on the fallopian tubes, total abdominal hysterectomy, vertical banding gastroplasty, cholecystectomy, and ovarian cystectomy or myomectomy. The anesthesia methods consisted of either isoflurane with 70% nitrous oxide in oxygen to produce end-tidal concentrations of 1.0, 1.3, or 1.5 MAC; or 70% nitrous oxide in oxygen combined with high or low doses of opioids. Assessments of the efficacy of the therapeutic suggestions in the recovery room and throughout the postoperative hospital stay included: the frequency of administration of analgesic and antiemetic drugs; opioid doses; the incidence of fever; nausea, retching, and vomiting; other gastrointestinal and urinary symptoms; ratings of pain; ratings of anxiety; global ratings of the patients' physical and psychological recoveries by the patients and their nurses; and length of postoperative hospital stay. There were no meaningful, significant differences in postoperative recovery of patients receiving therapeutic suggestions and controls. These negative results were not likely to be due to insensitivity of the assessments of recovery, as they showed meaningful interrelations among themselves and numerous differences in recovery following different types of surgery. Widespread utilization of therapeutic suggestions as a routine operating room procedure seems premature in the absence of adequate replication of previously published positive studies.
 ...
PMID:Efficacy of therapeutic suggestions for improved postoperative recovery presented during general anesthesia. 195 99

In a randomized study, 80 healthy unpremedicated female patients were included. For short gynaecological procedures (curettage) they were anaesthetized with either propofol 2 mg/kg (n = 40) or thiopentone 5 mg/kg (n = 40) in combination with nitrous oxide/oxygen (1/1). Supplementary doses of propofol (25 mg) or thiopentone (50 mg) were given when necessary during the procedure. Propofol caused a significant fall in arterial blood pressure (greater than thiopentone in diastolic pressure) and a decrease in heart rate (thiopentone did not change heart rate). Discomfort on injection was similar in both groups. Recovery times were shorter in propofol group: Patients opened their eyes at 1.3 minutes, were awake at 2.2 minutes and could seat with no help at 5.2 minutes. In the thiopentone group, there was a greater incidence of nausea. Propofol was associated with euphoria, "clear-headedness" and pleasant dreams more than thiopentone. We conclude that propofol is a good alternative to thiopentone in short operative procedures.
 ...
PMID:[Comparative study between thiopental and propofol in short-duration anesthesia]. 196 54


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>