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)

Patients consider nausea (N) and vomiting (V) as severe adverse events to chemotherapy (CT). The introduction of the 5-HT3 antagonists have added a new dimension to the treatment of acute N and V. A review of the pathophysiology of N and V induced by CT and of the prescription of antiemetics used in Denmark is given. Dopamine D2 antagonists such as metoclopramide and metopimazine have a moderate antiemetic effect, when given in conventional low doses. A combination of one of these drugs and a steroid is recommended as first choice in patients receiving moderately emetogenic CT. In severe emetogenic CT, especially cisplatin-based, the 5-HT3 antagonists have resulted in a significant improvement and ondansetron, granisetron or tropisetron are in these patients recommended as first choice, either given alone or in combination with steroids. The duration of such a treatment should be restricted to the first 24 hrs after CT, as none of these expensive drugs seem to improve treatment of delayed emesis. The best known treatment of delayed emesis is the combination of a dopamine D2 antagonist and a steroid. Many pathophysiological and clinical questions are unanswered. Future trials using correct methodology should focus on patients receiving multiple-day CT, patients receiving multiple cycles of CT and on patients resistant to first-line antiemetic treatment.
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PMID:[Treatment of drug-induced nausea and vomiting]. 814 Jun 60

The novel benzamide derivative itopride was assayed for its effect on gastrointestinal motility in conscious dogs when it was administered intraduodenally (i.d.). Gastrointestinal motility was measured by means of chronically implanted force transducers, and itopride at a dose of 10 mg/kg, i.d. or more increased the gastric contractile force during the digestive state. Intraduodenal cisapride, domperidone and metoclopramide also stimulated gastric motility, and their threshold doses were 1, 3 and 1 mg/kg, respectively. Dopamine infusion (1 mg/kg/hr, i.v.) caused the postprandial gastric motility to disappear, but it was immediately restored by itopride at a dose of 3 mg/kg, i.d. With itopride at 1 and 3 mg/kg, i.d., acetylcholine (0.05 mg/kg/min)-induced contractions were greatly enhanced. In addition to its gastric stimulation, itopride at doses of 10-100 mg/kg, p.o. inhibited apomorphine (0.1 mg/kg, s.c.)-induced vomiting in dogs. In conclusion, intraduodenal itopride stimulates gastric motility through both anti-dopaminergic and anti-acetylcholinesterase actions. Its gastroprokinetic threshold dose was as large as 3-10 times those of cisapride, domperidone and metoclopramide. These findings suggest that itopride is an orally active gastroprokinetic with a moderate anti-emetic action.
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PMID:Gastroprokinetic effect of a new benzamide derivative itopride and its action mechanisms in conscious dogs. 883 39

Dopamine is a neurotransmitter in both central and peripheral nervous system. In the central nervous system dopamine is involved in regulation of: movements, emotional processing of sensory input, appetite, vomiting and secretion of anterior pituitary hormones. The most important peripheral effect of dopamine is control of splanchnic and renal blood flows. There are five subtypes of dopamine receptors. D1 receptors are responsible for majority of peripheral dopamine effects; in the brain they modulate activity of limbic system. Symptoms of schizophrenia are produced by increased activation of D2 and D4 receptors. On the other hand, Parkinson's syndrome could be induced by D2 receptors blockade. D3 receptors decrease craving in drug-dependent laboratory animals. Although D5 receptors were found in many brain regions and in peripheral blood lymphocytes, their functions remain unknown. Linking dopamine receptor subtypes with actual effects of dopamine will enable more selective therapy of disorders caused by malfunction of this important system.
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PMID:[Dopamine receptor subtypes]. 892 44

Nausea and vomiting are the most distressing side effects reported by patients undergoing CDDP-based cancer chemotherapy. Dopamine receptor antagonists and corticosteroids are used as anti-emetics for chemotherapy induced nausea and vomiting. Recently, a highly selective 5-HT3 receptor antagonist are proved to demonstrate antiemetic activity. 5-HT3 receptor antagonists are developed such as Granisetron, Ondansetron, Ramosetron, Azasetron. For acute emesis, complete control of vomiting was achieved in 80% of patients receiving 5-HT3 receptor antagonists. Though, it is reported to be only 20% effective for the complete control of delayed emesis. Psychiatric medications sometimes play a prominent role in the control of persisting emesis, particularly anticipatory or conditioned nausea. Nausea and vomiting are well controlled using various anti-emetics considering patient's condition and chemotherapy schedule.
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PMID:[Nausea and vomiting]. 1280 42

Dopamine agonists are the drugs of choice in the treatment of prolactinomas, the most common type of pituitary adenomas. However, up to 25% of prolactinomas do not respond to these drugs and alternative treatments have to be considered. We describe a 37-year old female with a microprolactinoma who, although having received all available formulations of dopamine agonists over a period of 11 years, did not respond either clinically--diminution of galactorrhea and restoration of her menstrual cycle--or hormonally through normalisation of the elevated prolactin levels. Throughout the same period, the size of the adenoma remained unchanged. While on high doses of dopamine agonists, the patient presented with side effects such as nausea, vomiting, orthostatic hypotension and tachycardia without any symptoms of psychosis. Therefore, either the dose of the dopamine agonists was not toxic enough for the mesolimbic dopaminergic pathway to be activated or the patient was dopamine-resistant in this pathway as well.
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PMID:A case of a prolactinoma resistant to dopamine agonists. 1661 27

Dopamine antagonists, such as metoclopramide and domperidone, and the motilin receptor agonist erythromycin have been the cornerstones in drug treatment of severe gastroparesis for more than a decade. No new drugs have been approved for treatment of this disorder in this period. Instead, the 5-HT4 agonist cisapride has been withdrawn due to side-effects. The effectiveness of intrapyloric botulinum toxin for gastroparesis remains to be shown. In the last decade, gastric electrical stimulation (GES) with a fully implantable device has evolved as a promising treatment, with significant effects on nausea and vomiting in most patients with severe, drug-refractory diabetic gastroparesis and postsurgical gastroparesis. A proportion of patients with severe idiopathic gastroparesis and patients with idiopathic nausea and vomiting also respond. More research is needed to achieve precise selection of responders/non-responders to GES, and to study the potential benefit of GES in other patient groups suffering from severe nausea or vomiting.
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PMID:Severe gastroparesis: new treatment alternatives. 1764 6

Attention deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioral disorder in children and adolescents, and in about half of these patients, significant symptomology continues into adulthood. Although impulsivity and hyperactivity are the most salient features of ADHD, cognitive deficits, particularly impairments in attention and executive function, are an important component, particularly in adolescents and adults, with over 90% of adults seeking treatment for ADHD manifesting cognitive dysfunction. Currently available medications treat the core ADHD symptoms but typically do not adequately address cognitive aspects of ADHD, underscoring the need for new therapeutics. Dopamine and norepinephrine are hypothesized to be particularly important in ADHD, but there is emerging evidence that cholinergic neurotransmission, particularly involving neuronal nicotinic acetylcholine receptors (nAChRs), may play a role in the pathophysiology of ADHD. Nicotine has demonstrated procognitive effects in both humans and experimental animals and has produced signals of efficacy in small proof-of-concept adult ADHD trials. Although adverse effects associated with nicotine preclude its development as a therapeutic, a number of novel nAChR agonists with improved safety/tolerability profiles have been discovered. Of these, ABT-418 and ABT-089 have both demonstrated signals of efficacy in adults with ADHD. Notably, tolerability issues that might be expected of a nAChR agonist, such as nausea and emesis, were not observed at efficacious doses of ABT-089. Further understanding of the effects of novel neuronal nAChR agonists on specific aspects of cognitive functioning in ADHD is required to assess the full potential of this approach.
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PMID:Neuronal nicotinic receptor agonists for the treatment of attention-deficit/hyperactivity disorder: focus on cognition. 1768 98

Dopamine receptor antagonists are commonly used to counter the adverse effects of opioids such as hallucinations, delusions and emesis. However, most of these agents themselves have side effects, including extrapyramidal symptoms. Here, we investigated the effect of the dopamine system stabilizer aripiprazole on morphine-induced dopamine-related actions in mice. Morphine-induced hyperlocomotion and reward were significantly suppressed by either the dopamine receptor antagonist prochlorperazine or aripiprazole. Catalepsy was observed with a high dose of prochlorperazine, but not with an even higher dose of aripiprazole. The increased level of dialysate dopamine in the nucleus accumbens stimulated by morphine was significantly decreased by pretreatment with aripiprazole. These results suggest that the co-administration of aripiprazole may be useful for reducing the severity of morphine-induced dopamine-related side effects.
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PMID:Suppression of dopamine-related side effects of morphine by aripiprazole, a dopamine system stabilizer. 1895 42

6-Hydroxydopamine administration for 28 days (8 microg/2 microL) reduced the number of tyrosine hydroxylase (TH)-immunopositive neurons to 40.2% in the substantia nigra compared to the intact contralateral side. Dopamine, 3,4-dihydroxyphenylacetic acid, homovanillic acid and norepinephrine levels were reduced to 19.1%, 52.3%, 47.1% and 67.4% in the striatum of 6-hydroxydopamine-lesioned rats compared to the control group, respectively. However, an oral administration of herbal ethanol extracts from Gynostemma pentaphyllum (GP-EX) (10 mg/kg and 30 mg/kg) starting on day 3 post-lesion for 28 days markedly ameliorated the reduction of TH-immunopositive neurons induced by 6-hydroxydopamine-lesioned rat brain from 40.2% to 67.4% and 75.8% in the substantia nigra. GP-EX administration (10 and 30 mg/kg) also recovered the levels of dopamine, 3,4-dihydroxyphenylacetic acid, homovanillic acid and norepinephrine in post-lesion striatum to 64.1% and 65.0%, 77.9% and 89.7%, 82.6% and 90.2%, and 88.1% and 89.2% of the control group. GP-EX at the given doses did not produce any sign of toxicity such as weight loss, diarrhea and vomiting in rats during the 28 day treatment period and four gypenoside derivatives, gynosaponin TN-1, gynosaponin TN-2, gypenoside XLV and gypenoside LXXIV were identified from GP-EX. These results suggest that GP-EX might be helpful in the prevention of Parkinson's disease.
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PMID:Neuroprotective effects of herbal ethanol extracts from Gynostemma pentaphyllum in the 6-hydroxydopamine-lesioned rat model of Parkinson's disease. 2042 81

Dopamine agonists are effective treatments for a variety of indications, including Parkinson's disease and restless legs syndrome, but may have serious side effects, such as orthostatic hypotension, hallucinations, and impulse control disorders (including pathological gambling, compulsive eating, compulsive shopping/buying, and hypersexuality). The most effective way to alleviate these side effects is to taper or discontinue dopamine agonist therapy. A subset of patients who taper a dopamine agonist, however, develop dopamine agonist withdrawal syndrome (DAWS), which has been defined as a severe, stereotyped cluster of physical and psychological symptoms that correlate with dopamine agonist withdrawal in a dose-dependent manner, cause clinically significant distress or social/occupational dysfunction, are refractory to levodopa and other dopaminergic medications, and cannot be accounted for by other clinical factors. The symptoms of DAWS include anxiety, panic attacks, dysphoria, depression, agitation, irritability, suicidal ideation, fatigue, orthostatic hypotension, nausea, vomiting, diaphoresis, generalized pain, and drug cravings. The severity and prognosis of DAWS is highly variable. While some patients have transient symptoms and make a full recovery, others have a protracted withdrawal syndrome lasting for months to years, and therefore may be unwilling or unable to discontinue DA therapy. Impulse control disorders appear to be a major risk factor for DAWS, and are present in virtually all affected patients. Thus, patients who are unable to discontinue dopamine agonist therapy may experience chronic impulse control disorders. At the current time, there are no known effective treatments for DAWS. For this reason, providers are urged to use dopamine agonists judiciously, warn patients about the risks of DAWS prior to the initiation of dopamine agonist therapy, and follow patients closely for withdrawal symptoms during dopamine agonist taper.
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PMID:Dopamine agonist withdrawal syndrome: implications for patient care. 2368 24


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