Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighteen patients with advanced epithelial ovarian cancer were given 36 courses of cis-platinum-containing chemotherapy at Cedars-Sinai Medical Center. Patients were given lorazepam (Ativan) prior to chemotherapy. Amnesia for the day of chemotherapy was reported in 29 courses. Lack of recall for the chemotherapy infusion and the subsequent 8 hr or greater was reported in 33 of the 36 courses. In two courses, no amnesia effects were noted. No serious side effects of lorazepam therapy occurred and all patients believed that the amnesic effect was beneficial during chemotherapy. Lorazepam (Ativan) appears to be a safe medication to induce amnesia for cis-platinum chemotherapy and deserves further study to determine its effect on anticipatory vomiting, nausea and vomiting, and patient compliance with continued chemotherapy.
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PMID:A pilot study of lorazepam-induced amnesia with cis-platinum-containing chemotherapy. 653 34

Nausea and vomiting may be the most distressing part of cytotoxic chemotherapy for malignant disease and frequently leads to default from treatment. Furthermore, in some patients, anxiety associated with chemotherapy precipitates anticipatory vomiting. 24 patients with refractory vomiting associated with chemotherapy were selected from a homogeneous group of malignancies. 25% of these also had anticipatory vomiting. Lorazepam, a benzodiazepine, in a dose of 3 mg/m2, was given by mouth in conjunction with a standard centrally acting antiemetic 30 min before chemotherapy. Vomiting was totally abolished in 70% of patients; in only 4% two vomiting episodes occurred. In addition, 17% of patients had complete amnesia of the events of chemotherapy. This pilot study suggests that lorazepam in conjunction with standard antiemetic therapy may be an effective means of controlling refractory nausea and vomiting.
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PMID:Improved tolerance of cytotoxic chemotherapy with lorazepam. A pilot study. 664 6

An efficient narco-analgesia is given by the association of two drugs: -- diazepam (Valium): a benzodiazepine with an anxiolytic and myoresolutive effect, inducing sleep and giving amnesia; -- lysine acetylsalicylate (Aspegic) giving an analgesia inferior to that of morphinomimetic drugs but not inducing respiratory depression. These two drugs are given in an intravenous catheter. Their effects last about 20 minutes - vomiting is rare. The authors report their experience of 50 cases and think that this technique is recommended in remote medical units for moderately painful and short duration operations.
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PMID:[Valium-aspegic association. Its value in a remote medical unit (author's transl)]. 678 84

A variety of agents are used as premedication for upper gastrointestinal endoscopy (U.G.E.). To our knowledge, no double blind studies have been performed to compare their value. In this study phenoperidine (2 mg i.v.) was compared with diazepam (t mg i.v.) in 200 consecutive patients undergoing elective U.G.E. The study was randomized and double blind in regard to both endoscopists and patients. All patients were given atropine (0.4 mg i.v.) and a throat spray with 2% amethocaine. Patients who needed supplemental medication were given diazepam and excluded from final analysis. A graded questionnaire was recorded by endoscopists and patients after U.G.E., and a further anonymous questionnaire was returned by patients four days later. Statistical analysis revealed that phenoperidine was superior at facilitating intubation and providing more relaxation as judged by the endoscopist. Patient questionnaires, four days after U.G.E., indicated less distress during intubation and examination with phenoperidine. Nausea, vomiting, amnesia and phlebitis were uncommon after either phenoperidine or diazepam.
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PMID:A comparison of diazepam and phenoperidine in premedication for upper gastrointestinal endoscopy: a randomized double blind controlled study. 704 71

Midazolam was given intravenously to 100 children over the age of 8 years to induce anaesthesia and a similar control group was anaesthetised with diazepam. The actions of midazolam in children were found to be similar to those of diazepam. Midazolam acted more quickly in children than has been reported in adults. The effects on the circulation and respiration, and the incidence of postoperative amnesia were similar in children to that which has been reported in adults. The incidence of postoperative vomiting after midazolam was 1% in the recovery room and 32% during the first two postoperative days. Laboratory investigations did not demonstrate any adverse effects. Midazolam has a considerable advantage over diazepam being water soluble and injectable safely without dilution. This clinical trial suggests that midazolam is a satisfactory induction agent for children.
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PMID:Midazolam in paediatric anaesthesia. 706 92

8-Chloro-6-(2-fluorophenyl)-1-methyl-4H-imidazol[1,5-a][1,4]benzodiazepine (midazolam maleate, Ro 21-3981, Dormicum) or thiopental were administered to 99 women undergoing short gynecological surgical procedures for induction and maintenance of anesthesia along with 67% nitrous oxide. Either fentanyl 1.5 microgram kg-1 or a saline placebo were given i.v. as acute premedication 5 min before induction. We measured the quality of induction and maintenance. Induction was more rapid after thiopental but thiopental produced more apnea especially when combined with fentanyl. Fentanyl premedication reduced the dose of hypnotics necessary to keep patients asleep. It was difficult to keep patients from moving during the procedure when only the hypnotics and nitrous oxide were used, so the use of these drugs for both induction and maintenance is recommended only when combined with narcotics or other analgesics. Although recovery after midazolam was slower than after thiopental, it was without untoward reactions such as hallucinations or excitement. Vomiting was less frequent after midazolam. Midazolam produced a profound period of amnesia for 1-2 h, so important instructions could not be given to patients during this time. All patients were awake enough to discharge from the hospital 200 min after the last dose of hypnotic was given. We would recommend a combination of midazolam, fentanyl and nitrous oxide for induction and maintenance of anesthesia for short surgical procedures except when a rapid induction is desired, then thiopental is preferred as the hypnotic.
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PMID:Awakening characteristics following anesthesia induction with midazolam for short surgical procedures. 719 31

Acute confusional migraine in children and transient global amnesia in adults share a number of similar clinical manifestations. Acute confusional migraine in 6 children (mean age: 11.7 years; range: 7.5-17 years) was characterized by transient episodes of amnesia and acute confusion lasting 1-12 hours. Episodes were preceded by headache and vomiting in 4 patients. In 2 patients acute confusional migraine was the initial symptom. A history of preceding trivial head injury was reported in 3 patients and migraine in 4. Urine and serum drug screens were negative. Cerebral imaging studies and interictal electroencephalograms were normal. Ictal electroencephalograms in 3 patients revealed diffuse or bioccipital delta wave slowing. Recurrent episodes of acute confusional migraine occurred in 2 children during 1-3 years of follow-up. The clinical manifestations of acute confusional migraine in this series of children are similar to those reported in transient global amnesia. The similarity of the clinical manifestations of acute confusional migraine in children and transient global amnesia in adults suggests that these disorders may share a common pathophysiology.
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PMID:Acute confusional migraine: variant of transient global amnesia. 777 9

Nausea and vomiting are extremely common and most distressing side effects of high-dose cisplatin therapy. Cisplatin induces anticipatory and acute, as well as, delayed emesis. High doses of metoclopramide can effectively decrease the intensity of these symptoms in up to 70% of cases. Several agents, including dexamethasone and antihistamines have been demonstrated to either increase the efficacy of metoclopramide or decrease the side effects. Lorazepam, a benzodiazepine, has both antiemetic and anxiolytic properties. It can be useful as an adjunct to metoclopramide-based therapy. We conducted a randomized trial to evaluate the efficacy of lorazepam in managing anticipatory, acute, and delayed emesis induced by high doses of cisplatin. A total of 180 events involving cisplatin administration (100 mg/m2 as a 24-hour continuous infusion) were randomized to receive metoclopramide along with dexamethasone and clemastine with and without lorazepam. Categorical scales were utilized to document the incidence of nausea and vomiting and side effects related to antiemetic therapy. All episodes are evaluable. Lorazepam significantly reduced the incidence of anticipatory nausea and vomiting (P < .05) as well as acute emesis (P = .05) induced by cisplatin. Delayed emesis was also decreased; however, it was statistically significant on day 3 only (P < .05). Side effects were few except for mild sedation and amnesia, which were significantly more common in those receiving lorazepam (P < .001). We conclude that lorazepam increases the efficacy of metoclopramide against cisplatin-induced anticipatory, acute, and delayed nausea and vomiting. This four-drug regimen may offer one of the best combinations to be utilized in comparative trials against the newly introduced serotonin antagonists.
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PMID:Clinical efficacy of lorazepam in prophylaxis of anticipatory, acute, and delayed nausea and vomiting induced by high doses of cisplatin. A prospective randomized trial. 790 Jul 11

In order to identify signs to be used in the decision whether or not to admit patients after minor head injuries (MHI), the records of 713 females and 1163 males were reviewed. Skull X-ray was not obtained routinely, all patients were able to talk and walk when they reached medical contact. Nine patients developed an intracranial complication, three had an operation and one died. The risk of developing an ICC was 16.7% when the patient was agitated, 3.4% in the presence of impaired consciousness and 2.1% when positive neurological signs were observed at the time of examination. Based on the medical history, amnesia for more than five minutes and vomiting were associated with a risk of 3.3% and 1.2% respectively. The risk increased considerably in the presence of two of the above mentioned signs and was 60% if the patient was agitated and had amnesia for more than five minutes. Consequently, we recommend that all patients with one or more of the above symptoms or alcohol intoxication after a MHI should be admitted for observation. This policy may hold the possibility of considerable economic savings.
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PMID:[Minor head injuries. Prognostic factors in the evaluation of patients]. 794 Oct 85

To evaluate unwanted side effects expressed in hemodynamic parameters, postanesthetic recovery and quality of intravenous total anesthesia (IVTA) with propofol, fentanyl and atracurium. A prospective study in 292 patients undergoing general surgery. Fifty-three percent of the patients were ASA I, 32.2% were ASA II and 14.8% were ASA II, representing a wide range of ages, weights and heights. Mean time of anesthesia was 108.25 +/- 56.96 min. Anesthesia was achieved with propofol 0.108 +/- 0.027 mg/kg/min, fentanyl 0.093 +/- 0.035 microgram/kg/min and atracurium 0.011 +/- 0.0034 mg/kg/min. Slight pain was evident at injection in 1.7% of the patients. Greater hemodynamic instability was recorded at induction, with mean decreases in systolic and diastolic arterial pressures of 16% and 10%, respectively, with scarcely any response to intubation and extubation. Anesthetic recovery was recorded at 5.95 +/- 4.97 min, with surgical amnesia in 100% of the patients. Nausea was seen in 3.42% and vomiting in 1.7%. Patient evaluation of anesthetic technique was "good" in 60.3% and "excellent" in 39.7%. Propofol dose was significantly (p < 0.05) correlated with age (r = -0.33) and time of anesthesia (r = -0.4). IVTA with propofol and fentanyl in general surgery provides adequate maintenance of anesthesia for surgery and recovery, with good hemodynamic stability. In older patients and longer times of anesthesia, the total dose of propofol administered decreases, with negative effect on time and quality of recovery. Total dose of propofol administered is not significantly correlated with either time or quality of recovery.
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PMID:[Total intravenous anesthesia in general surgery]. 799 10


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