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)

Comparative clinical investigation was performed in 80 ASA I/II patients undergoing cataract surgery on one eye. Patients were randomly divided in to four groups, according to the method of anesthesia. Intraoperatively (T0-T6), decreasing of intraocular pressure (IOP) to the optimal values at the start of the operation (T3), and the hemodynamic stability of patients after the induction (T1) were evaluated. Postoperatively, the recovery rate, and the incidence of vomiting were measured. Optimal decreasing of IOP was noticed in the second group (75% of patients). Best hemodynamic stability was observed in the second group (80% patients). Fast recovery rate was noticed in the first and the second groups (13.9 +/- 1.1 and 14.4 +/- 0.8 min). Vomiting was noticed in 5% patients in the first group, 15% in the third group, and in 20% in the 4th group. The authors have concluded that TIVA fourth propofol and coinduction with midazolam is anesthesia of choice in the cataract surgery.
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PMID:[Total intravenous anesthesia with propofol with midazolam coinduction--the anesthesia of choice in cataract surgery]. 1093 30

We evaluated the effectiveness of a multifaceted general anesthesia protocol designed to minimize postoperative vomiting after pediatric eye surgery. A convenience sample of 150 consecutive children, aged 2 weeks to 18 years, who received general anesthesia for pediatric ophthalmic surgery was studied. General anesthesia was administered with induction by mask for 82.7% of the children and intravenously using propofol in 17.3% of the children. Anesthesia was maintained using halothane or isoflurane, oxygen, and air mixture for all patients. Morphine sulfate was used for additional pain relief, up to 0.1 mg/kg. Gastric aspiration was performed after intubation for each child. Metoclopramide, 0.15 mg/kg, and 0.1 mg/kg of ondansetron were administered before the end of each operation. Postoperatively, patients were monitored for vomiting for 24 hours. Postoperative vomiting occurred in 11 (7.3%) of 150 cases. Acute elevation of intraocular pressure was found in 5 of the 11 children who vomited. This vomiting was unresponsive to intravenous rescue ondansetron, but responded to lowering the intraocular pressure. The incidence of postoperative vomiting after general anesthesia for pediatric eye surgery can be substantially decreased by adopting a protocol designed to lessen the emetic effects of general anesthesia. Limited use of nitrous oxide for mask induction only, gastric emptying, and administration of metoclopramide and ondansetron intravenously in combination proved effective in reducing the incidence of postoperative vomiting.
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PMID:Prevention of vomiting after general anesthesia for pediatric ophthalmic surgery. 1175 37

Brimonidine is an ophthalmic solution of 0.2% brimonidine tartrate used to lower intraocular pressure in human glaucoma patients. A retrospective study was conducted of brimonidine ophthalmic solution ingestion in 52 dogs reported to the ASPCA Animal Poison Control Center between January 1998 and December 2000. Eighty percent of the dogs were < 1-y of age. Approximate ingested dosages ranged from 0.18-5.55 mg/kg. Incidence of clinical signs were bradycardia (67%), depression (46%), ataxia (27%), hypotension (25%), pallor (23%), weakness (17%), change in mucous membrane color (17%), hypothermia (13%), vomiting or retching (13%.). Shock, weak pulses, and poor capillary refill time were also reported. Treatment involved early decontamination, supportive care, andyohimbine and atipamezole as specific alpha-2 antagonists that could be helpful in reversing the effects of brimonidine. Due to the possibility of severe cardiovascular effects developing, the ingestion of brimonidine ophthalmic solution in dogs should be considered dangerous.
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PMID:Clinical effects of brimonidine ophthalmic drops ingestion in 52 dogs. 1182 75

Medetomidine is a relatively new sedative analgesic drug that is approved for use in dogs in Canada. It is the most potent alpha2-adrenoreceptor available for clinical use in veterinary medicine and stimulates receptors centrally to produce dose-dependent sedation and analgesia. Significant dose sparing properties occur when medetomidine is combined with other anesthetic agents correlating with the high affinity of this drug to the alpha2-adrenoreceptor. Hypoventilation occurs with medetomidine sedation in dogs; however, respiratory depression becomes most significant when given in combination with other sedative or injectable agents. The typical negative cardiovascular effects produced with other alpha2-agonists (bradycardia, bradyarrhythmias, a reduction in cardiac output, hypertension +/- hypotension) are also produced with medetomidine, warranting precautions when it is used and necessitating appropriate patient selection (young, middle-aged healthy animals). While hypotension may occur, sedative doses of medetomidine typically raise the blood pressure, due to the effect on peripheral alpha2-adrenoreceptors. Anticholinergic premedication has been recommended with alpha2-agonists to prevent bradyarrhythmias and, potentially, the reduction in cardiac output produced by these agents; however, current research does not demonstrate a clear improvement in cardiovascular function. Negatively, the anticholinergic induced increase in heart rate potentiates the alpha2-agonist mediated hypertension and may increase myocardial oxygen tension, demand, and workload. Overall, reversal with the specific antagonist atipamezole is recommended when significant cardiorespiratory complications occur. Other physiological effects of medetomidine sedation include; vomiting, increased urine volumes, changes to endocrine function and uterine activity, decreased intestinal motility, decreased intraocular pressure and potentially hypothermia, muscle twitching, and cyanosis. Decreased doses of medetomidine, compared with the recommended label dose, should be considered in combination with other sedatives to enhance sedation and analgesia and lower the duration and potential severity of the negative cardiovascular side effects. The literature was searched in Pubmed, Medline, Agricola, CAB direct, and Biological Sciences.
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PMID:A review of the physiological effects of alpha2-agonists related to the clinical use of medetomidine in small animal practice. 1466 51

Dronabinol (Delta 9-tetrahydocannabinol, THC), the main source of the pharmacological effects caused by the use of cannabis, is an agonist to both the CB1 and the CB2 subtype of cannabinoid receptors. It is available on prescription in several countries. The non-psychotropic cannabidiol (CBD), some analogues of natural cannabinoids and their metabolites, antagonists at the cannabinoid receptors and modulators of the endogenous cannabinoid system are also promising candidates for clinical research and therapeutic uses. Cannabinoid receptors are distributed in the central nervous system and many peripheral tissues including spleen, leukocytes; reproductive, urinary and gastrointestinal tracts; endocrine glands, arteries and heart. Five endogenous cannabinoids have been detected so far, of whom anandamide and 2-arachidonylglycerol are best characterized. There is evidence that besides the two cannabinoid receptor subtypes cloned so far additional cannabinoid receptor subtypes and vanilloid receptors are involved in the complex physiological functions of the cannabinoid system that include motor coordination, memory procession, control of appetite, pain modulation and neuroprotection. Strategies to modulate their activity include inhibition of re-uptake into cells and inhibition of their degradation to increase concentration and duration of action. Properties of cannabinoids that might be of therapeutic use include analgesia, muscle relaxation, immunosuppression, anti-inflammation, anti-allergic effects, sedation, improvement of mood, stimulation of appetite, anti-emesis, lowering of intraocular pressure, bronchodilation, neuroprotection and antineoplastic effects.
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PMID:Pharmacology of cannabinoids. 1515 77

This study of sixty ASA grade 1 or 2 children, aged 1 to 12 years, undergoing elective ophthalmic procedures, compared the use of the laryngeal mask airway (LMA) with that of an endotracheal tube. Changes in intraocular pressure and haemodynamic parameters, and intraoperative and postoperative complications were measured Patients were randomly allocated into two groups of 30 patients. In group 1, the airway was secured with an LMA and in group 2 with an endotracheal tube. A standard technique of general anaesthesia incorporating positive pressure ventilation was used in both groups. The changes in intraocular pressure, heart rate (HR) and mean arterial pressure (MAP) were observed before and after insertion of the airway device, two minutes after insertion, and pre and post removal of the device. The incidence of airway complications was also noted. There was no significant change in mean intraocular pressure after insertion of the LMA, but removal caused a significant increase to 19.3 +/- 7.6 mmHg (from a baseline of 13.9 +/- 4.3 mmHg). In the endotracheal tube group, intubation increased the mean intraocular pressure significantly to 19.9 +/- 7.3 mmHg (from a baseline of 13.1 +/- 4.0 mmHg) and extubation caused an increase to 24.6 +/- 10.4 mmHg which was clinically as well as statistically significant. The incidence of postoperative coughing was lower in the LMA group, but the incidence of vomiting higher. Two patients had displacement of the LMA during the procedure. We conclude that the use of an LMA is associated with less increase in intraocular pressure than the use of an endotracheal tube in children.
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PMID:Comparison of laryngeal mask airway with tracheal tube for ophthalmic surgery in paediatric patients. 1526 35

Motion sickness is a common and distressing but poorly understood syndrome associated with nausea/vomiting and autonomic nervous system accompaniments that develops in the air or space as well as on sea or land. A bidirectional aetiologic link prevails between migraine and motion-sickness. Motion sickness provokes jerk nystagmus induced by both optokinetic and vestibular stimulation. Fixation of gaze or closure of eyes generally prevents motion sickness while vestibular otolithic function is eliminated in microgravity of space, indicating a predominant pathogenetic role for visuo-sensory input. Scopolamine, dimenhydrinate, and promethazine reduce motion-related nystagmus. Contraction of extraocular muscles generates proprioceptive neural traffic and can provoke an ocular hypertensive response. It is proposed that repetitive contractions of the extraocular muscles during motion-related jerk nystagmus rapidly augment brain stem afferent input by increasing proprioceptive neural traffic through connections of the oculomotor nerves with the ophthalmic nerve in the lateral wall of the cavernous sinus as well as by raising the intraocular pressure thereby stimulating anterior segment ocular trigeminal nerve fibers. This verifiable hypothesis defines the pathophysiological basis of individual susceptibility to motion sickness, elucidates the preventive mechanism of gaze fixation or ocular closure, advances the aetiologic link between MS and migraine, rationalizes the mechanism of known preventive drugs, and explores new therapeutic possibilities.
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PMID:Motion sickness is linked to nystagmus-related trigeminal brain stem input: a new hypothesis. 1582 12

Sulfonamide medications can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma. The risk of an adverse reaction to a sulfonamide is approximately 3%, and the exact mechanism of the myopia and angle-closure glaucoma remains controversial. Typical clinical presentation includes bilateral involvement with blurring of vision that generally occurs over minutes to hours, nausea or vomiting, red eye, and headache. Examination may show conjunctival injection, corneal edema, anterior chamber inflammation, and flat or shallow anterior chamber. Diagnosis is based on clinical suspicion, although an ultrasound biomicroscopy may be helpful in diagnosing swelling of the ciliary body. Topiramate, a sulfa derivative, is used for the treatment of migraines or seizures. The side effects include acute myopia and angle-closure glaucoma. Treatment of this condition is primarily supportive along with discontinuation of the medication; topical miotics and peripheral iridectomy are not helpful. If intraocular pressure remains uncontrolled, additional therapies, such as topical intraocular pressure-lowering medications, high-dose steroids, and trabeculectomy, may need to be considered.
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PMID:Review of sulfonamide-induced acute myopia and acute bilateral angle-closure glaucoma. 1820 14

We report a case of bilateral intraocular hemorrhage from vascularization of cataract wounds. The patient experienced decreased vision following an episode of vomiting more than 2.5 years after phacoemulsification through a scleral tunnel incision in the right eye and combined trabeculectomy and extracapsular cataract extraction in the left eye. Gonioscopy demonstrated abnormal vessels in the region of the cataract wound superiorly and small hyphemas inferiorly in both eyes. The hemorrhages and elevated intraocular pressure normalized over weeks. The left eye had a recurrent hemorrhage 5 months later, which was successfully treated with argon laser goniophotocoagulation.
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PMID:Bilateral intraocular hemorrhage from vascularization of cataract wounds. 1968 67

An 84-year-old woman presented with bilateral visual loss that had appeared 3 days previously. Split lamp examination showed bilateral corneal edema with normal intraocular pressure. The patient complained of headache and vomiting, and finally collapsed. Elevated levels of inflammation markers led to the suspicion of an inflammatory disease. After investigation for internal or neurological diseases, a biopsy of the temporal artery was performed. Giant cell arteritis (Horton's disease) was found, and steroid therapy was begun. The patient's general condition then improved.
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PMID:[Acute visual loss with bilateral corneal edema]. 2038 45


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