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)

During the period from March through November 1989, 70 children who were attended at the Pediatric Department at Central Hospital in Valencia, were enrolled in the study, it was thought that Giardia lamblia infection might be present. Giardia L. were identified using two different diagnostic procedures: from stool samples and duodenal aspirates for cysts or trophozoites examination. These children were treated with Metronidazole three dosage of 15, 30 and 50 mg/kg per day for a ten day period. Our study showed predominant giardiasis in children with ages ranging from 2 to 6 years old (60%) with a relationship between female and male sex 1.05:1. In this series, 72.8% of patients presented normal nutrition, and 55.7% of them were from the suburban area. The most frequent symptoms were abdominal pain, diarrhea, vomiting, abdominal distention, constipation and flatulence. The infants prevalent symptom was diarrhea (83.3%) and the older children and school children prevalent symptom was abdominal pain with 78.5 and 100% respectively. In this study, stool examination was positive in 97.1% of the children and duodenal aspirate was positive in all 70 children (100%); the first procedure showed predominant Giardia cysts (88.2%) and the second one showed predominant trophozoites (47.1%). All 70 patients (100%) were cured with Metronidazole to different dosage. Side effects were seen with only the maxim dose, such as nausea 40%, headache 10% and appearance of yeast into 50% of duodenal aspirate.
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PMID:[Giardia lamblia: comparison of two diagnostic methods and evaluation of response to treatment with metronidazole]. 184 30

Metronidazole, administered to 5 dogs for periods ranging from 3 to 14 days, was associated with acute development of CNS dysfunction. Metronidazole dosage ranged from 67.3 to 129.0 mg/kg of body weight/d. Clinical signs of toxicosis began with anorexia and intermittent vomiting and progressed rapidly to include pronounced, generalized ataxia and vertical, positional nystagmus. These signs were consistent with lesions of the vestibular nuclei and/or cerebellum. High CSF protein content was detected in 2 of 3 dogs from which CSF was collected. Two dogs were euthanatized because of severe neurologic dysfunction. Three dogs improved slowly and recovered completely over several months. These findings suggest that currently recommended dosages of metronidazole may be too high for some dogs.
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PMID:Central nervous system toxicosis associated with metronidazole treatment of dogs: five cases (1984-1987). 276 64

We have reported a case of diarrhea caused by Blastocystis hominis, an intestinal protozoan parasite of man. The organism is present in small numbers in up to one fifth of stool samples in hospitalized patients, but is associated with diarrhea in only heavily infested patients. Typical symptoms include diarrhea, crampy abdominal pain, nausea, vomiting, low-grade fever, gas, malaise, and chills. Fecal leukocytes are occasionally seen. The pathophysiologic mechanism of the diarrhea is not clear. Not all patients having large parasite burdens are symptomatic. Metronidazole, 1 to 2 gm/day orally in divided doses, is the treatment of choice.
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PMID:Diarrhea due to Blastocystis hominis: an old organism revisited. 360 19

A 15 year old boy was admitted to hospital with five days history of fever, headache, vomiting and otorrhea. Findings on physical examination included high fever, purulent drainage from right ear, nuchal rigidity, Brudzinski's and Kernig's signs. Laboratory finding was polymorphonuclear leukocytosis. Computerized tomography (CT) of his brain was normal. A lumbar puncture disclosed purulent CSF. Chloramphenicol and Penicillin G were given intravenously as treatment for the meningitis. After five days of this therapy he continued to be febrile and nuchal rigidity, Brudzinski's and Kerning's signs increased. The second CT demonstrated the presence of an abscess in the cerebellum. The abscess was aspirated during mastoidectomy. In the cultures of the aspiration material Bacteroides species and gram positive micrococci grew out. Metronidazole, 500 mg qid per oral, was added to the therapy. During treatment, his condition was evaluated with serial computerized tomography scans of his brain and these studies showed progressive decrease in the size of the lesion. Metronidazole and antibiotics therapies were continued 45 days. The patient made an uneventful recovery.
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PMID:[A cerebellar abscess caused by anaerobic and aerobic (mixed) microorganisms]. 651 26

Metronidazole, in particular, and the other nitroimidazoles (tinidazole, ornidazole) available in Australia are well established drugs for the treatment of protozoal (trichomonal or amoebic) infections; recent data testify to their efficacy in the prevention and therapy of anaerobic infections. Administration by oral and rectal routes is indicated rather than by the intravenous route on the basis of efficacy, safety and cost; this recommendation is applicable to both loading and maintenance dosing. Intravenous administration should be restricted to emergency preoperative loading (single 500-mg dose); to patients with proven anaerobic infections; patients with serious sepsis associated with an unidentified organism; patients who are unable to take medication by mouth and those without a functional rectum or with diarrhoea; and patients with leukaemia who are vomiting. These drugs are remarkably safe under conditions of acute use if the intravenous route is avoided. However, extreme caution in their long-term use and use in obstetric and paediatric patients should be exercised until toxicological issues are resolved. It is concluded that the nitroimidazoles are effective, cheap and safe drugs for the short-term treatment of protozoal and bacterial (anaerobic) infections.
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PMID:Current clinical applications and dose regimens of metronidazole and related nitroimidazoles. 674 31

A short review is given of the pharmacokinetic characteristics and side effects of the nitroimidazoles: metronidazole, tinidazole and ornidazole. The drugs are well absorbed from the gastrointestinal tract, maximum plasma levels generally being obtained 1 to 4 h after oral intake. Metronidazole has been shown to be absorbed after rectal administration; vaginal absorption is documented for all three drugs. The nitroimidazoles are widely distributed in the body, cross the placenta and appear in breast milk. Therapeutically effective concentrations of e.g. metronidazole have been demonstrated in e.g. the central nervous system, middle ear discharges, bile, peritoneal fluid, and fluids and tissues of the female genital tract. The binding to plasma proteins is less than 20%. Available data suggest that the elimination half-lives of these drugs differ, being 7-8 h for metronidazole, about 12 h for tinidazole and 14-15 h for ornidazole. Both metronidazole and ornidazole, but not tinidazole, seem to be extensively metabolized before elimination. The nature and frequency of adverse reactions to this drug include encephalopathy in a few patients treated with doses between 5 and 10 g daily as an adjunct to radiotherapy, and peripheral neuropathy observed in patients treated for prolonged periods with high doses. Among the common side effects of the nitroimidazoles are symptoms from the gastrointestinal tract such as nausea, anorexia, vomiting and metallic or bitter taste. Dizziness, ataxia and headache have been reported. When given together with alcohol, a disulfiram-like intolerance reaction can be obtained.
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PMID:Pharmacokinetics of nitroimidazoles. Spectrum of adverse reactions. 694 57

A 4-month-old male infant was admitted to our hospital because of poor intake and mild abdominal distention for 1 day. Fever and watery diarrhea had occurred 4 days prior to admission, but subsided 2 days later after taking oral medications. A physical examination showed an acute ill-looking baby with a soft and mildly distended abdomen. The bowel sound was hypoactive and no obvious abdominal tenderness was found. Normal leukocyte and differential counts were noted in initial laboratory examinations; however, the serum level of C reactive protein was extremely high (31.4 mg/dL). Progressive abdominal distention and bilious vomiting occurred. Serial plain films of abdomen showed ileus with a fixed gas pattern and an abdominal echo revealed intraperitoneal fluid accumulation. Under the impression of intestinal perforation, an emergency laparotomy was performed. A perforated appendicitis with turbid fluid in the peritoneal cavity was noted during surgery. A pus culture grew Pseudomonas aeruginosa which was sensitive to Ceftazidime only. Triple antibiotics consisting of Prostaphlin, Metronidazole, and Ceftazidime were administered for 2 weeks. The patient was discharged 3 weeks later without any complications. Appendicitis in infancy is a rare condition and associated with a high frequency of perforation and peritonitis. Diagnosis is often difficult because of variable and nonspecific clinical manifestations.
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PMID:Perforated appendicitis in a 4-month-old infant. 885 51

Medical records from 394 dogs and cats that had endoscopic aspiration of intestinal contents for identification of Giardia sp. trophozoites were retrospectively reviewed. The most common indications for endoscopy were chronic vomiting (152), chronic diarrhea (108), chronic vomiting and diarrhea (58), and acute vomiting (33). Metronidazole had been previously administered to 111 animals (28.2%), and to 58.6% of those with chronic diarrhea. Six aspirate samples (1.5%) were positive for Giardia sp. In 3 of these cases a single fecal flotation identified Giardia cysts before endoscopy. The authors conclude that intestinal aspiration in animals from a primarily referral population undergoing upper gastrointestinal endoscopy rarely identifies Giardia and should not be routinely performed. However, animals in which zinc sulfate flotation was not performed or those that did not previously receive metronidazole might benefit from intestinal aspiration.
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PMID:Endoscopic aspiration of intestinal contents in dogs and cats: 394 cases. 1035 7

Metronidazole is effective for the treatment of acute pouchitis after ileal pouch-anal anastomosis, but it has not been directly compared with other antibiotics. This randomized clinical trial was designed to compare the effectiveness and side effects of ciprofloxacin and metronidazole for treating acute pouchitis. Acute pouchitis was defined as a score of 7 or higher on the 18-point Pouchitis Disease Activity Index (PDAI) and symptom duration of 4 weeks or less. Sixteen patients were randomized to a 2-week course of ciprofloxacin 1,000 mg/d (n = 7) or metronidazole 20 mg/kg/d (n = 9). Clinical symptoms, endoscopic findings, and histologic features were assessed before and after therapy. Both ciprofloxacin and metronidazole produced a significant reduction in the total PDAI score as well as in the symptom, endoscopy, and histology subscores. Ciprofloxacin lowered the PDAI score from 10.1+/-2.3 to 3.3+/-1.7 (p = 0.0001), whereas metronidazole reduced the PDAI score from 9.7+/-2.3 to 5.8+/-1.7 (p = 0.0002). There was a significantly greater reduction in the ciprofloxacin group than in the metronidazole group in terms of the total PDAI (6.9+/-1.2 versus 3.8+/-1.7; p = 0.002), symptom score (2.4+/-0.9 versus 1.3+/-0.9; p = 0.03), and endoscopic score (3.6+/-1.3 versus 1.9+/-1.5; p = 0.03). None of patients in the ciprofloxacin group experienced adverse effects, whereas three patients in the metronidazole group (33%) developed vomiting, dysgeusia, or transient peripheral neuropathy. Both ciprofloxacin and metronidazole are effective in treating acute pouchitis with significant reduction of the PDAI scores. Ciprofloxacin produces a greater reduction in the PDAI and a greater improvement in symptom and endoscopy scores, and is better tolerated than metronidazole. Ciprofloxacin should be considered as one of the first-line therapies for acute pouchitis.
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PMID:A randomized clinical trial of ciprofloxacin and metronidazole to treat acute pouchitis. 1172 Mar 19

Intestinal parasites cause significant morbidity and mortality. Diseases caused by Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica occur in the United States. E. vermicularis, or pinworm, causes irritation and sleep disturbances. Diagnosis can be made using the "cellophane tape test." Treatment includes mebendazole and household sanitation. Giardia causes nausea, vomiting, malabsorption, diarrhea, and weight loss. Stool ova and parasite studies are diagnostic. Treatment includes metronidazole. Sewage treatment, proper handwashing, and consumption of bottled water can be preventive. A. duodenale and N. americanus are hookworms that cause blood loss, anemia, pica, and wasting. Finding eggs in the feces is diagnostic. Treatments include albendazole, mebendazole, pyrantel pamoate, iron supplementation, and blood transfusion. Preventive measures include wearing shoes and treating sewage. E. histolytica can cause intestinal ulcerations, bloody diarrhea, weight loss, fever, gastrointestinal obstruction, and peritonitis. Amebas can cause abscesses in the liver that may rupture into the pleural space, peritoneum, or pericardium. Stool and serologic assays, biopsy, barium studies, and liver imaging have diagnostic merit. Therapy includes luminal and tissue amebicides to attack both life-cycle stages. Metronidazole, chloroquine, and aspiration are treatments for liver abscess. Careful sanitation and use of peeled foods and bottled water are preventive.
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PMID:Common intestinal parasites. 1502 17


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