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)

Delayed nausea and emesis are common after cancer chemotherapy, especially cisplatin-containing regimens. Often no, or inadequate, prophylactic antiemetic cover is prescribed in these usually ambulant patients. Metoclopramide is a very effective drug in preventing the acute emetic and nauseating effects of cisplatin. The long-acting metoclopramide formulations (in the present study: Gastrosil retard) may be effective in preventing the delayed toxicity. 12-hourly dosing of 60 mg long-acting metoclopramide in a typical oncology ward situation led to stable metoclopramide levels of approximately 100ng/ml in the observed 74 h in 18 patients, with the well-known wide plasma concentration variability. The clinical efficacy of long-acting metoclopramide in this indication remains to be evaluated.
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PMID:Suitability of long-acting metoclopramide for prophylaxis of chemotherapy-induced delayed nausea and vomiting. 261 81

The authors have studied the side effects of a lyophilized and a dissolved cisplatin preparation in 133 patients with head and neck tumors. After intraarterial treatment (30 mg/24 hours) with dissolved cisplatin no nausea was observed, while treatment with lyophilized cisplatin was followed by nausea in rare cases (33%). Systemic treatment with dissolved cisplatin (50 mg/die) was associated with vomiting far less frequently (37%) than lyophilized cisplatin (90%). Metoclopramide was found to reduce these side effects.
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PMID:[Side effects of dissolved and lyophilized cisplatin in the treatment of 133 head and neck tumors]. 263 81

The pathophysiology of nausea and vomiting caused by antineoplastic therapy is described, and the literature on selected recent pharmacologic approaches to antiemetic therapy is reviewed. Nausea and vomiting associated with antineoplastic therapy remain serious deterrents to continued, potentially curative therapy for many patients. Although much research has been conducted in the area of antiemetic therapy over the past decade, the mechanisms by which antineoplastic agents cause nausea and vomiting are still not well defined. The most effective antiemetic agents to date are those that antagonize dopamine receptors. Metoclopramide is a dopamine antagonist that has been widely studied for the prevention of antineoplastic-agent-induced nausea and vomiting. Recent studies with this agent focus on routes of administration other than the traditional high-dose intermittent bolus intravenous injections. Continuous intravenous infusions of the drug and high-dose oral administration have been studied in an attempt to decrease the adverse effects associated with the traditional regimen and to allow administration on an outpatient basis. Prochlorperazine, a phenothiazine derivative, has been a mainstay of antiemetic therapy for many years. Although it is generally reserved for use with regimens that cause mild to moderate emesis, recent data suggest that higher-than-traditional doses given intravenously impart greater antiemetic protection. Perhaps the most promising antiemetic research has been conducted with a new group of agents, the serotonin antagonists. Preliminary trials suggest that these agents are comparable in efficacy to high doses of metoclopramide but devoid of many of the adverse effects commonly associated with metoclopramide. Further research in the area of neuropharmacology is necessary to direct the development of the most effective antiemetic agents.
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PMID:Recent advances in the management of nausea and vomiting caused by antineoplastic agents. 265 Sep 57

This study was designed to compare the antiemetic effect of betamethasone alone with that of betamethasone combined with metoclopramide. Forty-seven patients on chemotherapeutic regimens including cisplatin were entered into this study. Betamethasone was given in 4 doses of 20 mg/body at 30 minutes before and at 2.5 and 8 hours after cisplatin. Metoclopramide was given in 4 doses of 1mg/kg on the same schedule. Within 24 hours after the administration of cisplatin, no vomiting was observed in 42.9% of the patients treated with betamethasone alone and in 76.9% with betamethasone and metoclopramide. Betamethasone combined with metoclopramide was superior to betamethasone alone for the antiemetic effect in cisplatin-treated patients.
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PMID:[Antiemetic efficacy of betamethasone versus betamethasone combined with metoclopramide in cisplatin-treated cancer patients]. 271 78

Metoclopramide was orally administered (10 or 20 mg) to 22 subjects, 75 min before parabolic flight. Serum levels of ACTH, EPI, NE, and vasopressin (AVP) were unaltered by metoclopramide. AVP and ACTH (1.2 and 36 pg.ml-1) were elevated 77 and 3.8-fold (92.3 and 135 pg.ml-1) following emesis, after 40 parabolas (68.7 and 140 pg.ml-1) and landing (8.7 and 79 pg.ml-1). Seven subjects displaying no nausea and no emesis demonstrated smaller elevations (8.2 and 2.2-fold). Of 15 vomiting subjects, 7 reported no nausea and had lower elevations of AVP with faster recoveries. These findings are consistent with Rowe's suggestion (1979) that nausea may correlate with AVP release. Inhibition of AVP release by fluid shifts during microgravity might account for our findings and astronaut-reported episodes of vomiting without nausea. Elevations in EPI followed emesis or exposure to 40 parabolas whether emesis occurred or not. Only emesis elevated NE (578 to 840 pg.ml-1).
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PMID:Hormonal responses of metoclopramide-treated subjects experiencing nausea or emesis during parabolic flight. 282 88

The effects of eight neuroleptic drugs injected into the cerebral ventricles on behavior, autonomic and motor activity of unanesthetized cats have been studied. Chlorpromazine, trifluorpromazine, droperidol, haloperidol, domperidone and spiperone induced emotional behavior (restlessness, miaowing, rage, attack, defense, fighting with paws, biting), autonomic (mydriasis, tachypnoea, dyspnoea, panting, salivation, defecation, urination, licking, vomiting) and motor (ataxia, muscular weakness, adynamia) phenomena. The main and the most consistent effect was the motor impairment, while the aggression was inconsistent and of moderate intensity. Of the neuroleptic drugs injected, only spiperone, domperidone and trifluorpromazine produced a dose-dependent motor impairment. The autonomic effects were also inconsistent and of low intensity. Metoclopramide induced inconsistent autonomic and motor effects, while sulpiride was devoid of any visible behavioral, autonomic and motor activity. It appears, therefore, that the motor impairment as well as the aggression caused by the neuroleptic drugs is perhaps related to central D-1 rather than to central D-2 dopamine receptors, but an effect on central norepinephrine and on central serotonin receptors cannot be excluded.
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PMID:Behavioral, autonomic and motor effects of neuroleptic drugs in cats: motor impairment and aggression. 286 89

Sixty-four patients treated with cisplatin-containing regimens were entered into a randomized, double-blinded study examining the antiemetic efficacy of metoclopramide with and without lorazepam for control of cisplatin-induced emesis. Metoclopramide was administered to all patients at 2 mg/kg, intravenously, 30 minutes before chemotherapy and 1.5, 3.5, and 5.5 hours posttreatment. Patients randomized to receive combined antiemetic therapy were administered lorazepam at 2 mg/m2 (maximum, 4 mg dose) intravenously, 30 minutes before chemotherapy. Those patients not receiving lorazepam were given normal saline placebo. Degree of nausea and number of vomiting episodes were recorded on a data flow sheet with a visual analogue scale. Drug toxicities were evaluated before each administered dose. Patients receiving both metoclopramide and lorazepam experienced significantly less vomiting episodes (P less than 0.05) and nausea (P less than 0.01) when compared to patients given metoclopramide alone. Forty-four percent of those receiving the combined therapy reported no nausea or vomiting episodes compared to only 22% receiving metoclopramide alone. Sedation was significantly more common in patients receiving lorazepam (88%) as opposed to patients receiving only metoclopramide (43%), P less than 0.01. Amnesia was seen in 25% receiving lorazepam. No significant difference in diarrhea, dystonia, or disinhibition was observed between the two arms. The authors conclude that the combination of lorazepam and metoclopramide was superior to metoclopramide alone in the prevention of cisplatin-induced nausea and vomiting, with sedation and amnesia more commonly observed in the combined regimen.
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PMID:Metoclopramide versus metoclopramide and lorazepam. Superiority of combined therapy in the control of cisplatin-induced emesis. 291 33

BMY-25801, 4-amino-5-chloro-N-[2-(diethylamino)ethyl]2-(1-methyl-2-oxopropoxy ) benzamide, a new antiemetic agent free of D2-dopamine receptor antagonist properties, was effective against emesis induced by cytostatic agents (cisplatin, cyclophosphamide and doxorubicin) and total body radiation in the ferret. It also was effective against cisplatin-induced emesis in the dog; however, it was inactive against emesis caused by apomorphine and hydergine in the same species. In terms of activity profile, BMY-25801 could be differentiated both from metoclopramide and domperidone. Metoclopramide was nonselectively active against emesis induced by cytostatic agents, radiation and D2-dopamine receptor agonists, whereas domperidone was selectively effective against emesis induced by apomorphine and hydergine only. BMY-25801 failed to reveal any D2-dopamine receptor antagonist properties in several pharmacological tests (catalepsy, apomorphine stereotypy, serum prolactin, striatal dihydroxyphenylacetic acid and [3H]spiperone displacement) whereas metoclopramide was uniformly active in these tests. The activity profile of domperidone was compatible with its classification as a peripherally acting D2-dopamine receptor antagonist. BMY-25801 and metoclopramide antagonized serotonin-induced bradycardia (Bezold-Jarisch reflex) in the anesthetized rat, a response involving peripheral neuronal 5-HT3 receptors. Thus, BMY-25801 represents a novel antiemetic acting independently of D2-dopamine receptor mechanisms; however, its exact mode of action remains unknown.
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PMID:BMY-25801, an antiemetic agent free of D2-dopamine receptor antagonist properties. 297 41

The involvement of 5-hydroxytryptamine (5-HT) 5-HT3 receptors in the mechanisms of severe emesis evoked by cytotoxic drugs or by total body irradiation have been studied in ferrets. Anti-emetic compounds tested were domperidone (a dopamine antagonist), metoclopramide (a gastric motility stimulant and dopamine antagonist at conventional doses, a 5-HT3 receptor antagonist at higher doses) and BRL 24924 (a potent gastric motility stimulant and a 5-HT3 receptor antagonist). Domperidone or metoclopramide prevented apomorphine-evoked emesis, whereas BRL 24924 did not. Similar doses of domperidone did not prevent emesis evoked by cis-platin or by total body irradiation, whereas metoclopramide or BRL 24924 greatly reduced or prevented these types of emesis. Metoclopramide and BRL 24924 also prevented emesis evoked by a combination of doxorubicin and cyclophosphamide. These results are discussed in terms of a fundamental role for 5-HT3 receptors in the mechanisms mediating severely emetogenic cancer treatment therapies.
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PMID:Evidence that 5-hydroxytryptamine3 receptors mediate cytotoxic drug and radiation-evoked emesis. 331 Nov 9

The effect of antiemetic agents on the nausea and emesis of ovarian cancer patients treated with CDDP (45 mg/m2), ADM (45 mg/m2) and CPM (450 mg/m2) combination chemotherapy was examined in a randomized parallel study. Metoclopramide (1 mg/kg, 4 times every 2.5 hours), dexamethasone (3.8 mg, 4 times every 2.5 hours) and antihistamine (10 mg, 2 times every 5 hours) were used as antiemetic agents and these agents were gradually decreased for 5 days. The above regimen significantly suppressed the frequency and volume of vomiting on the day of the first PAC chemotherapy but showed no effect on the delayed persistent nausea during chemotherapy. The frequency and volume of vomiting on the day of chemotherapy were 1.6 times and 102 ml respectively in the antiemetic group, but 8.9 times and 352 ml, respectively, in the control group. Although this antiemetic regimen sufficiently suppressed acute drug-induced emesis during chemotherapy, delayed persistent nausea was not eliminated. We next investigated whether these combined antiemetic agents protected the quality of life of patients during maintenance chemotherapy. Our data indicated that about 2 weeks was necessary to recover health after maintenance PAC chemotherapy. These results indicated that this regimen was effective in suppressing the acute drug-induced emesis and in maintaining the quality of life following maintenance PAC chemotherapy.
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PMID:[The effect of metoclopramide, dexamethasone and antihistamine in the prevention of PAC chemotherapy-induced emesis]. 336 Nov 70


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