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)

Omeprazole efficacy and tolerance were evaluated in 20 patients with longstanding Zollinger-Ellison syndrome (ZES) committed to long-term antisecretory therapy. The study included 13 men and 7 women, aged 53 (30-74) years (median and range). Nineteen patients presented with epigastric pain, 14 with vomiting, and 9 with diarrhea. All patients had gastroduodenal ulcerations, associated with esophagitis in 9 cases. Median and extreme values for basal acid output (BAO) and serum gastrin (SG) levels before omeprazole treatment were 41 (3.7-80) mmol H+/h and 413 (111-11,490) pg/ml, respectively. In 18 patients, omeprazole treatment was initiated because of resistance to H2-antagonists, and in 2 patients because of carbothioamide RP 40749 discontinuation. Initial doses of omeprazole were 60 mg per day in 10 patients and ranged from 80 to 160 mg per day in the others. Esophagogastrectomy was performed in one patient at day 15 because of esophageal stenosis. In the remaining 19 patients, median duration of treatment was 16 (7-54) months and median doses of omeprazole were 70 (20-160) mg per day during the survey. Omeprazole therapy was highly effective in inducing rapid disappearance of clinical abnormalities in 18 of 19 patients. Twenty-two days after initiation of treatment, median BAO was 4 (0-14) mmol/h and ulcerations had healed in 17 of 19 patients. Median BAO was less than 5 mmol/h during follow-up. However, asymptomatic ulcer recurrence was noted in 4 patients, but disappeared quickly after omeprazole doses were increased. Median basal gastrin level was 700 (116-36.625) pg/ml at the least determination and was statistically higher than pretreatment values (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Long-term efficacy and tolerability of omeprazole in 20 patients with severe Zollinger-Ellison syndrome]. 280 1

Omeprazole has been marketed in France since 1989, for the healing of peptic ulcers, erosive reflux esophagitis and the Zollinger Ellison syndrome. It is a proton pump inhibitor which inhibits the acid secretion in the stomach. In the majority of the clinical trials, omeprazole has been found to be well tolerated: headache, dizziness, skin rash, constipation have just been noted. Since September 1989, 143 adverse reactions have been reported to pharmacovigilance centres and Astra France: 37 neurological and psychiatric side effects, especially confusion in patients with hepatic diseases and/or advanced age; 35 cutaneous reactions, generally rash and urticaria; 22 hematological effects: leucopenia and agranulocytosis have been reported but the relation with omeprazole is very uncertain; 10 gastrointestinal effects, generally diarrhoea, nausea, vomiting and abdominal pain; 8 hepatic disorders, especially moderate elevation of aminotransferases. This study confirms the safety of this drug, during short treatment; the frequency of notified adverse effects is about 1/12 200 treatments of 4 weeks. The ministry of health, has decided, in november 1991, to inform the prescribers of this potential toxicity of omeprazole, particularly, of the risk of confusion, hepatotoxicity and leucopenia.
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PMID:[Evaluation of unexpected and toxic effects of omeprazole (Mopral) reported to the regional centers of pharmacovigilance during the first 22 postmarketing months]. 814 27

A 29-year-old woman was hospitalized with a 1-month history of postprandial epigastric pain, nausea, and vomiting. An upper gastrointestinal tract X-ray series showed a marked narrowing of the pyloric region. A histological examination of duodenal mucosal biopsy samples showed granulomatous inflammation, and thus a diagnosis of intrinsic duodenal Crohn's disease was made. A second upper gastrointestinal tract X-ray revealed a persistent gastric outlet obstruction. At laparotomy, the duodenal wall was found to be thickened over a distance measuring 3.5 cm in length from the pyloric ring. A longitudinal incision was made over the entire length, up to 5.5 cm beyond the pyloric ring on either side, while Finney-type anastomosis was also performed. A postoperative upper gastrointestinal tract X-ray showed an improvement in the gastroduodenal passage. Enteral nutrition therapy was provided postoperatively. Omeprazole was administered at a dose of 20 mg/day for 2 months. The patient currently remains on maintenance therapy with famotidine at 20 mg/day and is clinically doing well.
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PMID:Surgical treatment for duodenal involvement in Crohn's disease: report of a case. 930 11

A 9-year-old male German Shepherd Dog was presented with the primary complaints of vomiting, profuse watery diarrhea, anorexia, and severe weight loss. The dog developed hematemesis and melena, which were unresponsive to treatment with an H2-receptor antagonist and a gastrointestinal protectant. A marked neutrophilia, panhypoproteinemia, hypokalemia, and mildly increased activities of alkaline phosphatase and alanine aminotransferase were the only relevant abnormalities found on a CBC, serum biochemical profile, and urinalysis. An exploratory laparotomy revealed several small nonresectable masses at the root of the mesentery, which were identified histologically as a neuroendocrine neoplasm. Immunohistochemical staining of the neoplasm was positive for gastrin and negative for insulin, glucagon, pancreatic polypeptide, and vasoactive intestinal polypeptide. Fasting serum gastrin concentrations were high. Zollinger-Ellison syndrome was diagnosed, and the dog was treated with omeprazole, an H+,K(+)-ATPase inhibitor. All clinical signs resolved, and the dog remains asymptomatic 2 years later. Omeprazole may be the gastric acid antisecretory drug of choice for dogs with gastrinoma.
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PMID:Omeprazole in a dog with gastrinoma. 947 Jan 66

Interstitial lung diseases comprise a heterogeneous group of pulmonary conditions that cause restrictive lung disease of poor prognosis, especially if growth failure, pulmonary hypertension and fibrosis appears. We report on the case of a girl of 11 years of age who suffered from severe nonallergic asthma in early childhood and who developed severe interstitial pulmonary disease caused by gastro-oesophageal reflux at the age of 8 years. This diagnosis was established by lung biopsy, bronchoalveolar lavage and a high amount of lipid-laden alveolar macrophages, 2-level pH measurement and oesophageal biopsy. Because therapy with oral and inhaled steroids failed and Omeprazol showed benificial effects, hemifundoplication according to THAL was performed. At present the lung function is clearly normal and there is no need of any medicaments. Following the history, we can assume the pathological gastro-oesophageal reflux to be the cause of the disease. It is important to state that there were no typical symptoms at any time pointing to gastro-oesophageal reflux disease. The development of pulmonary disease by pathological reflux is very often caused by "silent aspiration". Very typically there are no symptoms such as vomiting, heartburn and pain but only signs of chronic lung disease.
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PMID:[Severe interstitial lung disease from pathologic gastroesophageal reflux in children]. 1044 54

Omeprazole is a proton pump inhibitor that is used commonly in the treatment of acid-peptic disorders. Although omeprazole is generally well tolerated, serious adverse effects such as renal failure have been reported. Thus far, 17 cases of acute interstitial nephritis (AIN) secondary to omeprazole have been described. Another case of AIN is described in a 36-yr-old woman presenting with nausea, vomiting, weight loss, and a rising serum creatinine concentration. Omeprazole therapy had ceased 2 wk before admission. AIN was diagnosed by renal biopsy and corticosteroid therapy was initiated. After 4 wk of therapy the serum creatinine concentration had normalized. Among the reported cases in the literature, AIN was diagnosed after an average of 2.7 months of therapy with 20-40 mg of omeprazole daily. Recurrence was universal on rechallenge. Common symptoms included fatigue, fever, anorexia, and nausea. The classic triad of fever, rash, and eosinophilia was uncommon. Typical laboratory features included hematuria, proteinuria, pyuria, eosinophilia, and anemia. Management consisted of withdrawal of omeprazole and corticosteroid therapy in some patients. All but one patient recovered normal renal function. Corticosteroid therapy was well tolerated and may have been beneficial.
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PMID:Acute interstitial nephritis due to omeprazole. 1177 62

Perforation, which occurs in seven to 10 patients per 100,000 population annually, complicates 5-10% of peptic ulcers. Crack cocaine has been associated with many gastrointestinal disorders, including ulcer perforation. Crack-related gastroduodenal perforations, typically prepyloric, have been on the rise in the last decade. Suggested mechanisms include ischemia, motility disorders, increased air swallowing, platelet-related thrombosis, and increased ACTH and corticosterone secretion. A 28-year-old man presented with vomiting and sudden generalized abdominal pain 3 h after smoking a "rock" (a 100-mg cube of crack). Physical examination revealed generalized guarding, and plain films showed free intraperitoneal air. Laparoscopy confirmed the diagnosis of generalized peritonitis secondary to a 5-mm perforation of the prepyloric anterior wall of the gastric antrum. Omentum-patched primary closure and thorough abdominal irrigation were undertaken. The postoperative course was uneventful. Omeprazole and anti-H. pylori treatment, including erythromycin and metronidazole, were maintained for 8 weeks and 1 week, respectively. Although drug addicts are not easily compliant with long-term medical treatment, in the particular case of crack addiction, the vasoconstrictive and dismotility effects of cocaine may precipitate gastric necrosis and paralysis, respectively, in the case of vagotomy. Although distal gastrectomy was the wisest choice when open ulcer surgery was adopted, the laparoscopic treatment of perforated ulcer, with either suture or sutureless techniques, has been found to be comparable to open surgery with regard to postoperative morbidity, reoperation rates, and mortality. The potential advantages of laparoscopy include the avoidance of large incisions, less attendant pulmonary morbidity, less wound infection, and possibly fewer postoperative adhesions.
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PMID:Crack cocaine-related prepyloric perforation treated laparoscopically. 1196 61

The literature on pediatric reflux can be divided into studies addressing clinically apparent reflux (vomiting or regurgitation) and reflux as measured by pH probe or other methods. Sodium alginate reduces vomiting and improves parents' assessment of symptoms (strength of recommendation [SOR]: B, small randomized controlled trial [RCT]). Formula thickened with rice cereal decreases the number of postprandial emesis episodes in infants with gastroesophageal reflux disease (GERD) (SOR: B, small RCT). There are conflicting data on the effect of carob bean gum as a formula thickener and its effect on regurgitation frequency (SOR: B, small RCTs). Metoclopramide does not affect vomiting or regurgitation, but is associated with greater weight gain in infants over 3 months with reflux (SOR: B, low-quality RCTs). Carob bean gum used as a formula thickener decreases reflux as measured by intraluminal impedance but not as measured by pH probe (SOR: B, RCT). Omeprazole and metoclopramide each improve the reflux index as measured by esophageal pH probe (SOR: B, RCT). Evidence is conflicting for other commonly used conservative measures (such as positional changes) or other medications for symptomatic relief of infant GERD. There is very limited evidence or expert opinion regarding breastfed infants, particularly with regard to preservation of breastfeeding during therapy.
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PMID:Clinical inquiries. What is the best treatment for gastroesophageal reflux and vomiting in infants? 1583 33

We report a case of a 25-year-old woman, gravida II, Para I, in pregnancy week 26 + 4 with severe polyhydramnios. The amniotic fluid index was about 39. Type 2 scanning showed a large urinary bladder only. Treated in pregnancy with repeated aminodrinage, total 21 litres. In week 33 + 5, a Caesarean section was performed. A girl with Apgar score 10/1, 0/10 was born, weight 1,804 grammes. Immediately after birth the child developed polyuria with diuresis, about 8-10 ml/kg/hour, electrolyte disturbance, and vomiting, treated with Losec, Gaviscon, indometacin, and Vioxx. The diagnosis was Bartter syndrome.
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PMID:[Bartter syndrome--a rare cause of severe polyhydramnios]. 1732 61

A 55-year-old male patient was hospitalized with severe nausea, vomiting and icterus. Laboratory testing showed hepatocellular damage. After exhaustive testing, the exclusion diagnosis of a toxic hepatitis was reached. There was a strong temporal correlation with the ingestion of Hong Hua 29, a preparation from Traditional Chinese Medicine (TCM). This medication had been started twelve days prior to the first appearance of symptoms. The existing drug regimen included gabapentin (Neurontin), esomeprazole (Nexium) and prednisone (Prednison Streuli) for the therapy of an acute sensory and motor neuropathy of unknown aetiology. After cessation of Hong Hua 29, gabapentin and esomeprazole, transaminase levels started to declined and normalized within three months. According to the Swissmedic criteria of imputability, a causal correlation between the observed symptoms and the administration of Hong Hua 29 is possible.
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PMID:[Drug-induced toxic hepatitis]. 1854 5


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