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)

This in vitro study examines the possibility that the E prostaglandins (PGEs) supplement the action of syntocinon on human muscle strips. 11 strips of upper segment myometrium removed from 10 pregnant patients (17-40 weeks gestation) for various reasons were analyzed. The human myometrium at term responded to a minimum concentration of 0.01-0.05 mcg syntocinon and 1-5 ng PGE1 or PGE2 in the 5 ml bath, while the midtrimester myometrium responded to 0.2-1 mcg syntocinon and 2-20 ng PGE1 or PGE2. These results show a 20 times increase in myometrial sensitivity to syntocinon and a 2-4 fold increase in sensitively to PGE1 or PGE2 at term as compared to the midtrimester. A syntocinon dose given immediately following a dose of PGE exhibited a response greater than that elicited by the same dose of syntocinon prior to the PG; this sensitizing effect of PG was observed in both term and midtrimester myometrium. The enhancement effect was observed in the increased duration of syntocinon response or as an increase in amplitude of response or a combination of these, the effect lasting for as long as 90 minutes after the PGE dose had been washed out of the bath. These findings led to the hypothesis that during the parturition process, endogenous PGs act as mediators which sensitize the uterine muscle to circulating oxytocin. The physiological implication of this enhancement effect is that undesirable side effects (vomiting, diarrhea) associated with PG infusion may be reduced or even eliminated when the PG-syntocinon method is used.
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PMID:Interaction of E prostaglandins and syntocinon on the pregnant human myometrium. 555 14

In the early 1970s the effort was begun to examine the clinical benefits of "menstrual induction" (MI) at 6 weeks pregnancy (last menstrual period), in the belief that if pregnancy is to be terminated there was no sound medical nor psychological reason to delay the procedure. It was found that the transcervical, intrauterine delivery of a "PG-impact" compromised the conceptus and terminated pregnancy in 95% of the cases, with clinical symptoms of menstruation rather than abortion. The side-effects were acceptable; the prematurity rate did not increase in subsequent pregnancies. Yet, the need for strict asepsis limited the use of this otherwise simple and effective procedure. Recently, this limitation has been overcome by the development of the PGE2 analogue 16-phenoxy-w17,18,19,20 tetranor-PGE2-methyl sulfanylamide ('Sulproston'). Clinical trials have been done in terms of dealing with the questions of efficacy, acceptability, and preference. 90 volunteers have been studied. At 14 days follow-up the success rate (negative pregnancy test) was 96%. The side effects were acceptable -- vomiting 26%, diarrhea 10%, and endometritis 2%. Of the 42 patients interviewed, 90% were satisfied with the procedure. Of those who had previously experienced surgical interruption, 89% preferred this pharmacological method.
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PMID:Menstrual induction in preference to abortion. 610 32

2 doses of the prostaglandin (PG) analogue 16-phenoxy-omega-17,18,19,20-tetranor-PGE2 methyl sulphonylamide were compared in a randomized multicenter trial in 6 centers for the termination of 2nd trimester pregnancy. A total of 295 patients were treated with either 0.5 mg or 1.0 mg given by intramuscular injection every 4 or 8 hours, respectively. The 1 mg dose was more effective in inducing an abortion than the lower dose but the difference was not statistically significant. 84% of the patients aborted within 30 hours from the onset of treatment. The induction-abortion interval was approximately 15 hours in both groups. The incidence of incomplete abortion, heavy bleeding, and blood transfusion was similar for both treatments. Cervical lacerations occurred in 1.3% of patients who received the smaller dose and 2.1% of those receiving the larger. In 1 patient in the latter group, an anterior rupture of the lower uterine segment was diagnosed necessitating hysterectomy. 50% of the patients had no vomiting and 90% had no diarrhea. The frequency of gastrointestinal side effects was slightly higher with the 1 mg dose. The major advantages of this treatment are the simplicity of administration and the low frequency of gastrointestinal side effects in comparison with PGF analogues.
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PMID:Termination of second trimester pregnancy by intramuscular injection of 16-phenoxy-omega-17,18,19,20-tetranor-PGE2 methyl sulphonylamide. 612 70

Tolfenamic acid (TA), a potent inhibitor of prostaglandin (PG) biosynthesis and action, was tested prophylactically against hangover symptoms in 30 healthy volunteers in a double-blind cross-over study. One capsule of TA (200 mg) or placebo was taken before starting to drink alcohol and another before going to bed. The hangover symptoms were evaluated in the morning. TA was found significantly better than placebo in the subjective evaluation of drug efficacy (p less than 0.001) and in reducing the reported hangover symptoms in general (p less than 0.01). In the TA group, significantly lower symptom scores were obtained for headache (p less than 0.01), and for nausea, vomiting, irritation, tremor, thirst and dryness of mouth (all p less than 0.05). In a separate study with eight participants, plasma levels of PGs were followed during ingestion of alcohol with or without TA. The plasma concentrations of PGE2 and TXB2 (a metabolite of thromboxane A2) were lower in the TA group during alcohol ingestion, while PGF2 alpha and 6-keto-PGF1 alpha (a metabolite of prostacyclin) were unaffected. TXB2 correlated with blood alcohol levels in a U-shaped manner.
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PMID:Hangover headache and prostaglandins: prophylactic treatment with tolfenamic acid. 634 13

Prostaglandin E2 is known to stimulate erythropoiesis by different mechanisms. A clinical trial of prostaglandin E2 to stimulate erythropoiesis in four patients with anemia of end stage renal disease resulted in an increment in peripheral blood Burst Forming Units-Erythroid (BFU-E). This increase in erythroid progenitors returned to baseline with cessation of therapy. A significant increase in serum erythropoietin (EPO) activity was demonstrated in one patient and was noticeable in another. Side effects mainly consisted of local pain at the site of the infusion and vomiting.
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PMID:A clinical trial of prostaglandin E2 to increase erythropoiesis in anemia of end stage renal disease. A preliminary report. 637 77

The effect of Prostin (15/S/15 methyl prostaglandin F2 alpha) ampules applied intramuscularly to induce abortion in the second trimester of pregnancy was investigated. Out of 30 women who underwent the treatment, 28 (93.3%) cases were successful and 2 (6.7%) unsuccessful. The average time from the application of the medicament to the output of the ovulum was 30.04 hours. The medicament proved to have a strong uterotonic effect associated with highly manifested side effects, such as vomiting, diarrhea, nausea, perspiration, etc. Among serious complications due to the Prostin application, a single case of an incomplete low uterine rupture and one case of the cervical rupture (6.6%) were evidenced.
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PMID:[Intramuscular administration of Prostin for abortion in the second trimester]. 650 43

The new synthetic prostaglandin 11,15-dihydroxy-16-methyl-16-methoxy-9-oxo-prost-13-en-1-oic acid,methyl ester (8 alpha,11 alpha,15R,16R) (compound marked MDL 646), belonging to the 16-methyl-16-methoxy series, was tested for its activity on gastric secretion of different animal species and in different experimental conditions. In the dog provided with gastric fistula and Heidenhain pouch, MDL 646 (25 micrograms/kg by intragastric administration) caused a remarkable inhibition of the histamine- and bethanechol-induced acid secretion, an effect which was more evident in the main stomach than on the Heidenhain pouch. In the cat, but not in the dog, the compound inhibited not only the hypersecretion induced by histamine and bethanechol but also that induced by pentagastrin. However, in this case, high doses (50-100 micrograms/kg) had to be used to obtain a significant inhibition. Similar results were obtained with the perfused stomach of the anaesthetized rat in which the natural PGE2 appeared to be from 3 to 5 times less potent. In the conscious rat provided with gastric fistula MDL 646 (15 and 50 micrograms/kg) significantly inhibited spontaneous gastric secretion. Untoward reactions, represented by salivation and vomiting lasting 30 min, were experienced by some dogs following administration of 50-100 micrograms/kg of the synthetic prostaglandin. These data appear of considerable interest in view of the possibility of the use of MDL 646 also in humans.
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PMID:Action of MDL 646, a new synthetic prostaglandin, on gastric acid secretion of some experimental animals. 657 36

The prostaglandins F2alpha (PGF2alpha) and E2 (PGE2) used for abortion during the 2nd trimester of pregnancy were compared and are presented along with a method of management that minimizes patient discomfort. The study included 23 consecutive patients who wanted to undergo elective 2nd trimester abortion at the Unviersity of California, Davis Medical Center, during the January 1981-May 1981 period. Gestational age was determined by menstrual history, fundal size, and, when necessary, ultrasonography. Patients between 14-20 weeks of estimated gestational age were assigned to either PGF2alpha or PGE2 therapy using a set of random numbers. Patients were excluded from the study if a history of significant renal, cardiac, or pulmonary disease was obtained, if a uterine or cervical anomaly was suspected, or if abortion was desired because of a known fetal anomaly, abnormal karyotype, or fetal demise. 13 patients were in the PGF2alpha group and 12 were in the PGE2 group. 4 patients in the PGF2alpha group and 5 in the PGE2 group were nulliparas. The mean induction to abortion interval was 9.19 +or- 6.18 hours, 3-22 hours, for those in the PGF2alpha group and 9.19 +or- 2.59 hours, 5.75-12.78 hours, for those in the PGE2 group. The difference was not statistically significant. The cumulative abortions rates of the 2 methods were similar. Except for 2 patients who received PGF2alpha, all of the patients studied aborted within 14 hours. There was a 31% incidence of emesis in those patients in the PGF2alpha group, but none of these patients had more than a single episode. A 20% incidence of emesis was noted for the PGE2 group, with each of these patients having 2 episodes. No patient had diarrhea or hyperthermia develop, and none required antidiarrheal or antipyretic medication after the intial prophylactic dosages. Of the patients in the PGF2alpha group, 61.5% required supplementary analgesia as compared with 60% for those in the PGE2 group. Of those patients requiring additional analgesia, those in the PGF2alpha group, on an average, had more medication given orally and intramuscularly. Curettage was considered to be an integral part of the abortion procedure. Products of conception were obtained from all of the patients at the time of curettage. No patient returned after discharge from the hospital because of hemorrhage or infection as a result of retained products of conception. With the use of laminaria tents for cervical priming, prophylaxis of minor side effects, oxytocin supplementation and postabortal curettage, PGF2alpha and PGE2 are equivalent midtrimester abortifacients when rapidity, safety, and patient comfort are considered.
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PMID:A comparative study of two types of prostaglandins for abortion during the second trimester. 657 7

In the present study the efficacy of a new stable prostaglandin E analogue, 9-deoxo-16,16-dimethyl-9-methylene-PGE2 (9-methylene-PGE2), administered as a single vaginal suppository for preoperative dilatation of the cervical canal was evaluated in 382 mainly nulliparous patients. Late first trimester patients received either 20 mg 3 hours prior to or 30 mg 12 hours prior to vacuum aspiration. Early second-trimester patients received 40 mg of the analogue and vacuum aspiration was performed 12 hours later. The degree of cervical dilatation was related to the pretreatment time and the dose of 9-methylene-PGE2. However, even with 20 mg of the analogue and 3 hours pretreatment time, cervical dilatation was adequate in almost 40% of the patients and in the remaining women further mechanical dilatation was regularly performed with ease. The frequency of gastro-intestinal side effects was significantly lower than that found for comparable doses of 15-methyl-PGF2 alpha methyl ester administered by the same route. With 20 mg 9-methylene PGE2, side effects were very rare; only 9% of the patients experienced occasional episodes of vomiting. Three hours' pretreatment with 20 mg of the analogue seems suitable for late first trimester pregnant women in whom the abortion is performed on an outpatient basis. For early second trimester patients pretreatment with 40 mg 9-methylene-PGE2 for 12 hours followed by vacuum aspiration seems to be a better alternative than the two-stage procedures in current use.
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PMID:Pre-abortion treatment with a single vaginal suppository containing 9-deoxo-16,16-dimethyl-9-methylene PGE2 in late first and early second trimester pregnancies. 657 68

A randomized comparative study of 387 consecutive patients admitted for induction of labor was carried out using two orally administered oxytocics (prostaglandin E2 tablets (Prostin) or Demoxytocin resoriblets for buccal administration (Sandopart)), the results of which are reported here. One-hundred and twenty-three cases were suitable for primary amniotomy; of these 48 were given PGE2 tablets and 75 received demoxytocin resoriblets. In a further 264 cases, primary amniotomy was inadvisable and of these, 133 patients were allotted to the PGE2 treatment group and 131 to treatment with demoxytocin. A significantly higher success rate was observed (p less than 0.05) in the PGE2 group in cases where primary amniotomy had been carried out, as compared with the demoxytocin group. Parturition was successfully induced in 82.0% of the patients given PGE2 tablets, as against only 63.4% of those receiving demoxytocin following 2 days of stimulation without primary amniotomy. This difference is statistically significant at the 0.001 level, and presumably due to the highly significant difference (p less than 0.0001) between patients with a Bishop score of 5 or less, where induction was successful in 75.4% given PGE2 tablets, in contrast to a success rate of only 36.7% in patients receiving demoxytocin resoriblets. No difference was observed in the success rate between the two treatment groups when the Bishop score was 6 or more. No difference was recorded in the incidence of fetal distress, instrumental delivery or low Apgar score between the two treatment groups. However, a higher incidence of vomiting and diarrhea were observed in patients treated with PGE2 tablets (11%) as compared with those receiving demoxytocin (1.5%). There was no difference with regard to the induction-delivery time, nor to the different stages of labor between otherwise comparable treatment groups when the induction was successful. It is concluded in respect of induction of labor using orally administered oxytocics that PGE2 (tablets) are preferable to demoxytocin (resoriblets) as it is the more effective of the two.
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PMID:Oral oxytocics for induction of labor. A randomized study of prostaglandin E2 tablets and demoxytocin resoriblets. 657 75


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