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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Organic, physiologic, and psychologic causes of dysmenorrhea are presented. Signs and symptoms include pelvic fullness, nausea, vomiting, diarrhea, urinary frequency, nervousness, and headaches. Primary dysmenorrhea has been treated with analgesics, diuretics, and antispasmodics. Androgen therapy was also found to be effective, but it cannot be used for women who have acne or hirsutism. Surgery is rarely indicated for primary dysmenorrhea.
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PMID:Primary and membranous dysmenorrhea. 36 Apr 2

The purpose of prescribing combined oral contraceptives (OCs) is achievement of good cycle control and effective contraception with the least side effects, using an OC with the lowest possible dose of estrogen. Triphasil, Triquilar, Nordette, Microgynon 30, and Brevinor are good 1st choices because of the low estrogen dose (30-35 mcg). Women who probably cannot tolerate breakthrough bleeding and who need simple packaging should use a monophasic, more progestogenic OC, e.g., Nordette or Microgynon 30. Physicians should suggest a low dose estrogen and low dose antiandrogenic progestogen (OC) (e.g., Diane-35 ED) for women who have acne. They should advise patients that when they take OCs, their menstrual periods usually become shorter, regular, and lighter. Women need not take a break from OC usage. Vitamin C, antibiotics, griseofulvin, rifampicin, and anticonvulsants (except sodium valproate) interact with OCs. Women using warfarin and oral hypoglycemics and wanting to start using OCs need to consult their physician about changing requirements for warfarin and oral hypoglycemics. The effectiveness of OCs can be diminished by diarrhea and vomiting. Absolute contraindications to OCs include pregnancy, use during the first 2 weeks postpartum, history of thromboembolism, undiagnosed abnormal vaginal bleeding, focal migraine, coronary heart disease, steroid-dependent tumors, recent impaired liver function, and cardiovascular accidents. Some relative contraindications are older than 35 years old and smoking, breast feeding, and hypertension. This article provides a section on how to manage common side effects. For example, if the side effect is acne, the physician should prescribe an OC with increased estrogen and reduced progestogen (e.g., Triphasil/Triquilar to Biphasil/Sequilar). This article lists trade names of various OCs and their estrogen and progestogen doses, e.g., Nordette has 30 mcg ethinyl estradiol and 150 mcg levonorgestrel.
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PMID:Combined oral contraception. 147 9

A 39-year-old woman was evaluated for possible liver transplantation due to rapidly developing hepatic failure 4 weeks after initiation of oral minocycline 100 mg twice a day for the treatment of acne. The patient developed a maculopapular rash, malaise, fever, nausea, and vomiting 2 weeks prior to admission to the hospital. On admission, her symptoms rapidly progressed to liver failure characterized by rapidly rising liver enzyme levels, worsening encephalopathy, and coagulopathy. Viral hepatitis serologies and blood cultures were all negative. After intensive supportive care for 2 weeks, the patient's condition gradually improved and she was discharged with mildly elevated liver enzyme levels and pruritus, without need of liver transplantation. Minocycline-induced hepatic injury is an idiosyncratic reaction with a sensitization period that appears to be 3-4 weeks in duration. The characteristic features include rash, fever, lymphadenopathy, and eosinophilia, as well as severe alterations in liver function. The high liver enzyme levels and the significant prolongation of the prothrombin time suggest massive hepatocellular damage. In light of the profound liver damage that occurs with this adverse reaction, care should be taken in administering minocycline to patients who have concomitant liver disease. It is recommended that patients should be instructed as to the possible signs and symptoms of toxicity and be monitored for evidence of idiosyncratic reaction or liver failure.
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PMID:Acute hepatic failure associated with oral minocycline: a case report. 153 50

During 1989-90 there were a total of 3,475,862 prescriptions of oral contraceptives (OCs) made in Australia by general practitioners. A 2- sided insert to facilitate deciding on the proper dosage for patients with various conditions was developed containing the estrogen- progestogen doses of OC preparations, management of minor side effects (nausea, vomiting, weight gain, chloasma, breakthrough bleeding, breast tenderness, or acne), and the relative contraindications to OC use. The simple, user-friendly, and flexible flow chart contains relative contraindications: age over 35 in heavy smokers, migraine or severe vascular headache, age over 45, previous cholestasis during pregnancy, hypertension, smoking, diabetes mellitus, long term immobilization, abnormal vaginal bleeding, gallbladder disease, impaired liver function, acute infectious mononucleosis, and use of rifampin or anticonvulsants.
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PMID:Prescribing oral contraceptives and the medical record. 179 98

An antiemetic combination of methylprednisolone and droperidol was administered to 10 patients with breast cancer showing postoperative recurrence, receiving high-dose adriamycin. Methylprednisolone was given twice intravenously at a dose of 500 mg, before and after administration of adriamycin, and droperidol was given just before administration of adriamycin. The 10 patients received a total of 20 chemotherapy courses. Complete relief of vomiting was achieved in 95% of these 20 courses, and mild nausea occurred in 40%. Side effects were drowsiness, acne and akathisia, which were minimal. It was concluded that an antiemetic combination of methylprednisolone and droperidol was very effective for prevention of high-dose adriamycin-induced nausea and vomiting.
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PMID:[An antiemetic effect of methylprednisolone plus droperidol against nausea and vomiting caused by administration of high-dose adriamycin to breast carcinoma patients]. 361 64

This general review describes the progestagens and estrogens and their combinations marketed in France, their biologic effects (on ovulation, pharmacological and hormonal effects, effects on the female reproductive organs), the mechanism of inhibiting ovulation, indications, and trivial and serious side effects. The 3 series of progestagens are 17-alpha-hydroxyprogesterone derivatives, 19-nor-testosterone and 3-deoxy-19-nor-testosterone derivatives; the estrogens are ethinyl estradiol and mestranol. Indications discussed here are therapeutic tests, functional uterine bleeding, endometriosis, polycystic ovary, amenorrhea, Stein-Levanthal syndrome, sterility, intermenstrual pain, premenstrual breast congestion, and acne. Minor side effects include vomiting, bleeding, weight gain, depression, and vaginitis. Complications mentioned are thromboembolism, virilization, cholasma, jaundice, and fibroids. Genetic and congenital defects are not more common in steroid users than in the general population; it is too early to predict whether these drugs are carcinogenic.
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PMID:[The steroids, inhibitors of ovarian function]. 574 50

The oral contraceptive (OC) Stediril acts by inhibiting ovulation, rendering the endometrium inhospitable to implantation, and rendering the cervical mucus impermeable to sperm. The effectiveness of Stediril may be compromised by failure to follow the dosage schedule: 1 pill daily for 21 days followed by a pill-free interval of 7 days when withdrawal bleeding occurs. Stediril should be taken at a regular time each day. If pills are missed for more than 48 hours, efficacy cannot be guaranteed. If vomiting occurs within 4 hours of pill ingestion, the pill should be replaced. Certain drugs, such as Rifadine, may affect the action of Stediril. Stediril should only be prescribed after a complete medical history and examination, including responding to any questions the patient may have. At a 3-month follow-up visit the patient's tolerance to the drug should be assessed by absence of various symptoms: psychological problems such as nervousness and irritibality that resemble those of pregnancy; skin problems such as acne or changes of pigmentation; periods of nausea that diminish in frequency after a few weeks; weight gain; bleeding problems; or signs of thromboembolic risk, such as headaches, unusual visual disturbances, or hypertension, which require immediate cessation of OC use. Because Stediril constitutes a risk to the fetus in case of unplanned pregnancy, the preliminary gynecological examination is mandatory and the pill should only be prescribed to women able to comply with dosage requirements. The pill should be stopped 6 weeks-3 months before pregnancy to allow the endometrium to regenerate. The carcinogenic role of the pill is frequently discussed but not conclusively proven. Follow-up visits should occur 3 and 6 months after beginning use and every year thereafter.
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PMID:[Stediril]. 656 44

Results are presented of an evaluation of the contraceptive efficacy, cycle control, and tolerance of a low dose triphasic pill, Trigynon, used by 353 reproductive-aged women for a total of 1668 cycles. 20 physicians in different Belgian centers recruited and followed the women. Average weight of the patients was 56.8 kg, average age was 24.8 years, average parity was 1.07, and 1/3 smoked. None had any medical condition contraindicating the use of the preparation. 156 of the women had never used contraception, 163 had used combined pills, 4 had used injectables, 6 had used progestin-only minipills, 21 had used IUDs, and 22 had used other methods. 2.5% of the patients forgot to take at least 1 pill in a typical cycle. No pregnancies were imputed to forgetting, but 3 pregnancies occurred during the study: 1 already established but not recognized at the start of treatment, 1 in a woman taking antituberculosis drugs, and 1 in a patient suffering an attack of dysentery. Almost 90% of patients had regular cycles of 28 days with treatment, compared to only 57.5% before treatment. The duration and quantity of bleeding were significantly decreased. Compared to the last pretreatment cycle, the 3rd and 6th cycles with Trigynon showed a decrease in percentage of patients complaining of dysmenorrhea, nervousness, headaches, breast tenderness, nausea, vomiting, decreased libido, depression, thrombophlebitis, and edema. The percentage complaining of acne and vertigo increased slightly at 3 months and then declined to below pretreatment levels. Average weight was almost unchanged. It appears that Trigynon offers reliable protection, excellent cycle control and few side effects, and would be an appropriate contraceptive choice for most women except those with benign breast disease or hyperestrogenism.
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PMID:[Clinical evaluation of 1,668 cycles of triphasic oral contraception (Trigynon). Multicentric Belgian study]. 681 54

The objective of a double-blind randomized multicenter trial enrolling 60 women was to determine the suppressive effect on ovarian activity of 20 mcg ethinyl estradiol plus 75 mcg gestodene administered for 21 or 23 days. The sites were at the Department of Obstetrics and Gynecology, University of Manchester, UK, and the Institute for Sterility Treatment, Vienna, Austria. The 60 women were healthy volunteers 19-35 years old, and they were randomized with 30 subjects each entering the treatment phase for either the 21-day regimen or the 23-day regimen. A pre-treatment cycle, 3 treatment cycles, and a post-treatment period were monitored by ovarian ultrasound and by measurements of luteinizing hormone (LH), follicle stimulating hormone (FSH), 17-beta-estradiol, and progesterone every other day. Two women on the 21-day regimen forgot to take 1 pill each. Side effects were minor including breast tension, vomiting, nausea, acne, and weight loss or weight gain. Withdrawal bleeding commenced in the 23-day group 2 days later than in the 21-day group. The frequency of intracyclic bleeding decreased when progressing from treatment cycle 1 to 3. No ovulation and no luteinized, unruptured follicle were observed. After stopping the medication, spontaneous ovulations were observed in all volunteers in the 23-day regimen. Suppression of ovarian activity was more pronounced in the 23-day regimen. 17-beta-estradiol serum levels during the last 6 days of a cycle and during the first 6 days of the next cycle were significantly less (p 0.05) in the 23-day regimen. The superiority of the 23-day regimen in comparison to the 21-day regimen with regard to the suppression of ovarian activity was shown. The observed differences in the 17-beta-estradiol levels and follicular development between the 21-day and 23-day preparations suggest that shortening the pill-free interval in combined oral contraceptives may increase the contraceptive safety margin in women on low-dose formulations.
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PMID:Shorter pill-free interval in combined oral contraceptives decreases follicular development. 884 82

Combination oral contraceptives (OCs) (those that contain estrogen and progestin) are widely used in the treatment of acne because they modify an excessively androgenic hormonal environment and can decrease lesions. Dermatologists' knowledge of the most appropriate OC may be hampered by an incomplete understanding of these agents, misleading promotion, and confusion surrounding the new generation of OCs. Despite reports attributing significance to the degree of androgenicity of the progestin components of OCs, in vitro and animal bioassays of androgenicity have little clinical relevance. Because all of today's low-dose combination OCs are estrogen dominant, they are equally beneficial in women with androgenic conditions such as acne. Use of the OC containing the lowest dose of each hormone, consistent with the patient's needs, can enhance compliance by preventing or limiting common early-cycle side effects (e.g., nausea/vomiting, breast tenderness, weight gain, headache), while providing acne improvement.
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PMID:Treatment of acne with oral contraceptives: criteria for pill selection. 1110 51


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