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)

Metoclopramide has wide applications in both clinical and experimental medicine. It is useful in the management of gastro-oesophageal reflux and gastric stasis. It is being used increasingly in the management of nausea and vomiting, and at high doses will significantly relieve the emesis that is induced by cytotoxic agents. Metoclopramide also has an important place in the investigation of the role of dopamine in physiological and pathological processes.
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PMID:Metoclopramide--a review. 351 36

Alizapride is a new substituted benzamide with suggested superior antiemetic efficacy to and fewer side effects than metoclopramide. High-dose alizapride (4 mg/kg X five doses) was compared with high-dose metoclopramide (2 mg/kg X five doses) in a prospective, randomized, double-blind trial in 62 evaluable patients undergoing strongly emetic cancer chemotherapy. Patients receiving metoclopramide experienced significantly fewer vomiting episodes than patients receiving alizapride (median of three episodes vs. eight episodes; P less than 0.001). Metoclopramide was more effective in decreasing the volume of emesis than was alizapride (median of 100 ml vs. 360 ml; P less than 0.02). Seventy-two percent of the patients receiving alizapride and 57% of those receiving metoclopramide experienced side effects. High-dose metoclopramide is an effective antiemetic in patients receiving cancer chemotherapy. Alizapride is less effective and has more side effects than metoclopramide. We do not recommend the further use of alizapride.
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PMID:The antiemetic activity of high-dose alizapride and high-dose metoclopramide in patients receiving cancer chemotherapy: a prospective, randomized, double-blind trial. 351 41

High-dose intravenous (IV) metoclopramide has shown efficacy with few side effects for the treatment of nausea and vomiting on the day of cisplatin administration. From November 1984 to January 1986, two randomized trials in an antiemetic study were conducted. In trial I, the antiemetic effect of a short course of high-dose dexamethasone was compared with that of high-dose metoclopramide in 29 patients with lung cancer receiving chemotherapy containing cisplatin (80 mg/m2 IV) in a randomized controlled trial. Dexamethasone was given IV at a dose of 16 mg 1/2 hr before and 8 mg, 1 1/2, 3 1/2 and 5 1/2 hr after cisplatin. Metoclopramide was given IV at a dose of 2 mg/kg, 1/2 hr before and 1 1/2, 3 1/2 and 5 1/2 hr after cisplatin. Major emetic control (0-2 episodes of vomiting) during the 24 hr after cisplatin administration was achieved in 55% (6/11) and 67% (12/18) of the patients receiving dexamethasone and metoclopramide, respectively, without serious toxicity. The duration of nausea or anorexia was similar for the two treatment groups. In trial II, the combination of metoclopramide and dexamethasone was compared with metoclopramide alone to assess the additive antiemetic effect of the two drugs in 23 patients with lung cancer receiving cisplatin at a dose of 120 mg/m2 IV in a randomized cross-over study. A major antiemetic response was observed in 27% (3/11) and 92% (11/12) of the patients receiving metoclopramide alone and metoclopramide plus dexamethasone, respectively (p less than 0.005). The duration of nausea and anorexia was similar for the two treatment groups. Patients tended to prefer the combination of metoclopramide and dexamethasone; however, the difference was not statistically significant (p = 0.14) in the small number of patients entered in this study. Despite excellent control of acute chemotherapy-induced emesis, 45% of 52 patients experienced delayed nausea and vomiting more than 24 hr after cisplatin administration even among those who had had an excellent short-term response to the antiemetic agents.
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PMID:Antiemetic efficacy of high-dose intravenous metoclopramide and dexamethasone in patients receiving cisplatin-based chemotherapy: a randomized controlled trial. 353 48

One hundred and forty-two dogs with single or multiple pseudopregnancies were treated with bromocriptin at three different dose rates and once in combination with mobilerone. The treatments that scored best were 30 micrograms/kg bromocriptin for 16 days and 10 micrograms/kg bromocriptin for 10 days. Vomiting was a frequent side effect (about 20 per cent of cases) and was treated successfully with metoclopramide at a dosage of 0.5 mg/kg. Metoclopramide had no effect on the effectiveness of the bromocriptin.
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PMID:Treatment of pseudopregnancy with bromocriptin, an ergot alkaloid. 353 32

Twenty-six patients suffering from disseminated epithelial ovarian cancer (FIGO stages III and IV) under treatment with Cisplatin (80-100 mg/m2 in 8 hours) in combination on the same day with Cyclophosphamide (500 mg/m2 IV) and Adriamycin (50 mg/m2), a severely emetogenic regimen, entered a randomized, double-blind, cross-over trial comparing the antiemetic activity of high-dose IV Metoclopramide (1 mg/kg/dose X 5 doses) with that of a combination of Metoclopramide (same schedule) plus Nortriptyline (50 mg PO X 2 doses) plus Thiethylperazine (10 mg IV X 3 doses). The antiemetic combination was designed in an attempt to act simultaneously on gastrointestinal motility and neuroreceptors at the central emetic pathways (dopamine D-2, histamine H-1 and muscarinic cholinergic). This combination significantly reduced the emesis due to chemotherapy when compared with Metoclopramide alone and was also preferred by a significant number of patients after passing through both the antiemetic arms being compared.
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PMID:Antiemetic combination for PAC (cisplatin-adriamycin-cyclophosphamide) chemotherapy-induced emesis in ovarian cancer. 355 83

Thirty-six patients suffering from disseminated epithelial tumors under treatment with Cisplatin alone or in combination with Vindesine entered a randomized, double-blind, cross-over study comparing the antiemetic activity of low-dose IV Metoclopramide (total dose: 0.8 mg/kg) with that of a combination of Metoclopramide (same schedule) plus Nortriptyline (2 X 50 mg PO) plus Thiethylperazine (3 X 10 mg IV). This combination was designed in an attempt to act simultaneously on gastrointestinal motility and neuroreceptors at central emetic pathways (Dopamine D-2, Histamine H-1 and muscarinic cholinergic). The antiemetic combination significantly reduces the median number of emetic episodes (p less than 0.01), the median volume of vomiting (p less than 0.01) and the median time of emesis (p less than 0.01) when compared with Metoclopramide alone and was also preferred by a significant number of patients (p = 0.0001) after passing through both antiemetic treatment arms being compared.
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PMID:Antiemetic combination for cisplatin-induced emesis. Results from a controlled study. 375 65

Metoclopramide was compared to a metoclopramide plus dexamethasone combination in patients receiving high-dose cisplatinum. Metoclopramide 2 mg/kg intravenously was given every 2 hours for 4 doses during two consecutive chemotherapy cycles. A randomized double-blind crossover was used with placebo or dexamethasone 20 mg given intravenously before the first metoclopramide dose. Thirty-six patients completed both study arms. There was no difference in mean vomiting episodes (1.92 for metoclopramide versus 1.33 for the combination, p = 0.20). However complete protection (no vomiting episodes) was achieved in 56% receiving the combination but only 36% receiving metoclopramide alone (p less than 0.08). No significant difference in toxicity or patient preference was noted. Late nausea or vomiting lasting 2 to 7 days appeared in 26% of cycles and was associated with but not completely explained by a greater number of acute vomiting episodes. Combination antiemetic therapy can achieve a higher incidence of complete protection from cisplatinum-induced vomiting. However, late nausea and vomiting may require modification of present regimens.
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PMID:Comparison of metoclopramide and metoclopramide plus dexamethasone for complete protection from cisplatinum-induced emesis. 380 53

In order to search for methods of controlling cisplatin-induced emesis, a series of experiments were performed with dogs. Cisplatin was administered i.v. to dogs at three-day intervals, and the number of emetic episodes and latency period to the first episode following injection were examined. The dose of cisplatin was 0.3mg/kg at the first injection, and thereafter square root 2-fold higher doses than the preceding ones were injected up to a maximum of 2.4 mg/kg. Emesis was observed from 0.42 g/kg. The number of emetic episodes increased with escalation of the dose up to 0.85 mg/kg, but decreased at higher doses. On the other hand, the latency period shortened with increase of the dose up to the highest one. From these results, the latency period is concluded to be a reliable parameter for evaluating the emetic activity of cisplatin and the efficacy of anti-emetics. The anti-emetic effect of vagotomy, ethyl amino-benzoate or metoclopramide was then examined. When 1 mg/kg of cisplatin was administered i.v., mean values of latency period and the number of episodes in dogs of a control group were 200 minutes and 20 times, respectively. In vagotomized dogs, no emesis was observed. When ethyl amino-benzoate was administered p.o. at doses of 12, 24 and 48 mg/kg 30 minutes before and 90 minutes after cisplatin injection, the number of episodes decreased to between 8 and 4.3 times, but the latency period was not prolonged. When s.c. injections of 1 mg/kg metoclopramide were combined with cisplatin in a similar manner to ethyl amino-benzoate, the latency period was prolonged up to 343 minutes, and the number of episodes decreased to 2.7 times. These results suggest that the peripheral autonomic nervous system is involved in the mechanism of emesis induction by cisplatin. Finally, the anti-emetic effect of metoclopramide was examined using the following administration schedules of cisplatin: a single i.v. injection of 3.75 mg/kg and daily i.v. injections of 1.25 mg/kg for three days. Metoclopramide showed a superior anti-emetic effect in the latter schedule, when the dose of 2 mg/kg was given i.v. 30 minutes before and 90 and 210 minutes after the cisplatin injection.
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PMID:[Experimental study on the control of cisplatin-induced emesis in dogs]. 382 61

A series of consecutive trials were undertaken to determine whether higher doses of intravenous metoclopramide and combinations of metoclopramide, dexamethasone, and diphenhydramine would improve antiemetic control or decrease treatment-related side effects in patients receiving cisplatin at 120 mg/m2. Metoclopramide and dexamethasone were studied because of their proven efficacy as single agents and their differing mechanisms of action and side effects. Diphenhydramine was used because of its possible antiemetic properties and its ability to control acute dystonic reactions. Two hundred fifty-five patients who had never received chemotherapy or antiemetics were observed in the hospital for the 24 hours following cisplatin administration. The addition of dexamethasone or dexamethasone plus diphenhydramine to intravenous metoclopramide 2 mg/kg produced both improved antiemetic control and a decrease in treatment-associated diarrhea (P = 0.002). The use of metoclopramide alone at a dose of 3 mg/kg for only two doses appeared as effective as 2 mg/kg for five doses. When dexamethasone and diphenhydramine were given with metoclopramide 3 mg/kg for two intravenous dosages, 81% of patients experienced no emesis and 93% had two or fewer vomiting episodes. The antiemetic results of this 2-hour "short-course" regimen were superior to metoclopramide 2 mg/kg, with (P = 0.002) or without (P = 0.0001) dexamethasone and diphenhydramine. It was concluded that combinations of metoclopramide plus dexamethasone plus diphenhydramine improve antiemetic control, facilitate the usage of higher doses of metoclopramide, and decrease the incidence of treatment-related side effects.
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PMID:Improved control of cisplatin-induced emesis with high-dose metoclopramide and with combinations of metoclopramide, dexamethasone, and diphenhydramine. Results of consecutive trials in 255 patients. 388 Jun 60

Metoclopramide (MCP) was used as an antiemetic agent in 11 pediatric oncology patients during 22 courses of cancer therapy including cisplatin, doxorubicin, and other agents. Initial MCP regimens used 2 mg/kg/dose iv prior to and at 1.5, 3.5, 5.5, and 8.5 hours post-chemotherapy. Subsequent dose reduction to 1 mg/kg and addition of diphenhydramine to all regimens has been made to decrease adverse drug effects. Seven of 11 children reported subjective benefit, defined by comparison with previous antiemetic response, comfort, and willingness to continue MCP therapy. MCP effectively reduced the volume of emesis per 24-hour period as compared with volume of emesis recorded following other antiemetics, an observation that should be confirmed in controlled studies of efficacy. Acute dystonic reactions developed in five children, occurring most frequently in those who received 2 mg/kg/dose regimens or consecutive day dosing. These reactions were rapidly reversible with diphenhydramine, but limited patient acceptance of further MCP use.
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PMID:Metoclopramide as an antiemetic agent in pediatric oncology patients. 394 88


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