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)

A 19-year old woman who developed rapid nausea, vomiting, tachypnea, and alkalosis within 90 min of taking 3.25 g quinine S04 to induce abortion, was found to have an elevated anion gap and other electrolyte abnormalities. She was normovolemic, and had benign findings on drug screen except for quinine. Her abnormal laboratory values were high serum anion gap of 20 (normal 8-14), high urine anion gap of 171, low HC03- of 29 mEq/L, high Pa)@ of 130 mm Hg, alkalotic pH of 7.5, and hypokalemia of 2.6 mEq/L. Her hypokalemia was judged due to diuresis and vomiting. She was successfully treated with intravenous fluids and supportive care and was discharged on the third day. Quinine intoxication can also cause cinchonism, which is marked by tinnitus, vertigo, blurred vision and scotomata, and possible optic atrophy or death. The toxic dose is 2 g, and the lethal dose 8 g.
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PMID:Self-induced abortion and an elevated anion gap. 249 93

The three best-described genetic polymorphisms of drug metabolism--the debrisoquin/sparteine type of oxidative polymorphism (hereafter referred to as the debrisoquin polymorphism), the polymorphism of N-acetylation, and the mephenytoin type of oxidative polymorphism--are reviewed. For all three polymorphisms, the poor-metabolizer phenotype is inherited as an autosomal recessive trait. The debrisoquin and mephenytoin oxidative polymorphisms involve defects in two separate cytochrome P450 enzymes. The prevalence of the poor-metabolizer phenotype for debrisoquin ranges between 2% and 10% for groups of various ethnic origins. The poor-metabolizer phenotype for mephenytoin comprises about 5% of the Caucasian population and about 20% of the Japanese population. N-acetyltransferase is a cytosolic enzyme whose clinical polymorphism was discovered using isoniazid as the substrate probe. The prevalence of the slow-acetylator phenotype among American and European Caucasian and American black groups is about 50%; among the Japanese it is about 10%. More than 20 agents are substrates for debrisoquin hydroxylase, about 15 for N-acetyltransferase, and 3-5 for mephenytoin. In poor metabolizers, debrisoquin can cause hypotension, and sparteine can cause blurred vision, headache, and dizziness. Clinical consequences of the slow-acetylator phenotype include increased susceptibility to systemic lupus erythematosus induced by procainamide and hydralazine, peripheral neuropathy induced by isoniazid, hydralazine, and dapsone, and sulfasalazine-induced dose-related leukopenia, nausea, vomiting, headache, and vertigo. After administration of mephenytoin, poor metabolizers have increased somnolence and intellectual impairment. Awareness of genetic polymorphisms of drug metabolism should improve understanding of interindividual variability in drug disposition and response.
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PMID:Polymorphic drug metabolism. 268 60

During May and June of 1985 the Health Protection Branch and several other agencies were involved in the investigation of over 300 reports of illness reported in the Vancouver area of British Columbia, Canada. Symptoms reported included nausea, vomiting, dizziness, muscle fasciculation and blurred vision. A review of the onset of symptoms and food consumed suggested that at least 140 people had become ill from eating cucumbers adulterated with a carbamate pesticide. The presence of residues of aldicarb in cucumbers from one particular producer was confirmed by laboratory analysis.
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PMID:Report of illnesses caused by aldicarb-contaminated cucumbers. 336 Feb 4

Cerebral symptoms were registered in a multicenter study including 64 patients with severe hypertension, diastolic blood pressure (DBP) greater than or equal to 135 mmHg, and more or less pronounced hypertensive encephalopathy. The symptoms were: headache (70%), dizziness (35%), consciousness disturbances (28%), nausea (27%), paresis (23%), blurred vision (22%), paraesthesia (21%) and vomiting (14%). None had convulsions or coma. Initial treatment was furosemide i.v., and if DBP was greater than or equal to 125 mmHg after one hour, patients were randomized to treatment with either i.v. diazoxide (bolus injections of 75-150 mg) or i.m. dihydralazine (bolus injections of 6-12.5 mg). A gradual fall in blood pressure (BP) was obtained in all three groups. Along with BP reduction a substantial regression of neurological symptoms was registered. After 5 hours only minor cerebral symptoms were present without significant difference between diazoxide and dihydralazine. None developed cerebral complications. The study failed to show a significant correlation between BP reduction and regression of neurological symptoms graded semiquantitatively. Reduction of BP by titration using small repeated bolus injections is recommended, but oral treatment should be considered in the patients who are able to ingest peroral medication in spite of neurological symptoms.
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PMID:Reversibility of cerebral symptoms in severe hypertension in relation to acute antihypertensive therapy. Danish Multicenter Study. 353 94

The main criteria of "cervicogenic headache" are considered to be as follows: relatively rare and long-lasting unilateral attacks of severe headache, although seemingly of a non-excruciating character, signs of neck involvement, and lack of "cluster pattern". In the present communication, the clinical manifestations in 11 patients fulfilling these criteria are described. All 11 patients selected in accordance with these criteria proved to be females, the age at onset ranging from 6 to 40 years (mean, 30 years). The mean duration of symptoms was 13 years. Six patients had had previous head/neck injuries. All patients had pain periorbitally, in the temporal region, and in the low occipital region (nape of the neck); less frequent were frontal, parietal, and facial pain and pain in the upper part of the occipital region. The duration of attacks was from 3 h to 3 weeks, and the interval between attacks lasted from 2 days to 2 months. The commonest accompanying phenomena were phonophobia, dizziness, ipsilateral eyelid edema, ipsilaterally blurred vision, and irritability. Some of the patients also had nausea (n = 7) and vomiting (n = 6). On physical examination, slight to moderate reduction of movements in the neck was noted, and five patients had ipsilaterally reduced sensation for touch in the trigeminal area. All the patients except one were severely afflicted. Attacks could, in addition to occurring spontaneously, be precipitated in all patients by head movements or by pressure at specific points in the neck.
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PMID:"Cervicogenic headache": clinical manifestation. 360 68

A case of intravenous labetalol in the treatment of a resistant hypertensive emergency is reported. Although there have been several reports of the use of oral labetalol in resistant hypertension, no intravenous administration in hypertensive emergency resistant to other drugs has been reported to date. A 36-year-old black female with BP of 270/160 mm Hg with complaints greater than one month's duration of dizziness, severe headaches, blurred vision, shortness of breath, vomiting, palpitations, flushing, agitation, diarrhea, weakness, and weight loss, was treated successfully with intravenous labetalol after she failed to respond to other established parenteral antihypertensive drugs. The patient received labetalol 20 mg iv bolus, and then 20 mg every ten minutes until a cumulative dose of 200 mg was attained. Labetalol produced a prompt but smooth reduction in BP without any reflex tachycardia or other adverse effects. Intravenous labetalol may be safe and effective for the management of rapid BP control in hypertensive emergencies resistant to other parenteral antihypertensive agents.
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PMID:Intravenous labetalol in the management of resistant hypertensive emergency. 360 97

Fifteen patients with ventricular premature complexes (VPCs) were included in this open study designed to assess the relative efficacy of bid (two times daily) and tid (three times daily) dosing regimens for cibenzoline as compared with qid (four times daily) administration. Patients started therapy with qid administration; this was followed in sequence by tid and bid administration at the maximum effective total daily dose determined during the qid administration. Of the nine patients evaluated for efficacy for suppression of VPCs, eight demonstrated a 75% or greater suppression of VPCs with cibenzoline administered qid (total daily dose of 130-325 mg). This effectiveness was maintained in four patients with a bid regimen and in three with a tid regimen. All four patients who had ventricular tachycardia (VT) had a decrease in the number of VT episodes while receiving cibenzoline (only one of these patients had satisfactory suppression of VPCs at the same dosage regimen). Twelve patients continued to receive extended therapy with cibenzoline for up to two years, as this was considered to be the optimum antiarrhythmic treatment for these patients. Two patients had to be removed from the study and two had the dosage lowered because of adverse reactions (dry mouth, blurred vision, dizziness, congestive heart failure) although in one instance, the congestive heart failure was subsequently considered to be unrelated to cibenzoline. One patient was able to complete the short-term phase of the trial, but was not given extended treatment because of persistent dry mouth. Two patients had treatment discontinued during the extended therapy phase because of adverse reactions (fever, nausea, vomiting, asthenia).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of dosing interval and optimum dose of cibenzoline. 368 May 96

After reviewing the literature, a personal series of 10 adult patients with cerebellar infarction diagnosed by CT scan is described. The clinical picture in young adult men is characterized by rapid onset of headache, vomiting, vertigo, ataxia and blurred vision. After this sudden onset the patients may present a stable course or a rapid or delayed onset of brain stem compression, revealed by impairment of consciousness. CT scan is the diagnostic method of choice. The correlation between angiographic and CT localization of the infarction is not good. For therapy the following policy is suggested: in alert and clinically stable patients: medical treatment (mannitol, glycerol, dexamethason), ICP and serial CT monitoring; in alert patients with hydrocephalus or mass effect: medical treatment and monitoring as mentioned before; ventricular drainage if ICP surpasses 350 mm H2O; in patients with impaired consciousness and hydrocephalus or mass effect: immediate ventricular drainage. If it is not followed by prompt improvement of the level of consciousness, an emergency suboccipital craniectomy with removal of the infarcted tissue should be done.
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PMID:Surgical management of acute cerebellar infarction. 398 89

A patient with primary open-angle glaucoma (POAG) underwent a trabeculectomy according to Watson's technique. Postoperative intraocular pressure (IOP) ranged from 8 to 11 mm Hg. However, repeat slit lamp evaluation revealed the absence of bleb formation. Two months post-filtration surgery the patient developed the sudden onset of nausea, vomiting, supraorbital pain, and blurred vision. The IOP was 46 mm Hg and gonioscopy revealed a hyaline membrane covering a cyclodialysis cleft. A Nd:YAG laser was used to reopen the cleft, with normalization of IOP.
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PMID:Reopening cyclodialysis cleft with Nd:YAG laser following trabeculectomy. 654 22

A case of a huge intracranial frontoparietal osteochondroma in a 20-year-old man is reported. The presenting symptoms were headache, vomiting, and blurred vision. Apart from papilledema, no other abnormal neurological signs were present. A specific preoperative diagnosis could not be reached from the information provided by plain skull films, angiography, and radionuclide scan. The findings on computed tomography were those of a high density mass interspersed with small foci of lower densities, producing a honeycomb appearance, and surrounded by deposits of nodular calcification. The postcontrast scan showed a moderate degree of enhancement with preservation of the precontrast honeycomb pattern. These particular features may enable a correct preoperative histological diagnosis to be offered with a high degree of probability.
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PMID:Computed tomography in intracranial supratentorial osteochondroma. 697 90


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