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)

This paper evaluates the use of metoclopramide (Maxolon) in emptying human stomach contents into the duodenum and beyond. A method of quantitative assessment of content by barium swallow radiography is used in the study, and the method is recommended as a diagnostic manoeuvre in patients presenting for emergency surgery in whom the stomach content is in doubt. Oral metoclopramide was found effective in emptying stomachs challenged by water load, and the intravenous route has been found effective in emptying semisolid contents in emergency clinical situations. A radiographic scan of the resting stomach was made on patients waiting for routine surgery who had received a variety of common premedication; it was shown that significant residues occur.We believe that metoclopramide deserves further investigation in order to exploit its potential in reducing the hazard of regurgitation and vomiting in patients requiring emergency anaesthesia and surgery.
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PMID:Pharmacological emptying of the stomach with metoclopramide. 557 92

The etiology, pathogenesis, diagnosis, and treatment of reflux esophagitis are reviewed. Reflux esophagitis is the subjective or objective response to gastroesophageal reflux (GER), which is defined as the entrance of gastroduodenal contents into the esophagus not associated with vomiting or belching. The pathogenesis of reflux esophagitis may involve a number of mechanisms, including changes in lower esophageal sphincter pressure, gastric volume, composition of the refluxate, esophageal acid clearance, and esophageal tissue resistance. The most common symptom of reflux esophagitis is heartburn. Regurgitation of fluid into the mouth, usually after bending or during the night, is an unequivocal symptom of GER. Treatment can be divided into three phases. Phase 1 involves the avoidance of certain foods and habits, elevation of the bed head, antacid, and alginic acid-antacid therapy. Phase 2 involves drug therapy with agents not yet approved by the FDA for this indication: bethanechol chloride, cimetidine, and metoclopramide hydrochloride. Bethanechol chloride 25 mg is generally given four times daily. Cimetidine is given in doses of 300-400 mg after meals and at bedtime. Metoclopramide hydrochloride is administered in doses of 10 mg before meals and at bedtime. Phase 3 is antireflux surgery. Clinical experience has shown that phase 1 therapy is successful for about 75% of all patients. Of the 25% that do not respond to phase 1 therapy, about 90% will respond to phase 2 therapy, leaving only 5-10% of all patients with this disorder who will require phase 3 treatment. Current data favor cimetidine and bethanechol over metoclopramide. The least proof of efficacy and the most frequent adverse side effects are seen with metoclopramide. Cimetidine and bethanechol appear to have similar efficacy and relatively infrequent side effects. Evidence confirming the superiority of cimetidine over bethanechol is lacking. Further research is needed to determine the optimal pharmacologic combinations and treatment regimens.
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PMID:Current concepts in the pathogenesis and treatment of reflux esophagitis. 636 Apr 95

Metoclopramide hydrochloride was administered to nine children for the treatment of gastric stasis (N=6) and unexplained vomiting (N=3). One additional patient with gastric stasis displayed no response to the test dose of metoclopramide. Both the frequency and apparent forcefulness of the gastric and duodenal waves increased with the administration of metoclopramide in the nine patients receiving treatment. Eight clinical aspects were monitored, with improvement seen in all during therapy; the rates of both improvement and freedom from symptoms were time dependent. After one month, the median rate of improvement in individual symptoms was 86%, and the median rate of freedom from symptoms was 54%. Only two of the nine patients became totally asymptomatic within the month. However, sustained improvement was maintained after discontinuance of metoclopramide administration. Within the administered dosages and within the study population, metoclopramide was found to be safe.
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PMID:Enhanced gastroduodenal motility in children. 707 65

Prolonged residence of drug formulation in the nasal cavity is important for the enhancing intranasal drug delivery. The objective of the present study was to develop a mucoadhesive in-situ gelling nasal insert which would enable the reduced nasal mucociliary clearance in order to improve the bioavailability of metoclopramide hydrochloride. Metoclopramide hydrochloride is a potent antiemetic and effective for preventing emesis induced by cancer chemotherapy, migraine, pregnancy and gastroparesis. It undergoes hepatic first pass metabolism and both the absolute bioavailability and the plasma concentrations are subjected to wide inter-individual variation showing values between 32% and 98%. Oral antiemetic often gets vomited out before the systemic absorption compelling parenteral administration which results in low patient compliance. Adverse effect of metoclopramide HCL on CNS caused by high plasma peaks can be avoided through sustained formulation. A novel combination of xanthan gum and guar gum was used to prepare the nasal inserts and the effect of blend ratio of xanthan gum and guar gum on drug release from in-situ gelling nasal inserts and on other insert properties such as bioadhesion potential and water uptake was studied. PXRD was used to determine the effect of freeze-drying on crystalline nature of formulation. The viscosities of xanthan gum in combination with guar gum were observed to be higher than that of single polymer solutions. This is because of the synergistic rheological interaction between xanthan and guar gum. There is a substantial loss in crystalline nature of the formulation after freeze-drying. The best nasal inserts formulation containing xanthan gum and guar gum ratio 1:5, showed good release (91.83%) as well as bioadhesion which may result in an increase in the nasal residence time.
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PMID:Freeze-dried Xanthan/Guar Gum Nasal Inserts for the Delivery of Metoclopramide Hydrochloride. 2425 Apr 74