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 comparison of the antiemetic effects of (H) and (M) was carried out by randomized control study in gynecologic cancer patients receiving CDDP (35-110 mg/m2). Metoclopramide was given at a dosage of 2 mg/kg (H) or 1 mg/kg (M), intravenously, 30 minutes before and 2.5 hours, 5.0 hours, and 7.5 hours following chemotherapy. Treatment with (H) resulted in 3.3 episodes of vomiting (range 0-5) whereas the episodes of vomiting noted with (M) were 3.4 (range 1-5). In patients receiving CDDP (H) or (M) dosage of metoclopramide gives similar antiemetic protection.
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PMID:[Randomized controlled study of high-dose metoclopramide (2 mg/kg x 4:H) vs moderate-dose metoclopramide (1 mg/kg x 4:M) in the prevention of CDDP-induced emesis]. 395 70

Prior studies in adults have shown that metoclopramide (MCP), when given in high intravenous (IV) doses (2 mg/kg), is a highly effective antiemetic for chemotherapy-induced vomiting. It is well-tolerated in older adults, but younger adults have an increased disposition to acute extrapyramidal reactions (EPRs). Before studying the efficacy of MCP as an antiemetic in children, we first had to establish the safe dose range. We performed a dose-increase MCP toxicity study in children receiving highly emetic chemotherapy such as cisplatin (120 mg/m2) or cyclophosphamide (greater than 900 mg/m2), beginning with a dose of 0.2 mg/kg and increasing the dose in nine steps to 3 mg/kg. MCP was given every two hours for four doses beginning one-half hour before chemotherapy. To reduce the incidence of EPRs, we added concomitant diphenhydramine. In MCP doses less than 2 mg, toxicity was minimal. In doses greater than or equal to 2 mg, 4/27 (15%) had EPRs and 9/27 (33%) had akathisia. Children who received two consecutive days of MCP had a higher frequency of EPRs. Metoclopramide (2 mg/kg) had promising antiemetic efficacy in a preliminary nonrandomized trial. Chemotherapy-experienced children vomited fewer than five times in 9/21 (43%) trials, and new patients vomited fewer than five times in 7/10 (70%) trials. MCP will become more useful as an antiemetic in children if better measures to prevent EPRs can be developed. Chemotherapy-induced emesis has the same negative implications in children as it does in adults and optimum antiemetic regimens can only be discovered by conducting randomized clinical trials in children.
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PMID:Metoclopramide: dose-related toxicity and preliminary antiemetic studies in children receiving cancer chemotherapy. 402 Apr 11

In 92 patients receiving 270 cytostatic courses which all included cis-platinum, the antiemetic efficacy of medium- or high-dose metoclopramide was investigated. Metoclopramide was given intravenously 4 times during a 6-hour period (1/2 h before and 1 1/2, 3 1/2 and 5 1/2 h after cytostatic treatment) in a total dose of 1, 2, 4, 6, or 8 mg/kg. Nausea, emetic episodes, and side effects were registered during 24 h. The 1 mg/kg dose was given in 20 courses for which the average of emetic episodes was 16. In the four higher dosed groups the averages were 8, 8, 5, and 6, respectively. The average number of emetic episodes was significantly higher (p less than 0.001) in the 1 mg/kg metoclopramide group than in the 250 higher dosed courses. The frequency of side effects seemed independent of the dose in the interval 2-8 mg/kg while diarrhoea and other side effects tended to be less frequent in the 1 mg/kg metoclopramide group. Since antiemetic effect of metoclopramide in the dose interval 2-8 mg/kg did not increase with the dose, it is recommended to treat cis-platinum-induced emesis with 2 mg/kg metoclopramide given intravenously as 4 doses during a 6-hour period.
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PMID:High-dose metoclopramide in the treatment of cis-platinum induced emesis. A dose-finding study. 404 61

An antiemetic combination of metoclopramide and methylprednisolone was administered to 16 lung cancer patients receiving cisplatin (80 cmg/m2) alone or in combination with other drugs. Metoclopramide was administered four times intravenously at a dose of 1.5 mg/kg. Methylprednisolone was administered three times intravenously at a dose of 125 mg. Sixteen patients received a total of 34 chemotherapy courses. No vomiting occurred in 70% of 34 chemotherapy courses and mild emesis (one or two vomiting episodes) occurred in 18% of chemotherapy courses. Side effects were minimal and included mild sleepiness (nine patients), diarrhea (three patients), and hiccups (three patients). It is concluded that a combination of metoclopramide and methylprednisolone is very effective in preventing cisplatin-induced vomiting.
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PMID:[Antiemetic combination of metoclopramide and methylprednisolone for cisplatin-induced vomiting]. 405 14

Metoclopramide (Paspertin) was infused intravenously in the high doses of 1.75, 3.5, 7.0, and 14 mg/kg body wt. per treatment cycle as antiemetic therapy for cisplatin-induced emesis (363 cycles, 25-120 mg/m2). The antiemetic potency of metoclopramide increased in a log linear manner, giving from 40% to 95% protection against emesis. Gastrointestinal motility showed a similar increase, i.e. diarrhoea. In contrast, the extrapyramidal reactions, namely akathisia, rigidity and acute dystonia, did not show a dose-dependent increase in frequency and remained constant over the dose range of 3.5-14 mg/kg per cycle. The results suggest increasing benefit of metoclopramide treatment with increasing doses of the drug.
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PMID:Improved benefit/risk ratio of higher-dose metoclopramide therapy during cisplatin-induced emesis. 407 27

Metoclopramide is a widely used anti-emetic drug with potent dopamine-blocking effects on brain structures involved in emesis and prolactin secretion but it is apparently devoid of therapeutic effect in schizophrenia, thus calling into question the supposed role of dopamine blockade in the action of antischizophrenic drugs. This investigation compared the depression of hypothalamic self-stimulation produced by metoclopramide and by a 'typical' neuroleptic, spiroperidol (spiperone), when injected by different routes. Metoclopramide was found to9 be nearly 30 times more potent when administered directly into the brain via the cerebral ventricles than when injected intraperitoneally; on the other hand the potency of spiroperidol was virtually unaffected by the route of administration. The blood-brain barrier is known to be absent from brain sites controlling emesis and prolactin secretion; thus the potency of metoclopramide as an anti-emetic and in releasing prolactin, and its relative ineffectiveness as an antipsychotic can be accounted for by a failure to enter the brain freely except at privileged sites. Thus its anomalous properties are not necessarily inconsistent with the dopamine theory of schizophrenia.
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PMID:Selective permeation of the blood-brain barrier as a cause of the anomalous properties of 'atypical'neuroleptics. 610 75

Metoclopramide antagonizes the effect of dopamine in the central nervous system and other organ systems. Metoclopramide's effect on the medullary chemoreceptor trigger zone makes it useful as a routine anti-emetic and in preventing vomiting induced by antineoplastic drugs, particularly cisplatin. Metoclopramide's gastrointestinal smooth muscle stimulatory effects are related to its ability to antagonize the inhibitory neurotransmitter, dopamine; to augment acetylcholine release and sensitize the muscarinic receptors of the gastrointestinal smooth muscle; and to coordinate gastric-pyloric-small intestinal motor function. The indications for which metoclopramide is approved in the United States are reviewed. Adverse effects, which may occur in up to 20% of patients, include drowsiness, lassitude, and akathisia; all are usually mild, transient, and reversible. Tremor, dystonic reactions, and extrapyramidal effects are infrequent; breast enlargement, galactorrhea, and menstrual irregularities are related to prolactin release.
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PMID:Metoclopramide: pharmacology and clinical application. 633 44

Thirty-five patients receiving chemotherapeutic regimens including cisplatin (CDDP) were entered into a randomized open cross-over trial. Sixteen patients had previously received chemotherapy. Metoclopramide (MCP) was given i.v. in 4 doses of 1 mg/kg over a period of 4 1/2 hr, dexamethazone (DXM) was administered i.m. in 4 doses of 8 mg over 24 hr and another 10 mg i.v. just prior to CDDP administration. Sixteen patients who expressed a positive opinion on both previous antiemetics were given placebo (PLC). No significant differences were found between MCP and DXM, considering the mean score of both emesis intensity and patient's opinion. The mean duration of the symptoms was significantly longer with MCP than with DXM (P less than 0.02). Both antiemetic agents were more effective than PLC. No significant side-effects were observed. The results of this study indicate that both MCP and DXM provide a similar protection against CDDP-induced nausea and vomiting.
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PMID:Randomized open cross-over trial between metoclopramide (MCP) and dexamethazone (DXM) for the prevention of cisplatin-induced nausea and vomiting. 636 41

Metoclopramide tablets were compared with placebo in the treatment of gastrointestinal symptoms in 40 patients with diabetic gastroparesis. Results of a 3-wk double-blind study indicate that metoclopramide at a dosage of one 10-mg tablet four times daily reduced nausea, vomiting, fullness, and early satiety and improved meal tolerance better than placebo. Statistically significant differences were noted for nausea and postprandial fullness. Mean gastric emptying assessed by radionuclide scintigraphy was significantly improved in the metoclopramide-treated group when compared with their baseline result. Metoclopramide is an effective agent for improving the upper gastrointestinal motor function in diabetic patients with gastroparesis.
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PMID:A multicenter placebo-controlled clinical trial of oral metoclopramide in diabetic gastroparesis. 640 Jul 7

The main treatment of the acute migraine attack remains sleep, sedation, an anti-nauseant and analgesics, and in some patients 1 or 2 mg of ergotamine tartrate. Drugs containing large amounts of caffeine should not be used. Absorption of drugs may be impaired in a migraine attack. Metoclopramide is probably the anti-emetic of choice because it is an effective anti-nauseant and promotes normal gastrointestinal activity. Domperidone has a similar action but is said not to go through the blood-brain barrier, so is less likely to cause extrapyramidal reactions. All drugs, including analgesics such as aspirin and paracetamol, are best given in a soluble or effervescent form. Where vomiting occurs early in the attack, suppositories may be indicated. Ergotamine tartrate is necessary in about one third of attacks and is best given by suppository or by inhalation. Doses higher than 2 mg per attack or 6 mg in one week may cause toxic symptoms, the early signs of which are headache, nausea, vomiting and a feeling of not being very well. The non-drug treatments of an acute attack include pressing on the temporal artery, hot and cold compresses and relaxation.
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PMID:Treatment of the acute migraine attack--current status. 640 72


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