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 aim of the study was to assess vomit and pain control in terminal cancer patients with inoperable gastrointestinal obstruction, using a pharmacologic symptomatic treatment which prevents recourse to nasogastric tube placement and intravenous hydration, in hospital and home care settings. Twenty-two symptomatic patients, who were judged as inoperable, were treated with a pharmacologic association of morphine hydrochloride and scopolamine butylbromide as analgesics and haloperidol as an antiemetic. The drugs were administered by continuous subcutaneous infusion via a syringe driver or intravenously only when a central venous catheter had been inserted previously. Daily recordings included assessment of pain, number of vomiting episodes, dry mouth, drowsiness, and thirst sensation. Data were examined before starting the treatment (T0), 2 days after (T2) and 2 days before death (T-2). They showed that there was a significant decrease in the pain score (p less than 0.001) on T2 and a further decrease on T-2 (p less than 0.05). Vomiting was controlled in all patients, with the exception of three patients with upper abdomen obstruction who required nasogastric tube placement. Dry mouth showed an upward trend throughout the observation period (p less than 0.05) but was successfully treated by administering liquids by mouth or ice-cubes to suck. Drowsiness too presented an upward trend from T0 to T-2 (p less than 0.001). Only one patient out of 16 who reported to be thirsty required intravenous hydration. We believe that in terminal cancer patients, vomit and pain resulting from inoperable intestinal obstruction, with the exception of obstruction of the upper abdomen, can be controlled through administration of analgesic and antiemetic drugs, in the hospital and at home, without recourse to nasogastric tube placement or intravenous hydration.
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PMID:The management of inoperable gastrointestinal obstruction in terminal cancer patients. 169 93

Paraquat, a useful contact herbicide is now used in over 130 countries of the world, including Sri Lanka. The number of cases of accidental poisoning reported with paraquat is small, relative to instances of suicide. When a clear history is not available, accidental paraquat poisoning is sometimes difficult to diagnose. A 9-year-old boy was admitted to a peripheral hospital with a history of diarrhoea and vomiting. He later developed abdominal pain, subcutaneous emphysema and difficulty in breathing. Following transfer to a district hospital and then to a teaching hospital, poisoning with paraquat was suspected only on day 11 of the illness. On persistent questioning, on day 13 of the illness the child remembered that the day prior to the onset of illness, on his way from a shop, he felt thirsty and having found an empty bottle of Gramoxone (paraquat) on the wayside he used it to drink water from a water tank. The child died on day 17 and the histology of the lung showed typical changes of paraquat poisoning. This tragic episode emphasises the need for proper disposal of empty containers of all poisonous substances.
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PMID:An unusual case of fatal accidental paraquat poisoning. 230 5

This paper discusses the use of oral rehydration therapy (ORT) in the clinical management of diarrhea with no dehydration, diarrhea with some dehydration, and diarrhea with severe dehydration. The 1st step in ORT is to weigh the patient and assess the degree of dehydration. It should be recognized that a child who has had 4 loose stools in the past 24 hours and is thirsty has some degree of dehydration, and ORT should start as soon as possible. If the child has no signs of dehydration, the mother should be given 3 instructions for treating diarrhea at home: 1) give the child more fluids more often; 2) continue to breastfeed; and 3) return the child to the clinic if he develops signs of dehydration, if the diarrhea gets worse, or if he is not better after 2 days. If a child has 2 or more of the signs of some dehydration (4-10 loose stools/day, more than a little vomiting, thirstiness, and less urine than usual), he should be rehydrated with oral rehydration solution (ORS). If available, the World Health Organization ORS packets should be used. After the child has been given 10-20 ml/kg of ORS each hour for 4 hours, the hydration should be reassessed. ORS should be given for each loose stool. If the child has 2 or more of the signs of severe dehydration (more than 10 loose stools/day, much vomiting, inability to drink fluids, and no urine for 6 hours), intravenous rehydration is necessary. A major problem with use of ORS is the time involved to explain the process to parents. Parents must understand that ORS does not treat the diarrhea per se; rather, it replaces fluids and salts lost by the child and prevents dehydration. If parents do not understand this, they may become discouraged if the diarrhea continues and stop ORT. ORT is as effective in treating adults with diarrhea as it is in children. In addition, ORT is just as good as intravenous rehydration, except in cases where the dehydration is severe.
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PMID:Oral rehydration therapy. 386 65

To investigate effects of epidural morphine and pentazocine on postoperative pain, eighty-eight women who have undergone gynecological abdominal surgery were studied. 1) As for onset of analgesia, there was statistically no significant difference between morphine and pentazocine. 2) The duration of analgesic effect of epidural morphine significantly lasted longer than epidural pentazocine. The duration of analgesic effect of epidural morphine showed a tendency to be longer in the groups of morphine 4 or 6mg than 2mg, but there was no significant difference between the groups of morphine 4 and 6mg. 3) On the postoperative first discharge of bowel gas, there was statistically no significant difference between morphine and pentazocine. The onset time of the gas discharge showed a tendency to be longer in the groups of morphine 4 or 6mg than 2mg. In case of pentazocine, it may be longer in 15mg than 10mg. 4) As for side effects, nausea, vomiting, thirsty, redness of the face and sweating were mainly observed. However, respiratory depression as well as sensory and motor disturbance which frequently observed after epidural injections of the local anesthetic were not recognized in these procedures. But circulatory depression and urinary retention were observed in only one cases of epidural morphine.
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PMID:[Studies on comparison of the postoperative analgesic method between epidural morphine hydrochloride and pentazocine]. 689 14

In early palliative stages effective nutrition can improve well-being. In late stages and in dying patients excessive amounts of proteins and lipids may induce nausea and vomiting, due to cachexia and subsequent changes in the metabolism. Excessive hydration may give rise to oedema and dyspnoea. In these late stages the patient rarely feels hungry or thirsty. The goal should therefore be to do good, not to harm and to respect the autonomy of the patient. Thus, the well-being of the patient should be in focus: to avoid hunger, thirst, nausea, vomiting, oedemas and dyspnoea. The consequences are that small amounts of carbohydrates and water often constitute the optimum for these patients.
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PMID:[Quality of life is the most important goal of nutritional support of the dying]. 1075 Mar 87

The purpose of our study was to determine the safety and tolerability of early oral hydration (EOH) compared with delayed oral hydration (DOH) after general anesthesia. One thousand anesthesiology (ASA) I to III adult patients undergoing non-gastrointestinal surgery with general anesthesia were randomized assigned into two groups: DOH (n=500, patients were given water 4 h after general anesthesia), EOH (n=500, patients were given 0.5 ml/kg water once recovered from general anesthesia.) in the postanesthesia care unit (PACU). Patients were evaluated for nausea, vomiting, drink desire, thirsty scale, oropharyngeal discomfort scale, and satisfaction scale. Statistical analysis was performed with Student's t and Chi-Square tests. Complete data were available for 983 patients (EOH=488, DOH=495). Twenty minutes after receiving water the incidence of vomiting in EOH group was very low. And there was no significant difference between the two groups at the same time point (p > 0.05). Compared with DOH group, after receiving water there was a significant decrease of patients' thirsty scales (p < 0.0001) and oropharyngeal discomfort scales (p < 0.0001) in EOH group. Significantly more patients' satisfaction were reported in EOH group (p < 0.001). No serious adverse effects were reported during the study period. For patients undergoing non-gastrointestinal surgery, early oral hydration after recovery from general anesthesia was safe, with lower thirsty scale and oropharyngeal discomfort scales, and higher satisfaction.
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PMID:Early versus delayed postoperative oral hydration after general anesthesia: a prospective randomized trial. 2541 88