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)

The efficacy of tropisetron in the prevention of nausea and vomiting induced by chemotherapy of varying emetogenic potential was evaluated in 545 patients with a variety of malignancies who had either proved refractory to antiemetic treatment during previous chemotherapy courses or who were considered to be at high risk of nausea and vomiting. Tropisetron 5 or 10mg was administered intravenously just before chemotherapy, with the possibility of additional oral or intravenous doses on the day before chemotherapy and on 1 or more subsequent days. On day 1 of the first course of chemotherapy, a complete response (no nausea and no vomiting) was achieved in 62% of patients and a partial response (1 to 4 vomits and/or episodes of nausea) in 29%. Among the 325 patients who received a second course of chemotherapy, more than 80% of those with a complete response on day 1 of course 1 also had a complete response on day 1 of course 2; 37% and 26%, respectively, of patients with a partial response or failure (1 or more vomits and/or episodes of nausea) on day 1 of course 1 then had a complete response on day 1 of course 2.
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PMID:Compassionate use of a 5-HT3-receptor antagonist, tropisetron, in patients refractory to standard antiemetic treatment. 138 Apr 30

In a placebo-controlled, double-blind study, we have compared the efficacy of ondansetron 16 mg, 8 mg and 1 mg administered 8-hourly for prevention of postoperative nausea and vomiting. We studied 995 patients undergoing major gynaecological surgery; 982 were included in the analysis. Study medication was administered 1 h before induction of anaesthesia and second and third doses were given 8 and 16 h after the first. The treatment groups were similar for patient characteristics, surgical procedures, anaesthetics administered and opioids given. The frequency of nausea was 75%, 70%, 56% and 55% after placebo and ondansetron 1 mg, 8 mg and 16 mg, respectively; the corresponding frequencies of vomiting were 60%, 55%, 37% and 37%. Ondansetron 8 mg was as effective as 16 mg and both resulted in significant reductions in nausea and vomiting compared with placebo and ondansetron 1 mg (P less than 0.001).
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PMID:Efficacy of orally administered ondansetron in the prevention of postoperative nausea and vomiting: a dose ranging study. 138 23

Ondansetron (GR 38032) has potent and highly selective antagonist properties at the 5-hydroxytryptamine (5-HT, serotonin) 5-HT3 receptor. The selectivity ratio for ondansetron on 5-HT3 receptors compared with actions on other neurotransmitter receptor types is greater than 1,000. The antiemetic properties of ondansetron have been determined in ferrets against the nausea and vomiting induced by cisplatin, cyclophosphamide, and whole-body radiation. Ondansetron (intravenous 0.01 to 0.1 mg/kg or subcutaneous 0.1 to 0.5 mg/kg) or metoclopramide (1.0 to 4.0 mg/kg) cause dose-dependent inhibitions of the vomiting induced by each of these procedures. Unlike ondansetron, the effects of metoclopramide are accompanied by moderate to marked behavioral depression. Since metoclopramide is 50 times more potent on dopamine D2 receptors than on 5-HT3 receptors, the behavioral depression is likely due to profound blockade of dopamine receptors. The 5-HT3 receptors have been shown to be present peripherally on vagal afferent fibers and are densely located in the vomiting center of the hindbrain. The current hypothesis is that there may be both a peripheral and a central site of action for ondansetron and other 5-HT3 antagonists. The lack of antagonist activity on dopamine and other non-5-HT3 receptors indicates that, unlike metoclopramide, ondansetron will not cause extrapyramidal or other dose-limiting side effects.
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PMID:Pharmacology and preclinical antiemetic properties of ondansetron. 138 45

Phase II trials of ondansetron were undertaken to assess the ability of this agent to control nausea and vomiting caused by specific chemotherapeutic agents, to establish the optimal number of doses and the most appropriate schedule of administration, to see if control could be improved by the use of continuous infusion, and to ascertain if the degree of efficacy and safety of ondansetron would warrant further investigations. In each of six multiplebolus trials, ondansetron was given at 0.15 mg/kg to 0.18 mg/kg intravenously for three doses, beginning 30 minutes prior to cisplatin. No patient had received prior cancer chemotherapy. Overall, 48% of patients experienced no emesis, and 71% had zero to two emetic episodes after receiving cisplatin doses of 100 mg/m2 or greater. Comparable antiemetic control was seen with all schedules studied. Three additional trials assessed the effect of the number of doses of ondansetron on antiemetic effectiveness. A single dose gave complete protection in 25% of patients and three doses gave a 50% no-emesis rate. Complete control was not improved when six doses of ondansetron were given. Efficacy rates with multiple-bolus therapy and continuous infusion over 24 hours were similar. Side effects were mild and reversible in all trials, and there were no remarkable differences in adverse events among different schedules or numbers of doses. The complete and major control rates observed show that ondansetron is as effective as or more effective than metoclopramide in controlling cisplatin-induced emesis.
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PMID:Phase II trials of ondansetron with high-dose cisplatin. 138 47

A logical outgrowth of the early clinical success with ondansetron in phase I and phase II trials has been an interest in comparative antiemetic trials using conventional agents. Metoclopramide is generally acknowledged to be the single most effective conventional drug for the prevention of acute cisplatin-induced emesis and, therefore, was considered an appropriate agent for inclusion in comparative trials with ondansetron. Three phase III trials comparing metoclopramide with ondansetron for the prevention of acute nausea and vomiting associated with cisplatin administration have been completed to date. One was a single-blind, parallel-group trial conducted in the United States, and the other two were double-blind, crossover trials performed in Europe. The efficacy results of these studies demonstrated either a consistent trend or clear superiority of ondansetron in comparison with metoclopramide. Treatment failure consistently developed much later with ondansetron than with metoclopramide. Less antiemetic toxicity was noted with ondansetron. With the exception of headache, there was a lower incidence of neurologic adverse events in the ondansetron group. No dystonic reactions were observed with ondansetron in any of the trials. In all three trials, patients expressed greater overall satisfaction with ondansetron for emesis control.
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PMID:Comparative trials of ondansetron versus metoclopramide in the prevention of acute cisplatin-induced emesis. 138 48

The emetogenic properties of chemotherapeutic agents differ in terms of the frequency, intensity, time of onset, and duration of vomiting and nausea. As the effects of antiemetic agents in the control of emesis induced by different chemotherapeutic agents could differ, new antiemetics must be tested against a variety of chemotherapy challenges. In many non-cisplatin chemotherapy situations, a partly or totally oral schedule of antiemetic administration may be preferable. The selective 5-hydroxytryptamine (5-HT3)-receptor antagonist, ondansetron, has been shown to be a safe, effective, and well-tolerated antiemetic in the prevention of nausea and vomiting from several non-cisplatin chemotherapies. In randomized studies, ondansetron has compared favorably with metoclopramide in patients receiving cyclophosphamide-containing chemotherapy regimens.
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PMID:Antiemetic activity of ondansetron in cancer patients receiving non-cisplatin chemotherapy. 138 49

Up to 30% of patients receiving chemotherapy experience uncontrolled nausea and vomiting despite pharmacotherapeutic advances. Currently marketed agents used to treat these symptoms are compared. Dose escalation of these agents may improve response rates. Recent focus has been on a new class of antiemetics, the serotonin antagonists. Ondansetron, currently the only serotonin antagonist with Food and Drug Administration approval for treatment of chemotherapy-induced emesis, demonstrates the efficacy and potential advantages of this class of antiemetics.
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PMID:Emesis as a complication of cancer chemotherapy: pathophysiology, importance, and treatment. 138 7

The anti-emetic effect, safety and clinical usefulness of ondansetron for the treatment of nausea and vomiting caused by anticancer drugs including cisplatin, was evaluated by a multi-institutional study in patients with various malignancies. In this study, ondansetron was given intravenously with mainly a single dose of 4 mg to intervene nausea and vomiting. 1. Efficacy ratio of overall effects on nausea and emesis observed for 24 hours after treatment was 69.8%. 2. No side effect was observed. Laboratory tests showed temporary elevation of serum uric acid level in 1 patient in the group given 4 mg. 3. From these results, it seems that ondansetron, given intravenously after initial vomiting, was highly safe and clinically useful anti-emetic for the treatment of nausea and vomiting associated with anti-cancer drugs.
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PMID:[Evaluation of SN-307 (ondansetron), given intravenously for the treatment of nausea and vomiting caused by anticancer drugs including cisplatin-open study]. 138 76

Cancer patients consistently rank nausea and vomiting as the most feared side effects of treatment. Cisplatin, one of the most active chemotherapeutic agents, causes acute emesis and a delayed emesis syndrome, which also results in considerable patient morbidity. Despite the use of metoclopramide-containing combination regimens, approximately one third of cisplatin-treated patients continue to experience emesis. In recent years, considerable progress has been made in managing chemotherapy-induced emesis. This review discusses several factors that have contributed to improved antiemetic control, including standardization of antiemetic trial methodology, insight into the pathogenesis of chemotherapy-induced emesis, and the development of a new class of antiemetic agents, the serotonin antagonists. In clinical studies performed to date, these agents have generally proven to be both effective and safe. Three multicenter trials of the selective serotonin antagonist ondansetron in the prevention of nausea and vomiting from cisplatin are reviewed.
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PMID:Advances in the control of chemotherapy-induced emesis. 139 Mar 17

Following a single intravenous dose given pre-chemotherapy, the efficacy and tolerability of oral ondansetron treatment given twice daily was compared with the established three times daily oral supplementary regimen in the prophylaxis of nausea and vomiting induced by cyclophosphamide (greater than or equal to 500 mg/m2) in combination with doxorubicin (greater than or equal to 40 mg/m2) or epirubicin (greater than or equal to 40 mg/m2). Oral ondansetron given twice daily or three times daily was equally effective in controlling nausea and emesis. The twice daily oral treatment prevented emesis in 73% of patients in the first 24 hours and in 65% of patients over 3 days. Both dose schedules were safe and were tolerated well. Twice daily oral ondansetron showed good efficacy for controlling emesis and nausea in oncology outpatients.
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PMID:Efficacy of twice daily versus three times daily oral ondansetron in the prevention of chemotherapy induced emesis: a randomized, single-blind, multicentre study. The Ondansetron International Emesis Study Group. 139 Mar 40


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