Antiemetics nausea/vomiting

Meclizine is an oral antiemetic used to treat nausea, vomiting, and dizziness associated with motion sickness. Compound 26, synthesized by our route, was spectroscopically identical with a commercially obtained sample (Sigma). 

Black horehound has antiemetic, sedative, and mild astringent properties. Traditionally, it is used for nausea, vomiting, nervous dyspepsia, and specifically for vomiting of central origin. 

The adverse effects of aldesleukin include fever, chills, malaise, skin rash, nausea, vomiting (often resistant to antiemetics), diarrhea, fluid retention, myalgia, insomnia, disorientation, life-threatening hypotension, and the capillary leak syndrome (which can be preceded by weight gain) (SEDA-15, 491) (2). 

In a randomized, placebo-controlled study, the addition of an intravenous bolus of dexamethasone 150 micro-grams/kg with a PCA system programmed to deliver tramadol 20 mg in a 1 ml solution on demand in 50 patients after major abdominal surgery significantly reduced the incidence of nausea, vomiting, and subsequent administration of rescue antiemetic therapy (27). 

A number of the antihistamines, particularly the phenothi-azines and aminoalkyl ethers, have antiemetic actions and thus may be u.seful in the treatment of nausea, vomiting, and motion sickness. Also, those agents that produce pronounced. sedation have application as nonpiescription sleeping aids." - "Several of the phenothiazines have limited u.se in Parkinson-like syndromes as a result of their ability to block central muscarinic receptors." -And. a number of antihistamines, including promethazine, pyrilamine. tri-pelennamine and diphenhydramine, display local anesthetic activity that may be therapeutically useful. ... 

There have been few reported complications from WBI therapy, especially pertaining to acute poisonings. Nausea, vomiting, abdominal cramps, and bloating have been described. Nausea and vomiting may make administration of WBI difficult. Antiemetics and a 15-30 min break followed by a slower rate may allow readministration. As discussed with the other methods of decontamination, attention should be directed to the airway and the potential for aspiration. Administration of a large amount of chilled or room temperature WBI fluid to pediatric patients could potentially cause hypothermia. Warmed fluid should be considered in these patients. 

Cyclimorph cyclizlne tartrate morphine tartrate, cyclizine [ban, inn) (cyclizIne hydrochloride (usan) cyclizlne tartrate BW 47-83 Valoid ) is one of the piperazine series of histamine H -receptor ANTAGONISTS, and a muscarinic CHOLINOCEPTOR antagonist with SEDATIVE actions. It can be used orally or systemically as an antiemetic in the treatment of nausea, vomiting, vertigo, motion sickness and disorders of the balance function of the inner ear. It is available in preparation together with morphine (e.g. Cyclimorph ). 

Use Provides symptomatic relief of allergic symptoms sedative/ antiemetic in surgery/labor decreases postop nausea/ vomiting adjunct to analgesics in control of pain management of motion sickness. Half-life UK minutes IM 20 minutes Rectal 20 minutes IV 3-5 minutes Onset PO 20 Peaks Duration 1-4 hours PO/IM Rectal/TV 2-8 hours... 

The efficacy of any of the regimens for EC declines if they begin more than 72 hours after intercourse. Treatment is totally ineffective by 7 days, when implantation usually occurs. Patients may experience nausea, vomiting, and breast tenderness with this regimen. Although some clinicians prescribe antiemetics prophylactically, others recommend simply repeating the dose if the patient vomits within an hour of taking the pills. 

Buclizine (50 mg p.o. 30 minutes prior to travel) is a centrally acting antiemetic agent used for the control of the nausea, vomiting, and dizziness of motion sickness. Buclizine depresses conduction in vestibular-cerebellar pathways and hence reduces labyrinth excitability (antivertigo action), and it inhibits the chemotrigger zone for emesis (antiemetic action) (see also Figures 73 and 81). 

Meclizine (25 to 50 mg 1 hour prior to travel) is indicated in prevention and treatment of nausea, vomiting, and dizziness of motion sickness. Meclizine has antiemetic, anticholinergic, and antihistaminic properties. It reduces the sensitivity of the labyrinthine apparatus. The action may be mediated through neuronal pathways to the vomiting center (VC), from the chemoreceptor trigger zone (CTZ), peripheral nerve pathways, or other CNS centers (see also Figure 73). 

Antihistamine antiemetics such as diphenhydiinate (Dramamine), meclizine hydrochloride (Antivert), and diphenhydramine hydrochloride (Benadryl) are over-the-counter medications that prevent nausea, vomiting, and dizziness (vertigo) caused by motion by inhibiting stimulation in the middle ear. They also cause drowsiness, dryness of the mouth, and constipation. 

The initial nausea and vomiting are rarely severe and can usually be relieved with atropine or common antiemetics. Later vomiting and diarrhea are usually indicative of systemic cytotoxicity and require fluid replacement. 

In a comparison of oral sustained-release morphine (mean 94 mg/day) and hydromor-phone (138 or 206 mg/day) with regard to nausea, vomiting, and constipation, in patients receiving opioids for cancer pain, morphine provided better pain relief at lower doses (after accounting for dose conversion) but was associated with more nausea, constipation, and higher consumption of antiemetic and gastroprotective drugs [104 ]. 

Dronabinol (tetrahydrocannabinol), the active principle from cannabis and synthetic cannabinoids, nabilone and levonantradol are effective in treating nausea and vomiting in cancer chemotherapy. The mode of action is unclear but appears to involve cannabinoid CBi receptors. Cannabinoids have been shown to reduce acetylcholine release in the cortex and hippocampus, and have been suggested to inhibit medullary activity by a cortical action. Inhibition of prostaglandin synthesis and release of endorphins may also be involved in the antiemetic effect. A review of trials of dronabinol, nabilone or levonantradol concluded that while the cannabinoids were superior to placebo or dopamine receptor antagonists in controlling emesis... 

It is important to note diat antivertigo dragp are essentially antiemetics because many of these preparations, whedier used for motion sickness or vertigo, also have direct or indirect antiemetic properties. They prevent the nausea and vomiting diat occur because of stimulation of die vestibular apparatus in the ear. Stimulation of diis apparatus results in vertigo, which is often followed by nausea and vomiting. 

Antiemetic—to lessen the incidence of nausea and vomiting during the immediate postoperative recovery period. 

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