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)

Ondansetron is a 5-HT3 receptor antagonist which has shown activity in the prevention of nausea and vomiting resulting from cytotoxic therapy. This paper describes the results of studies evaluating the efficacy of oral ondansetron in controlling radiation-induced emesis. Initial non-randomised studies showed that doses of 4 mg q.d.s. or 8 mg t.d.s. of ondansetron achieved complete or major control of vomiting in 77-91% of patients and mild or absence of nausea in 72-77% following single exposure high-dose (8-10 Gy) radiotherapy to the upper abdomen. A subsequent double-blind, prospective, randomised trial compared ondansetron 8 mg t.d.s. with metoclopramide 10 mg t.d.s. in the prevention of emesis following single radiation doses of 8-10 Gy to the upper abdomen. On the day of radiotherapy, ondansetron achieved significantly greater control of vomiting and retching (P less than 0.001) and nausea (P = 0.001) than metoclopramide. An advantage for ondansetron was also seen on days 2 and 3 after irradiation, although this did not reach a statistically significant level. Only two patients, out of 154, in all the studies experienced side effects attributable to ondansetron: one developed headache and the other experienced headache and vertigo. These studies show that ondansetron is a safe drug, with activity in the prevention of radiation-induced emesis and significantly greater efficacy than metoclopramide in the control of nausea and vomiting following single exposure upper abdominal high-dose radiotherapy.
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PMID:Clinical studies with ondansetron in the control of radiation-induced emesis. 253 96

Vomiting represents one of the most dangerous complications of general anesthesia. L-sulpiride has been able to control this complication very effectively. We studied the effect on vomiting of two doses of L-sulpiride (50/100 mg). Both these doses have been effective in reducing the episodes of vomiting other than in preventing nausea and retching if considered versus controls and also versus droperidol at the doses of 5 mg (50 mg L-sul = 12%, 100 mg = 4%, droperidol = 20%, controls = 28%). L-sulpiride is an antagonist of dopamine on D2 receptors therefore inhibits the action of dopamine increasing the secretion of prolactin. During the surgical distress per se prolactin levels are increased. Together with the increment of catecholamines, high concentration of prolactin can evoke arrhythmias. In view of this possibility we studied the time course of the administration of the two doses of L-sulpiride and of droperidol on prolactin secretion. Both of the drugs increased the plasma levels of prolactin. Droperidol-induced increase in prolactin secretion was significant already at ten minutes after the administration reaching the peak after 20 minutes. L-sulpiride increased prolactin secretion reaching the maximum increase 20 minutes after the administration of 50 mg of the drug, and 30 minutes after the administration of 100 mg doses. The hyperprolactinemizing action of droperidol lasts for at least 8 hours, whereas L-sulpiride action lasts 4 hours.
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PMID:[Antiemetic effect of the levo isomer of sulpiride (L-sulpiride) in humans]. 260 63

Five patients, aged 9-16, living in a community-based home for the mentally retarded, have undergone Nissen fundoplication for gastroesophageal reflux. They were all severely physically handicapped by cerebral palsy. Their symptoms had persisted from 1-10 years, and included chronic retching and vomiting, intermittent obstruction of the upper airways, frequent bronchial and pulmonary infections, and episodic abdominal pain and failure to thrive. Three had hematemesis. Two patients lost a great deal of weight. One had chronic reflux associated with lower airway obstruction, which improved postoperatively. All patients had undergone conservative medical treatment of four to 12 months duration, with no lasting improvement. There were very few postoperative complications. One patient had to be reoperated. After surgical treatment their main symptoms had disappeared and their subsequent management was easier. We have reasons to believe that this condition is seriously underdiagnosed in our society, thereby causing unnecessary pain and distress in patients who are unable to convey their complaints to others.
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PMID:[Gastroesophageal reflux associated with severe cerebral paresis]. 260 3

In order to assess the safety of cefmetazole, preclinical multiple-dose parenteral studies, varying from one to three months in length, were conducted in Sprague-Dawley rats and beagle dogs. Although the largest doses used were in multiples of several times the weight-adjusted doses intended for humans, cefmetazole was generally well tolerated. The principal adverse effect noted in the adult rats receiving the largest doses (2000 and 2500 mg/kg/day) of cefmetazole was slight elevation of serum alanine aminotransferase. Infant rats injected subcutaneously with 300 mg/kg/day or more of cefmetazole for 35 consecutive days had reversible reductions in testicular weight and maturation of spermatogenesis, but not lasting discernible effect on reproductive function. The most consistent effects of longterm multiple dosing with cefmetazole in dogs consisted of vomiting and retching during dosing and reversible haematological changes (mild regenerative anaemia, positive Coombs' test, clinically-silent thrombocytopenia) in a number of the dogs. These findings supported the interpretation that cefmetazole was acceptably safe for clinical studies in humans.
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PMID:Preclinical safety studies of cefmetazole. 272 19

The authors evaluated the antiemetic properties of transdermal scopolamine (TDS) in healthy patients undergoing elective cesarean section and receiving epidural morphine for postoperative analgesia. Prior to administration of anesthesia, 203 patients had either TDS or a placebo study patch applied behind one ear. All patients were hydrated with lactated Ringer's solution iv and given 2.0% lidocaine with 1:200,000 epinephrine epidurally for surgical anesthesia. Following delivery of the infant, 4 mg of morphine sulphate was injected through the epidural catheter. After the operation patients were evaluated by "blinded" observers at 2, 4, 6, 8, 10, 24, and 48 h for nausea, vomiting, retching, pain relief, itching, and adverse effects. In addition, medications received were noted. No differences were found between the groups in terms of severity or incidence of pain, or requests for analgesic or antipruritic medication. Although there was no difference between the groups in the first 2 h, patients with TDS had significantly less nausea, vomiting, and retching than patients in the placebo group in each time interval between 2 and 10 h. Additionally, the TDS group required less antiemetic medication. There was no difference in the frequency of retching or vomiting between groups. Side effects were minimal and equal in both groups. The authors conclude that TDS results in a decreased incidence of nausea and vomiting in patients who have delivered by cesarean section and received epidural morphine. TDS appears safe for continuous antiemetic administration.
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PMID:Transdermal scopolamine decreases nausea and vomiting following cesarean section in patients receiving epidural morphine. 281 61

The anterior hypothalamic preoptic area (AH/POA) was examined as a possible site of action of clonidine and other alpha noradrenergic receptor agonists which evoke motor and autonomic changes. Chronically indwelling guide cannulae were implanted stereotaxically in the diencephalon of the cat. Following post-operative recovery, a micro-injection into AH/POA was made in a volume of 1.0 microliter of one of the following compounds: 5.0-50.0 micrograms clonidine, 5.0-50.0 micrograms norepinephrine, 5.0-50.0 micrograms phenylephrine and 5.0-50.0 micrograms methoxamine. The smallest dose of 5.0 micrograms clonidine produced a brief period of restlessness, licking, retching and emesis but a much longer-lasting mydriasis. When the dose of clonidine was raised to 20 micrograms, the cat became behaviorally sedated, after a latency of about 15 min, for a period of up to 1.0-2.0 hr. This was accompanied by a prolonged period of mydriasis and preceded by a short interval of restlessness, licking, retching and emesis. After the highest dose of 50.0 micrograms clonidine was micro-injected in AH/POA, a profound impairment of motor activity, adynomia and restlessness developed within 15-20 min, persisted for 30 to 60 min and was accompanied also by mydriasis with maximal pupillary dilation lasting for up to six hr. When 5.0-50.0 micrograms phenylephrine or 5.0-50.0 micrograms norepinephrine were micro-injected at clonidine-reactive sites in AH/POA, only rarely were brief instances of restlessness, licking, retching and emesis observed; however, methoxamine at all doses tested failed to produce any visible signs of autonomic or motor disturbance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dissociation of locomotor impairment from mydriasis evoked by clonidine injected into cat's rostral hypothalamus. 287 57

The localized effect of noradrenergic agonists administered directly in the anterior hypothalamic preoptic area (AH/POA) in inducing emesis in the cat was investigated. Of the noradrenergic agonists tested, which included norepinephrine, clonidine, phenylephrine and methoxamine, only clonidine in doses of 5.0-50.0 micrograms was found to evoke emesis consistently when micro-injected in a volume of 1.0 microliter into AH/POA of the unrestrained cat. The emetic response to clonidine was short-lasting, generally dose-dependent in terms of latency and frequency, and occurred in bouts of one to three episodes. The sequence of the vomiting response, beginning with licking and retching, functionally resembled a normal pattern of an emetic response. The clonidine-induced emesis was not antagonized by the following antagonists micro-injected in AH/POA just prior to clonidine: alpha-adrenergic blocking agents, yohimbine, RX 781094 and phentolamine; the antimuscarinic drug, atropine; the serotonin antagonist, methysergide; the opioid antagonist, naloxone; and the dopamine antagonist, chlorpromazine. Therefore, it would appear that clonidine-induced emesis is not mediated by alpha noradrenergic, serotonergic, dopaminergic, muscarinic and opiate receptor systems within the AH/POA of the cat. Finally, the obtained results show that apart from the area postrema and a circumscribed zone of the brain-stem reticular formation, the hypothalamus is now implicated as a neuroanatomical site in the central nervous system mechanism underlying neurochemically-induced emesis.
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PMID:Rostral hypothalamus: a new neuroanatomical site of neurochemically-induced emesis in the cat. 288 12

The intravenous injection of cisplatin in the ferret caused a consistent emetic (vomiting/retching) response. Emesis induced by cisplatin was abolished by the 5-hydroxytryptamine (5-HT) M-receptor antagonists ICS205-930, zacopride, dazopride and metoclopramide. The neuroleptic agents haloperidol, fluphenazine, domperidone, sulpiride and tiapride also antagonized emesis induced by cisplatin but only a proportion of the animals were completely protected and diazepam and prednisolone only reduced the intensity of the response. It is concluded that compounds used in the clinic to antagonise emesis induced by chemotherapy are effective in the ferret model. Antagonism of emesis induced by cisplatin in the ferret was most potently achieved by the use of the 5-HT M-receptor antagonists ICS205-930 and zacopride. However, an antagonism of dopamine receptors would appear relevant to the anti-emetic effects of the neuroleptic agents and may contribute to the anti-emetic effects of metoclopramide. Diazepam and prednisolone exert their modest antagonism by unknown mechanisms. The use of the 5-HT M-receptor antagonists is revealed as a novel approach to the treatment of emesis induced by cisplatin.
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PMID:Emesis induced by cisplatin in the ferret as a model for the detection of anti-emetic drugs. 289 Jan 17

Xylazine produces retching and vomiting presumably by activation of the chemoreceptor trigger zone (CTZ). The purpose of this project was to investigate whether neuroinhibition can prevent xylazine vomiting. Inhibitory neurons in the cervical vagus nerve of cats were stimulated with implanted cuff electrodes. Female cats, weighing from 3 to 4 kg, were anaesthetized with pentobarbital for surgical implantation of electrodes. After full recovery from surgery, animals were tested in weekly sessions. Stimulation was via a pulse generator connected to photon coupled linear isolator supplying constant current. Videotape was used to record observations. The range of effective stimulation was 1-10 ma, 4-100 Hz and 0.3-0.6 msec. Stimulation was initiated thirty sec. after subcutaneous injection of xylazine, 0.66 mg/kg. Stimulation of the inhibitory nerve group of the cervical vagus was effective in preventing vomiting in over 85% of the experimental trials. In addition to preventing emesis during stimulation, the latency of xylazine emesis was increased over control values. Repeated experimental trials of stimulation coupled with xylazine injection could result in the complete absence of emesis.
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PMID:Neuroinhibition of xylazine induced emesis. 290 94

The Boerhaave syndrome is classically considered a panmural perforation of the distal esophagus secondary to forced vomiting or retching. A variant of the syndrome is described in which only the outer longitudinal muscle layer of the esophagus was torn, and in this case most of the usual radiological findings were absent. The clinical, radiological, and surgical findings are discussed.
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PMID:Computed tomography of mediastinal hematoma secondary to unusual esophageal laceration: a Boerhaave variant. 291 Sep 30


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