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 68-yr-old man had developed intractable vomiting soon after recovering from a flu-like illness. The use of Compazine as an antiemetic produced classic dystonic manifestations which resolved rapidly after discontinuation and treatment with Artane. However, he later developed a variety of neurobehavioral disturbances which led to his admission to the hospital. Extensive diagnostic procedures failed to identify any gastrointestinal or neurological causes. His condition unceasingly worsened until hypocortisolemia was serendipitously discovered, and all of his symptoms disappeared rapidly and completely with glucocorticoid replacement. Over the course of hospitalization, other than a single episode of orthostatic hypotension, the patient did not manifest any signs of adrenal insufficiency or endocrinopathy. Although detectable, his plasma ACTH level was markedly low in the presence of hypocortisolemia. His adrenal function was subnormal in the cortisol response to ACTH stimulation. His renin-angiotensin-aldosterone system and catecholamine levels were normal. He had normal pituitary responses to GnRH, TRH, and insulin, with rises in plasma levels of LH, FSH, TSH, PRL, and GH, but no stimulation of ACTH. Repeated CRH tests revealed no stimulation of ACTH and cortisol. No circulating anti-ACTH, antiadrenal, or antipituitary antibody was detected. We conclude that this elderly patient had a rare syndrome of selective corticotroph dysfunction which resulted in secondary adrenal failure and exacerbated his mental and neuromuscular abnormalities. To our knowledge, these symptoms, which clearly relate to hypocortisolism, have not been previously reported.
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PMID:Delirium and neuromuscular symptoms in an elderly man with isolated corticotroph-deficiency syndrome completely reversed with glucocorticoid replacement. 255 16

Prochlorperazine (Compazine; PCPZ) is often used to limit cisplatin (CDDP)-induced emesis. However, recent studies in mice have shown that PCPZ protects against renal injury produced by treatment with various nephrotoxicants (e.g., MethylCCNU, mercuric chloride). Because renal toxicity remains a serious limitation to the effective use of CDDP, we conducted the present study to determine whether PCPZ could also protect against CDDP-induced renal injury. PCPZ treatment was shown to ameliorate CDDP-induced renal lesions in both rats and mice at doses and treatment schedules that were comparable with those used for alleviating chemotherapy-induced emesis. A PCPZ dose of 10 mg/kg x 2 offered complete protection against CDDP-induced increases in blood urea nitrogen (BUN) levels in mice, with significant protection occurring at a PCPZ dose as low as 5 mg/kg. Similarly, PCPZ ameliorated CDDP-induced increases in BUN, glucosouria, and enzymuria in F344 rats. PCPZ treatment did not affect the urinary excretion or renal tissue levels of total platinum or the plasma pharmacokinetics of free platinum. However, it did cause a marked reduction in the concentration of total plasma platinum (free platinum + protein-bound platinum). PCPZ was not found to affect the in vivo antitumor activity of CDDP against P388 leukemia. The present study suggests that PCPZ may be of therapeutic benefit when used with CDDP and provides a rational basis for the selection of antiemetic therapy.
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PMID:Protection against cisplatin nephrotoxicity by prochlorperazine. 259 5

The current case study illustrates the innovative potential of combined medical and psychological treatment of postchemotherapy nausea and vomiting for cancer patients. A 58-yr-old male patient diagnosed with leukemia and on a weekly cytosine arabinoside (Ara-C) treatment protocol, experienced violent vomiting episodes approximately 3 hr. after each injection. Emesis was so severe that the patient considered terminating treatment. Control was attempted with antiemetics (Compazine, Reglan), an antianxiety agent (Valium), an hypnotic (Dalmane), canabinol, hypnosis, and relaxation training without success. A re-examination of these strategies employing experimental rigor and data-responsive experimental designs indicated how success can be achieved without the necessity of new interventions. The patient experienced complete emetic relief and at 3-yr. follow-up remained symptom-free.
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PMID:Combined medical and psychological treatment of postchemotherapy nausea and vomiting: a case study. 278 Sep 30

A group of 71 women between 11-20 weeks of gestation who desired termination of pregnancy and had no contraindications for prostaglandin (PG) administration were given complete physical and gynecological examinations; hemoglobin was estimated and urinalysis was done. They were then given orally 2 tablets of Lomotil (diphenoxylate HCl 2.5 mg + atropine sulphate 0.025 mg) and 1 tablet of Stemetil (Prochlorperazine 5 mg). They were then given 15 (S) 15 methyl PGF2alpha intravenously at the dose level of 1 mcg/min. 61 subjects (85.9%) aborted within 30 hours. At regular intervals pulse rate, blood pressure, uterine pain, nausea, vomiting, diarrhea, temperature, and respiratory rate were measured and any other side effects were recorded. The mean induction abortion interval was 15.65 hours, the mean number of episodes of vomiting and diarrhea was 0.9 and 0.6 respectively. This study compared well with the intramuscular route of administration with a higher rate of complete abortions and lower rate of side effects. The latter is explained on the basis of smaller amounts of the drug being infused at a slower rate. Disadvantages include confinement to bed, discomfort, and need of constant supervision. Compared with intraamniotic and extraamniotic case studies, the latter are invasive procedures while the intravenous method is not. Also, the intravenous route allows for adjusted drug dosage and stopping the procedure in the event of an undesirable reaction.
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PMID:Midtrimester abortion with intravenous administration of 15 methyl prostaglandin F2 alpha. 612 31

Sixty-four patients receiving cancer chemotherapy known to induce severe emesis entered a randomized double-blind study of the antiemetic efficacy of haloperidol (Haldol) and benzquinamide (Emetecon). Patients preferred haloperidol for control of emesis induced by cis-platinum (78 vs. 22%) or nitrogen mustard (67 vs. 16%). Patients receiving Doxorubicin preferred benzquinamide by a small margin (46 to 38%). Individual patients who experienced no relief with their first antiemetic (13 of 15) usually got some relief with the other after crossover. Haloperidol was more effective than benzquinamide (54 vs. 29%) in patients previously unrelieved by prochlorperazine (Compazine). Complete relief of vomiting was obtained in 14 of 45 patients receiving haloperidol but only five of 41 patients receiving benzquinamide experienced no vomiting, again dependent on the anticancer agent used. Although haloperidol is a more effective antiemetic agent overall, efficacy is related to the anticancer treatment and probably to individual patient characteristics.
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PMID:Specific antiemetics for specific cancer chemotherapeutic agents: haloperidol versus benzquinamide. 701 68

Prochlorperazine (Compazine, PCZ) is a frequently used medication in the emergency department (ED). Akathisia and dystonia are known adverse reactions to the use of this medication, but their incidence in the ED has not been well studied. We conducted a prospective, descriptive study to evaluate the frequency of akathisia and dystonia in the ED from the use of IV or IM PCZ in patients with nausea/vomiting or headache. Two hundred-twenty nine patients (> or =18 years old) were enrolled and contacted within 2 weeks of ED discharge to access the incidence of these adverse reactions. After the use of PCZ in the ED, 16% of patients developed akathisia and 4% developed dystonia. Emergency physicians and our patients need to be aware of these potential adverse reactions to the use of PCZ in the ED.
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PMID:Frequency of adverse reactions to prochlorperazine in the ED. 1123 74

Outlined is a protocol for the administration of emergency contraceptive pills. The indication for such treatment is unprotected intercourse within the past 72 hours. Absolute contraindications include the possibility of an existing pregnancy and a family history of stroke, heart attack, thrombophlebitis, breast or endometrial cancer, or liver tumor. Possibly excluded, depending on evaluation by a physician, are women with abnormal vaginal bleeding, active hepatitis, active gallbladder disease, high blood pressure, acute focal migraine, breastfeeding women, and those unable to understand instructions. The recommended regimen consists of six tablets of Ovral (two taken immediately, two more in 12 hours) or 12 tablets of Lo/Ovral, Nordette, or Levlen (four taken immediately, repeat dosage in 12 hours). The extra pills are to be used in cases of vomiting within three hours of pill ingestion. Women with a history of oral contraceptive-related nausea and vomiting should be provided with Compazine. Women should be informed that this method is effective in only about 92% of cases. All women who receive emergency contraception should be counseled that this is strictly a back-up method and helped to formulate a long-term birth control strategy.
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PMID:Emergency contraceptive pills (ECP) protocol. 1228 80