Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Target Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Query: UMLS:C0027497 (
nausea
)
23,468
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Sea-urchin stings may produce injurious and venomous wounds. Although numerous writers refer to the danger of pedicellarial stings, there is little worth-while clinical data. We report a case of sea-urchin injury with severe local reaction and acute hepatitis. A 47-y-o Taiwanese woman accidentally stepped on a sea urchin while scuba diving on a
beach
in Palau Islands. The puncture wounds were numerous and she felt faintness, and immediate and intense pain. Initial management included partial spine removal, betadine immersion, intravenous fluid and analgesics. She developed fever, chills,
nausea
, and persistent serous discharge and tenderness from the sites of stings in the following days. She was admitted due to right foot cellulitis, sea-urchin injuries of both soles and suspected toxic hepatitis on the 7th day after envenomation. Serum alanine transaminase was 810 U/L and aspartate transaminase 320 U/L; she received i.v. antibiotics and wound debridement for removal of residual stings. She recovered gradually and was discharged 2 w later. Travel related marine animal injury has an increasing tendency throughout the world. This case had the unusual presentation of severe local reaction and hepatitis; immediate and more aggressive spine removal might have lessened the degree of injury.
...
PMID:Sea-urchin envenomation. 1464 Apr 80
We describe a case series of seven patients presenting to an emergency department with symptoms of paralytic shellfish poisoning. They developed varying degrees of
nausea
, vomiting, diarrhea, weakness, ataxia and paresthesias after eating mussels harvested from a
beach
near their resort. Four patients were admitted to the hospital, one due to increasing respiratory failure requiring endotracheal intubation and the remainder for respiratory monitoring. All patients made a full recovery, most within 24 hours. The ability to recognize and identify paralytic shellfish poisoning and manage its complications are important to providers of emergency medicine.
...
PMID:Paralytic shellfish poisoning: a case series. 2503 37
The origins of the major classes of current anti-emetics are examined. Serendipity is a recurrent theme in discovery of their anti-emetic properties and repurposing from one indication to another is a continuing trend. Notably, the discoveries have occurred against a background of company mergers and changing anti-emetic requirements. Major drug classes include: (i)
Muscarinic receptor antagonists
-originated from historical accounts of plant extracts containing atropine and hyoscine with development stimulated by the need to prevent sea-sickness among soldiers during
beach
landings; (ii)
Histamine receptor antagonists
-searching for replacements for the anti-malaria drug quinine, in short supply because of wartime shipping blockade, facilitated the discovery of histamine (H
1
) antagonists (e.g., dimenhydrinate), followed by serendipitous discovery of anti-emetic activity against motion sickness in a patient undergoing treatment for urticaria; (iii)
Phenothiazines and dopamine receptor antagonists
-investigations of their pharmacology as "sedatives" (e.g., chlorpromazine) implicated dopamine receptors in emesis, leading to development of selective dopamine (D
2
) receptor antagonists (e.g., domperidone with poor ability to penetrate the blood-brain barrier) as anti-emetics in chemotherapy and surgery; (iv)
Metoclopramide and selective 5-hydroxytryptamine
3
(5-HT
3
) receptor antagonists-
metoclopramide was initially assumed to act only via D
2
receptor antagonism but subsequently its gastric motility stimulant effect (proposed to contribute to the anti-emetic action) was shown to be due to 5-hydroxytryptamine
4
receptor agonism. Pre-clinical studies showed that anti-emetic efficacy against the newly-introduced, highly emetic, chemotherapeutic agent cisplatin was due to antagonism at 5-HT
3
receptors. The latter led to identification of selective 5-HT
3
receptor antagonists (e.g., granisetron), a major breakthrough in treatment of chemotherapy-induced emesis; (v)
Neurokinin
1
receptor antagonists
-antagonists of the actions of substance P were developed as analgesics but pre-clinical studies identified broad-spectrum anti-emetic effects; clinical studies showed particular efficacy in the delayed phase of chemotherapy-induced emesis. Finally, the repurposing of different drugs for treatment of nausea and vomiting is examined, particularly during palliative care, and also the challenges in identifying novel anti-emetic drugs, particularly for treatment of
nausea
as compared to vomiting. We consider the lessons from the past for the future and ask why there has not been a major breakthrough in the last 20 years.
...
PMID:A History of Drug Discovery for Treatment of Nausea and Vomiting and the Implications for Future Research. 3023 61
