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)

Fifteen patients with osteogenic sarcoma receiving high-dose methotrexate chemotherapy were studied in a randomized, double-blind, placebo-controlled trial of oral and smoked delta-9-tetrahydrocannabinol (THC) as an antiemetic. Each patient served as his or her own control. Fourteen of 15 patients had a reduction in nausea and vomiting on THC as compared to placebo. Delta-9-tetrahydrocannabinol was significantly more effective than placebo in reducing the number of vomiting and retching episodes, degree of nausea, duration of nausea, and volume of emesis (P less than 0.001). There was a 72% incidence of nausea and vomiting on placebo. When plasma THC concentrations measured less than 5.0 ng/mL, 5.0 to 10.0 ng/mL, and greater than 10.0 ng/mL, the incidences of nausea and vomiting were 44%, 21%, and 6%, respectively. Delta-9-tetrahydrocannabinol appears to have significant antiemetic properties when compared with placebo in patients receiving high-dose methotrexate.
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PMID:Delata-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate. A prospective, randomized evaluation. 29 41

A double-blind cross-over trial with delta 9-tetrahydrocannabinol (THC) and placebo was employed to test the antiemetic effect on nausea and vomiting after MOPP-therapy. Although THC had remarkable antiemetic effects, the side effects were severe. Most patients preferred the nausea and the vomiting after MOPP-therapy to the use of THC. A relation between the antiemetic action or the side-effects and the blood-level of THC could not be demonstrated.
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PMID:delta 9-Tetrahydrocannabinol (THC) as an antiemetic in patients treated with cancerchemotherapy; a double-blind cross-over trial against placebo. 51 62

Anecdotal accounts suggested that smoking marihuana decreases the nausea and vomiting associated with cancer chemotherapeutic agents. Oral delta-9-tetrahydrocannabinol was compared with placebo in a controlled, randomized, "double-blind" experiment. All patients were receiving chemotherapeutic drugs known to cause nausea and vomiting of central origin. Each patient was to serve as his own control to determine whether tetrahydrocannabinol had an antiemetic effect. Twenty-two patients entered the study, 20 of whom were evaluable. For all patients an antiemetic effect was observed in 14 of 20 tetrahydrocannabinol courses and in none of 22 placebo courses. For patients completing the study, response occurred in 12 of 15 courses of tetrahydrocannabinol and in none of 14 courses of placebo (P less than 0.001). No patient vomited while experiencing a subjective "high". Oral tetrahydrocannabinol has antiemetic properties and is significantly better than a placebo in reducting vomiting caused by chemotherapeutic agents.
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PMID:Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. 109 49

Dronabinol (Marinol, Roxane Laboratories, Columbus, OH) and prochlorperazine were tested alone and in combination in a randomized, double-blind, parallel group, multicenter study. Patients were randomized to receive either 1) dronabinol 10 mg every 6 hr plus placebo; 2) placebo plus prochlorperazine 10 mg every 6 hr; or 3) dronabinol and prochlorperazine, each 10 mg every 6 hr. Antiemetic treatment was begun 24 hr prior to and continued for 24 hr after the last dose of chemotherapy; all was given orally. Only 29% of patients in group 3 versus 47% in group 1 and 60% in group 2 experienced nausea after chemotherapy. In addition, the median duration per episode and severity of nausea were significantly less with combination therapy. Vomiting occurred after chemotherapy in 41%, 55%, and 35% of patients in groups 1, 2, and 3, respectively. The median duration per episode of vomiting was 1 min in group 3 versus two in group 1 and four in group 2. Side effects, primarily CNS, were more common in group 1 than in group 2; addition of prochlorperazine to dronabinol appeared to decrease the frequency of dysphoric effects seen with the latter agent. The combination was significantly more effective than was either single agent in controlling chemotherapy-induced nausea and vomiting.
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PMID:Dronabinol and prochlorperazine in combination for treatment of cancer chemotherapy-induced nausea and vomiting. 165 11

A random-sample, anonymous survey of the members of the American Society of Clinical Oncology (ASCO) was conducted in spring 1990 measuring the attitudes and experiences of American oncologists concerning the antiemetic use of marijuana in cancer chemotherapy patients. The survey was mailed to about one third (N = 2,430) of all United States-based ASCO members and yielded a response rate of 43% (1,035). More than 44% of the respondents report recommending the (illegal) use of marijuana for the control of emesis to at least one cancer chemotherapy patient. Almost one half (48%) would prescribe marijuana to some of their patients if it were legal. As a group, respondents considered smoked marijuana to be somewhat more effective than the legally available oral synthetic dronabinol ([THC] Marinol; Unimed, Somerville, NJ) and roughly as safe. Of the respondents who expressed an opinion, a majority (54%) thought marijuana should be available by prescription. These results bear on the question of whether marijuana has a "currently accepted medical use," at issue in an ongoing administrative and legal dispute concerning whether marijuana in smoked form should be available by prescription along with synthetic THC in oral form. This survey demonstrates that oncologists' experience with the medical use of marijuana is more extensive, and their opinions of it are more favorable, than the regulatory authorities appear to have believed.
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PMID:Marijuana as antiemetic medicine: a survey of oncologists' experiences and attitudes. 165 43

Oral delta-9-tetrahydrocannabinol (THC), 15 mg/m2, was compared to prochlorperazine (PCZ), 10 mg. for the control of cancer chemotherapy-related emesis. Thirty-six patients whose vomiting was refractory to standard antiemetic therapy were entered in this randomized comparative cross-over study. THC decreased nausea and vomiting in 23 of 36 (64%) patients compared to 1 of 36 receiving PCZ. THC efficacy was not dependent on the class of antineoplastic-agent inducing the emetic symptoms, age of patients or type of sensorial change experienced. Using the 15 mg/m2 dose, all patients experienced transient sensorial changes, characterized as a pleasant "high" in 19 or a variable state of dysphoria in 17 cases. This study confirms the usefulness of THC in patients whose chemotherapy-induced nausea and vomiting is refractory to other standard antiemetics. While excellent antiemetic control was achieved at the dosage 15 mg/m2, dysphoria was encountered at this dose level and we recommend that an initial dose of 5 mg/m2 which, if necessary, can be carefully increased to achieve maximum antiemetic benefit.
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PMID:Efficacy of tetrahydrocannabinol in patients refractory to standard antiemetic therapy. 284 94

Fifty-three patients receiving antineoplastic chemotherapy who had experienced severe nausea and vomiting refractory to standard antiemetic agents were treated with delta 9-tetrahydrocannabinol (THC). These patients were given THC 8 to 12 hours before, during, and for 24 hours after chemotherapy. Ten patients (19%) had no further nausea and vomiting; 28 (53%) had at least a 50% reduction of nausea and vomiting compared to previous courses with the same agents. No appreciable reduction of nausea and vomiting was seen in 15 patients (28%). Toxic reactions were generally mild, with only four patients experiencing reactions that necessitated stopping THC therapy. We suggest that, since THC is a useful antimetic agent in patients having refractory chemotherapy-induced vomiting, existing restrictions prohibiting its therapeutic use should promptly be eased.
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PMID:delta 9-Tetrahydrocannabinol for refractory vomiting induced by cancer chemotherapy. 624 18

A randomized, double-blind, placebo-controlled trial of oral and smoked delta-9-tetrahydrocannabinol (THC) was performed in eight patients with resected soft tissue sarcomas who received adjuvant Adriamycin and Cytoxan chemotherapy. Each patient served as his own control. Delta-9-tetrahydrocannabinol, in comparison with a placebo, did not significantly reduce the number of vomiting and retching episodes, volume of emesis, degree of nausea, or duration of nausea. In contrast to a previous report where significant antiemetic effects of THC were observed in patients receiving high-dose methotrexate, THC did not effectively reduce emesis induced by Adriamycin and Cytoxan. These findings suggest that the antiemetic properties of THC are effective only against specific chemotherapeutic drugs.
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PMID:A prospective evaluation of delta-9-tetrahydrocannabinol as an antiemetic in patients receiving adriamycin and cytoxan chemotherapy. 626 26

The use of delta-9-tetrahydrocannabinol (THC) as an antiemetic in patients undergoing cancer chemotherapy is reviewed. The pharmacokinetics of THC is discussed, and the agent's effects on the central nervous, cardiovascular, respiratory, gastrointestinal, immune, endocrine, and reproductive systems are presented. The toxicology, potential hazards, and adverse reactions of THC are reviewed. Also reviewed are studies of THC's use as an antiemetic. THC appears to be an effective antiemetic in cancer patients undergoing chemotherapy. The maximal antinauseant effects often correlate with the attainment of a "high". THC has been found consistently more effective than placebo and at least as effective as prochlorperazine. In phenothiazine-resistant patients, THC's effectiveness has exceeded that of the phenothiazines. Efficacy may depend on the chemotherapeutic agent causing emesis. Elderly patients do not tolerate the THC "high" well. Concurrent administration of phenothiazines with THC may block the "high" without reducing THC's antiemetic effectiveness. Because of variations in individual tolerance, absorption, and the form of chemotherapy, flexibility is necessary in establishing the correct dose of THC.
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PMID:Delta-9-tetrahydrocannabinol as an antiemetic. 626 23

Although delta 9-tetrahydrocannabinol (THC) possesses many pharmacologic activities, attempts to define sites of biochemical action for the natural cannabinoids have been hampered by their low solubility, their low potency, and their relative lack of biologic selectivity. We have recently described a potent, cannabinoid-related analgetic, levonantradol, which acts stereospecifically in animals to produce analgesia qualitatively similar to morphine but at 1/9 to 1/34 the dose. While levonantradol does not act at or through the opiate receptor, the finding of one-way cross tolerance in animals suggests that morphine and levonantradol influence common nociceptive pathways. This report describes a striking structural homology between PGE1 and levonantradol as elucidated by x-ray and conformational studies. This observation is consistent with the generally recognized involvement of prostaglandins in pain and emesis and may have relevance to the site of levonantradol's analgetic actions. More importantly, it provides an ongoing, heuristic basis for exploring, in depth, the role of prostaglandins in the action of levonantradol and cannabinoids.
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PMID:Levonantradol: a role for central prostanoid mechanisms? 627 37


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