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)

The safety/tolerance of anisoylated plasminogen streptokinase activator complex (APSAC) versus heparin therapy in acute myocardial infarction has been studied in the first 65 patients treated in a multicentre study. A transient marked hypotensive effect was observed in 2 patients on APSAC given over 2 minutes. Primary ventricular arrhythmias during the first 4 hours after treatment occurred in 16 APSAC-treated patients and in 7 patients who received heparin; in 88% of the cases on APSAC these arrhythmias were reported by the investigators as being associated with reperfusion. Vomiting, shivering and fever were reported transiently in 2 APSAC-treated patients. Bleeding occurred in 7 patients in the APSAC group; none of these required transfusions, but the heparin dosage was adjusted in 1 patient. A reduction of blood haemoglobin was observed in 4 APSAC- and 2 heparin-treated patients; these were possibly drug-related. Three patients on APSAC died, while in the heparin group 4 deaths were reported.
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PMID:Preliminary safety and tolerance data obtained in the comparative study of anisoylated plasminogen streptokinase activator complex versus heparin. 331 11

Clinical investigation was carried out into the coagulation and fibrinolytic systems in a series of patients undergoing intraamniotic instillation of dinoprost tromethamine (prostaglandin F2alpha, or PGF2alpha) for 2nd-trimester abortion. 20 healthy women, aged 14-27 years, were studied. The 1st 8 patients received PGF2alpha, 30 mg at hour 0 and 25 mg at hour 6 and again at hour 24 if needed. The last 12 patients received 30 mg at hour 0, and 25 mg at hour 8, 24, and 32 if necessary. The PGF2alpha used did not contain sodium chloride. 18 of the patients aborted in an average of 16 hours and 7 minutes; 2 required additional procedures. Some vomiting and 1 instance of fever but no other significant side effects were noted. Coagulation studies in these patients were normal. The prothrombin time, thrombin time, euglobulin lysis time, and plasminogen levels were normal and unchanged from the control blood value. Plasma fibrinogen concentration increased slightly 6 hours after the initial infusion of PGF2alpha. Red blood cell fragmentation was not observed at any time during labor, delivery, or the postpartum period. The increased white blood count was statistically significant but without clinical significance. Previous studies have shown that use of saline solution to achieve abortion causes alterations in the coagulation and fibrinolytic systems. This study with PGF2alpha showed no such effects.
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PMID:Abortion and coagulation by prostaglandin. Intra-amniotic dinoprost tromethamine effect on the coagulation and fibrinolytic systems. 474 Jun 10

The case of a 26 year old woman who had been taking tranexamic acid to prevent uterine bleeding due to an IUD and who died from thrombosis of the left internal carotid artery is reported. The patient's father had died at age 54 of myocardial infarction. Otherwise the family history was entirely negative for thromboembolic disease. The patient was a mild smoker. She had been previously healthy and in particular, she was not affected with hypertension, diabetes, or dyslipidemia. She had carried to term 2 uncomplicated pregnancies. 40 days prior to hospital admission her gynecologist had inserted an IUD. The insertion of the IUD was followed by persistent uterine bleeding, and for this reason she began treatment with tranexamic acid (1.5 g/daily). Uterine bleeding persisted despite this treatment, and the IUD was removed. Because of persistence of a mild uterine bleeding, tranexamic acid was continued. 2 hours before admission the patient suddenly presented a left sided hemiparesis with disarthria and vomiting. On admission she was stuporous. The left side of her face drooped and the strength of the left arm and leg was markedly decreased. Both arm and leg reflexes were symmetrical. Her blood pressure was 110/70. An electroencephalogram on arrival confirmed a right sided cerebral lesion. Subsequently the patient's condition deteriorated rapidly. She developed a full left hemiplegia and became deeply comatose. A CAT scan performed 4 hours after admission showed no abnormalities. A CAT scan performed 3 days after admission showed a large cerebral infarction involving nearly the whole right cerebral hemisphere. The patient's condition remained essentially unchanged until she died 6 days after admission. Permission for autopsy was refused. Antifibrinolytic drugs competitively inhibit plasminogen activators and noncompetitively plasmin. Thromboembolic complications after the administration of antifibrinolytic drugs have long been recognized. The use of IUDs is often associated with troublesome uterine bleeding and particularly excessive menstrual bleeding. To avoid these complaints, antifibrinolytic drugs are increasingly used.
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PMID:Tranexamic acid, intrauterine contraceptive devices and fatal cerebral arterial thrombosis. Case report. 710 62

Tranexamic acid (Transamin), Cyklokapron, Exacyl, Cyklo-f) is a synthetic lysine derivative that exerts its antifibrinolytic effect by reversibly blocking lysine binding sites on plasminogen and thus preventing fibrin degradation. In a number of small clinical studies in women with idiopathic menorrhagia, tranexamic acid 2-4.5 g/day for 4-7 days reduced menstrual blood loss by 34-59% over 2-3 cycles, significantly more so than placebo, mefenamic acid, flurbiprofen, etamsylate and oral luteal phase norethisterone at clinically relevant dosages. Intrauterine administration of levonorgestrel 20 microg/day, however, produced the greatest reduction (96% after 12 months) in blood loss; 44% of patients treated with levonorgestrel developed amenorrhoea. Tranexamic acid 1.5 g three times daily for 5 days also significantly reduced menstrual blood loss in women with intrauterine contraceptive device-associated menorrhagia compared with diclofenac sodium (150 mg in three divided doses on day 1 followed by 25 mg three times daily on days 2-5) or placebo. Tranexamic acid, mefenamic acid, etamsylate, flurbiprofen or diclofenac sodium had no effect on the duration of menses in the studies that reported such data. In a large noncomparative, nonblind, quality-of-life study, 81% of women were satisfied with tranexamic acid 3-6 g/day for 3-4 days/cycle for three cycles, and 94% judged their menstrual blood loss to be 'decreased' or 'strongly decreased' compared with untreated menstruations. The most commonly reported drug-related adverse events are gastrointestinal in nature. The total incidence of nausea, vomiting, diarrhoea and dyspepsia in a double-blind study was 12% in patients who received tranexamic acid 1g four times daily for 4 days for two cycles (not significantly different to the incidence in placebo recipients). In conclusion, the oral antifibrinolytic drug tranexamic acid is an effective and well tolerated treatment for idiopathic menorrhagia. In clinical trials, tranexamic acid was more effective at reducing menstrual blood loss than mefenamic acid, flurbiprofen, etamsylate and oral luteal phase norethisterone. Although it was not as effective as intrauterine administration of levonorgestrel, the high incidence of amenorrhoea and adverse events such as intermenstrual bleeding resulting from such treatment may be unacceptable to some patients. Comparative studies of tranexamic acid with epsilon - aminocaproic acid, danazol and combined oral contraceptives, as well as long-term tolerability studies, would help to further define the place of the drug in the treatment of menorrhagia. Nevertheless, tranexamic acid may be considered as a first-line treatment for the initial management of idiopathic menorrhagia, especially for patients in whom hormonal treatment is either not recommended or not wanted.
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PMID:Tranexamic acid: a review of its use in the management of menorrhagia. 1282 66

A 1-year-old-female Yorkshire Terrier was referred to the Veterinary Teaching Hospital of the Autonomous University of Barcelona (VTH-UAB) (Spain) with a 6-month history of unilateral chronic proliferative conjunctivitis and intermittent vomiting and cough. Several medical and surgical treatment efforts to manage conjunctival lesions had resulted in no improvement of the clinical signs. Complete general and ophthalmic examinations revealed several proliferative 'wood-like' masses in the conjunctiva, oral cavity and an interscapular subcutaneous nodule. Conjunctival and buccal biopsies were performed as diagnostic procedures. A diagnosis of ligneous conjunctivitis was made on the basis of histopathology findings and clinical presentation. The only biochemical abnormalities found were severe proteinuria and low plasminogen activity in plasma. No other analytical abnormalities were observed. Topical treatment with heparin and anti-inflammatory and immunosuppressive drugs have controlled the ophthalmological clinical signs. To our knowledge, this is the first case report of a dog with plasminogen deficiency and ligneous conjunctivitis with a long survival period and 2-year follow-up.
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PMID:Ligneous conjunctivitis in a plasminogen-deficient dog: clinical management and 2-year follow-up. 1960 41