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)

Such hygroscopic compounds as LiCl, CaCl2, and MgCl2 are used to improve water retention capacity and, as a consequence, the effectiveness of heat and moisture exchangers (HME). Resorption of these substances via the bronchopulmonary tract and a resulting systemic action cannot be excluded, especially if additional active moisturizing devices are used. The narrow therapeutic range of lithium is known, as are its unwanted side effects, such as nausea, vomiting, somnolence and even cardiac arrhythmia. These are symptoms that also frequently occur during anaesthesia and intensive care, so that differentiation against effects of lithium is nearly impossible. We investigated whether, in theory and in practice, LiCl-coated HME could result in effective Li plasma concentrations. We measured (1) total LiCl content of HMEs, (2) release of this content, simulating the worst-case situation with a breathing model, and (3) lithium plasma concentrations of adult patients being ventilated during anaesthesia with a rebreathing circuit and LiCl-coated HME, but with no additional active moisturizing system incorporated. RESULTS. The results show striking differences with LiCl content ranging from 3 to 251 mg varying not only between different types of HME but also within the same lots. After 20 min of ventilation more than 90% of the LiCl coating was rinsed into the test lung of the breathing model. In practical use, we observed an increase in lithium plasma concentration in 3 of 20 investigated patients. The plasma values of maximum 49.5 micrograms/l (= 0.007 mmol/l) do not amount to potentially toxic concentrations. Nevertheless, clinically relevant concentrations might occur in patients with small distribution volumes, e.g. newborns or infants with frequent exposition within short intervals such as in intensive care units. The differences in lithium content also indicate qualitative differences in water retention capacity. Because of the potential side effects of lithium, we prefer qualitatively equivalent HMEs, e.g., with MgCl2 or CaCl2 as hygroscopic substance.
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PMID:[Is the lithium chloride-coated heat and moisture exchanger a danger for patients?]. 131 37

The safety and efficacy of intravenous granisetron were compared with combinations of conventional antiemetics in two single-blind, parallel-group studies which have been reported previously. In this review updated data from both studies is presented. In both studies granisetron (40 micrograms/kg) was given as a single 5-min infusion before chemotherapy with two additional doses allowed to control subsequent nausea and vomiting. All patients were naive to chemotherapy. Patients due to receive cisplatin (greater than 49 mg/m2) were randomly assigned to receive either granisetron alone or metoclopramide (3 mg/kg) plus dexamethasone (12 mg) given prophylactically followed by an 8-h infusion of metoclopramide (4 mg/kg). In the 24 h after the start of chemotherapy 70% of granisetron-treated patients and 67% of comparator group were complete responders. In patients due to receive moderately emetogenic chemotherapy, granisetron was compared with chlorpromazine (up to 200 mg/24 h) plus dexamethasone (12 mg). Twenty-four hour efficacy was significantly higher in the granisetron group with complete response in 68% of patients compared to 47% in the comparator group (P less than 0.001). A subset of 40 patients in this study were crossed over to receive the alternative antiemetic on their next cycle of chemotherapy. A significant majority of patients (32/34; 94%) preferred granisetron (P less than 0.001). Around 80% of the granisetron-treated patients in both groups required only a single prophylactic dose of granisetron. Following the first additional dose of granisetron, around 87% of patients reported symptoms to be improved or resolved. Adverse experience reporting was higher in the comparator groups with somnolence and extrapyramidal reactions representing the most common events. Headache was the most commonly reported adverse experience in granisetron-treated patients. Granisetron has proved safe and effective in controlling chemotherapy-induced emesis and is more convenient to administer than conventional antiemetics.
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PMID:A comparison of granisetron as a single agent with conventional combination antiemetic therapies in the treatment of cytostatic-induced emesis. The Granisetron Study Group. 132 Sep 13

A 73-year-old woman was admitted to the hospital for severe persistent vomiting with fever, drowsiness, and weight loss. Elevated serum levels of thyroid hormones and the presence of a consciousness disorder with fever and vomiting led to the diagnosis of thyroid storm. A low normal concentration of serum cortisol, urinary 17-hydroxycorticosteroids and an elevated plasma level of corticotropin suggest that an inadequate adrenal reserve have been involved in the pathogenesis of the thyroid storm in this patient. She responded to the administration of intravenous methimazole and oral supersaturated potassium iodide solution.
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PMID:Thyroid storm associated with probable subclinical hypoadrenocorticism in an elderly woman. 133 85

A review of the safety and tolerability of fluvoxamine in worldwide marketing studies involving 24,624 patients, predominantly receiving fluvoxamine treatment in uncontrolled studies in depression, has been conducted. There was a marked preponderance of female patients and patients aged between 30 and 50 years. The majority of patients were treated for 6 weeks, with the most frequent modal total daily dose being 100mg. The greatest proportion of adverse experiences occurring, by COSTART body system, affected the digestive system (24.1%), the nervous system (23.7%), and the body as a whole (15.3%). The only adverse experience with an incidence greater than 10% was nausea (15.7%), with somnolence (6.9%) and asthenia (6.2%) as the next most frequent experiences. Notably, the rates of agitation and anxiety were only 1.4 and 1.3%, respectively. The incidences of adverse experiences increased with age, and were slightly higher in females than males. 15.1% of patients discontinued treatment prematurely as a result of adverse experiences, principally nausea, dizziness, vomiting, somnolence, abdominal pain, and headache. The overall incidence of serious adverse events associated with fluvoxamine treatment was 2.5%, and the incidence of overall suicidality, including suicidal ideation, overdose, and intentional overdose as well as attempted and completed acts of suicide, was remarkably low at 0.8%.
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PMID:Review of fluvoxamine safety database. 137 74

Inhibitory effects on acute nausea and emesis, safety and usefulness of a single oral dose of Ondansetron tablet were evaluated in 3 different dose levels for comparison by telephone registration system, in patients receiving non-platinum anti-cancer drugs. A single dose of ondansetron at 4 mg, 8 mg or 12 mg was given orally at 2 hrs before the initial administration of anti-cancer drugs. The patients were observed for 24 hours after administration of anti-cancer drugs, for occurrence of nausea and emesis. Efficacy rates of inhibitory effects on nausea and emesis were 83.3% (10/12 cases) in 4 mg dose group, 78.6% (11/14 cases) in 8 mg dose group and 84.6% (11/13 cases) in 12 mg dose group, without statistically significant difference. Side effects were observed in 3 cases (headache, cold feeling and trembling in limbs, sleepiness) in 12 mg dose group, but these symptoms were not severe and disappeared after several hours or several days. No abnormality in clinical laboratory findings attributable to Ondansetron was observed. From the above, it was considered that Ondansetron was a clinically useful anti-emetic for nausea and emesis induced by non-platinum anti-cancer drugs and that 4 mg once daily was the optimal dose.
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PMID:[Examination of anti-emetic effect, safety and usefulness of single oral dose of ondansetron tablet in nausea and emesis induced by anti-cancer drugs--dose-finding study of ondansetron tablet in patients receiving non-platinum anti-cancer drugs]. 138 76

Two children with osteosarcoma are presented in whom Wernicke encephalopathy with vomiting occurred during the chemotherapy. One of the children died with symptoms of toxic cardiomyopathy. Autopsy revealed Wernicke encephalopathy. The other child had similar symptoms (ocular signs, ataxia, somnolence). Parenteral thiamine had been given and after this therapy the child recovered from the encephalopathy. The authors emphasize the importance of the recognition of this neurological disorder occurring rarely in childhood: it can be cured with parenteral thiamine. Without thiamine treatment this condition is lethal.
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PMID:[Wernicke encephalopathy in childhood osteosarcoma]. 140 86

Zardaverine is a newly developed selective phosphodiesterase III and IV inhibitor. This study investigates the bronchodilatory properties of zardaverine, administered by inhalation. Twelve patients with reversible bronchial obstruction (increase in forced expiratory volume in one second (change FEV1 % predicted) at least 15% after 200 micrograms salbutamol, median age 31 yrs, range 21-54 years) entered the double-blind, crossover study. Four puffs of either zardaverine (total dose 6 mg) or placebo were inhaled at 15 min intervals. Pulmonary function (specific airway conductance (sGaw) and FEV1 was measured by body plethysmography at regular intervals (5 and 12 min after each puff and, in addition, 30, 60, 120, 180 and 240 min after the last puff). Compared to placebo, sGaw and FEV1 increased significantly during the first hour of repeated inhalations, but not during the entire observation period of almost 5 h. The maximum mean difference between zardaverine and placebo for FEV1 was 0.3 l or 12% and occurred approximately 1 h after inhalation of the first puff. In seven patients FEV1 increased by > 15%. The duration of action varied considerably between patients. Three patients complained of side-effects (headache, drowsiness, vertigo, nausea), and one of these dropped out of the study due to vomiting. We conclude that inhalational administration of zardaverine has a modest and short-lasting bronchodilating activity.
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PMID:Bronchodilatory effect of inhaled zardaverine, a phosphodiesterase III and IV inhibitor, in patients with asthma. 142 7

A military tank driving simulator has recently been introduced as a training aid for tank drivers in the Israel Defense Forces. Reports of nausea and vomiting among the first users of the simulator launched our investigation of the possible existence of a motion sickness-like syndrome among simulator drivers. Although the 59 subjects drove the simulator without any report of vomiting, other motion sickness-like symptoms were frequently reported. A comparison of symptoms reported after simulator and real tank driving show that dizziness, nausea, disorientation and hypersalivation were more frequently reported by simulator drivers and were of greater intensity. However, sweating and drowsiness were more prevalent among real tank drivers. The objective effect of driving the simulator was evaluated by instability and performance tests that were conducted before, during and after driving the simulator. A greater decrement in test results was observed among subjects reporting higher frequency of motion sickness-like symptoms.
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PMID:Motion sickness-like syndrome among tank simulator drivers. 142 18

In order to identify the factors to which patients attach importance when undergoing general anaesthesia, 678 patients were retrospectively asked about their recollections of previous anaesthetics during routine preoperative screening over a period of 14 months. The most frequently mentioned recollections concerned the post-anaesthetic period, followed by recollections of the induction of anaesthesia. From the post-anaesthetic period, nausea/vomiting and drowsiness were most often cited. The number of anaesthetics previously undergone had no influence on the reports of the two most frequently mentioned complaints. The rate of nausea/vomiting in this series was 21.0%. The number of patients reporting nausea/vomiting following an anaesthetic has not changed over the years. The last 250 patients were asked to assess the quality of their anaesthetics on a 5-point scale. More than a quarter of the patients were not satisfied with the anaesthesia. No correlation was found between the assessment of the anaesthesia and complaints about nausea/vomiting and drowsiness. The possible role of psychological factors in the origin of complaints about anaesthesia is discussed.
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PMID:Recollections of general anaesthesia: a survey of anaesthesiological practice. 146 11

Vomiting in the postoperative period is common in children after strabismus surgery. One hundred ten pediatric patients, ages 8 months to 14 yr, admitted for outpatient strabismus surgery were enrolled in a randomized, double-blinded study to compare droperidol and metoclopramide to placebo for the prevention of postoperative emesis. Each child was prospectively assigned at random to one of four treatment groups: metoclopramide 0.15 mg/kg, metoclopramide 0.25 mg/kg, droperidol 0.075 mg/kg, or saline control. Drugs were administered intravenously immediately after induction of inhalation anesthesia. No neuromuscular blocking agents were used. Tracheal extubation was performed while patients were still deeply anesthetized. Acetaminophen and meperidine were given in standard doses for postoperative pain to all children. The incidence of vomiting was less in both the droperidol (33%) and metoclopramide 0.25 mg/kg (29%) groups when compared to controls (88%) (P less than 0.01). Patients receiving metoclopramide 0.15 mg/kg had a 68% incidence of vomiting (P not significant). The mean frequency of emesis was reduced in all treatment groups compared with control (P less than 0.05). Patients receiving droperidol and metoclopramide 0.25 mg/kg also had decreased postoperative stays (metoclopramide 201 min; droperidol 213 min) versus control (258 min, P less than 0.05). No child exhibited extrapyramidal symptoms, excessive drowsiness, or agitation. We conclude that metoclopramide in a dose of 0.25 mg/kg, administered prior to the start of surgery, is at least as effective as droperidol in preventing postoperative emesis and can reduce the time to patient discharge compared to control.
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PMID:A double-blinded comparison of metoclopramide and droperidol for prevention of emesis following strabismus surgery. 153 45


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