• Title/Summary/Keyword: Antiemetic

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Granisetron in the Treatment of Radiotherapy-Induced Nausea and Vomiting (방사선치료 중 오심 및 구토에 대한 그라니세트론의 효과)

  • Hong, Seong-Eon;Kang, Jin-O
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.141-145
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    • 1999
  • Purpose : Granisetron is a potent, the most selective 5-HT3 receptor antagonist and is reported to b effective in treatment of radiation-induced emesis. The antiemetic efficacy and safety of oral granisteron was evaluated in patients with receiving highly emetogenic treatment by conventional fractionated irradiation. Materials and Methods : Patients with various cancers who were being treated with irradiation were accrued into the present study. The intensity of nausea was evaluated on first 24 hours and on day-7 by patients according to the degree of interference with normal daily life as followings; a) none; b) present but no interference with normal daily life (mild): c) interference with normal daily life (moderate): and d) bedridden because of nausea (severe). Non or mild state was considered to indicate successful treatment. The efficacy of antiemetic treatment was graded as follows; a) complete response; no vomiting, no worse than mild nausea and receive no rescue antiemetic therapy over the 24h period, b) major response; either one episode of vomiting or moderate/severe nausea or had received rescue medication over 24h period, or any combination of these, c) minor response; two to four episodes of vomiting over the 24h period, regardless of nausea and rescue medication, d) failure; more than four medication. The score of the most symptom was recorded and the total score over 24 hours was summarized. The complete or major response was considered to indicate successful treatment. Results : A total of 10 patients were enrolled into this study, and all were assessable for efficacy analysis. Total nausea control was achieved in 90$\%$ (9/10:none=60$\%$ plus mild=30$\%$) of total patients after 7 days. The control of vomiting by granisteron was noted in seven patients (70$\%$) of complete response and three (30$\%$) of major response with a hundred-percent successful treatment over 7 days. The minor response or treatment failure were not observed. No significant adverse events or toxicities from granisetron were recorded in patient receiving granisetron. Conclusion : We concluded that granisetron is a highly effective antiemetic agent in controlling radiotherapy-induced nausea or vomiting with a minimal toxicity profile.

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Ethanol Detoxicant Composed of Pueraria thunbergiana and Alpinia katsumadai (갈화 및 초두구를 주재로 하는 알코올 해독제)

  • Park, Jeong-Sook;Kim, Gee-Young;Han, Kun
    • YAKHAK HOEJI
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    • v.50 no.5
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    • pp.308-312
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    • 2006
  • Alpinia katsumadai is used in traditional oriental medicine as an antiemetic and for treatment of stomach disorders. This study was to investigate the effect of the 50% methanol extract of Alpinia katsumadai and Puerariae thunbergiana on ethanol metabolism in rat. The administration of 50% methanol extract of Alpinia katsumadai significantly decrease the ethanol concentration in rat. The AUC and Cmax of Alpinia katsumadai was 3.1 and 2.4 times less than the control group, respectively. It was more effective than Pueraria thunbergiana is known to as ethanol detoxicant. Furthermore, we tested on its ethanol metabolizing effect with the preparation containing this herb (Haeju pill) in beagle. The AUC of Haeju pill was about 1.9 times less than the control group. It was estimated that the extract of Alpinia katsumadai had feasibility as a ethanol detoxication agent.

Acute Dystonia Induced by Epidural Droperidol -A case report- (경막외강으로 Droperidol을 투여한 후 발생한 불수의 근수축 -증례 보고-)

  • Chae, Yoon-Jeong;Yoon, Kyung-Bong;Lim, Jae-Woo;Choi, Jae-Chan;Lee, Young-Bok
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.255-258
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    • 2000
  • Epidural morphine is effective in the treatment of postoperative pain, but side effects, such as nausea, vomiting, pruritus and urinary retention commonly occur. Droperidol is frequently used as an antiemetic to prevent intraoperative and postoperative vomiting. But it has been reported to cause acute extrapyramidal effects including dystonia. We report one case of acute dystonia in young adult following the use of epidural droperidol.

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Systematic review of the effect of dried ginger powder on improvement of nausea and vomiting associated with early pregnancy or motion sickness (생강 건조 분말의 임신 및 멀미에 의한 오심, 구토 개선 기능성에 대한 체계적 고찰)

  • Kwak, Jin Sook;Paek, Ju Eun;Jeong, Sewon;Kim, Joohee;Kim, Ji Yeon;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.47 no.1
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    • pp.45-50
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    • 2014
  • Purpose: Ginger (Zingiber officinale) has been widely used as an antiemetic agent. This systematic review was aimed at evaluation of the effect of dried ginger powder supplementation on improvement of nausea and vomiting associated with early pregnancy or motion sickness. Methods: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) using keywords such as ginger or Zingiber officinale in combination with nausea, vomiting, motion sickness, or pregnancy, published in March 2013. Results: The strength of the evidence was evaluated on the selected 12 RCTs (randomized controlled trials). Eleven trials including 2,630 subjects showed that supplementation with dried ginger powder resulted in significant improvement of nausea or vomiting related to early pregnancy or motion sickness. Among the nine studies including 809 women in early pregnancy before 20 weeks of gestation, ginger supplementation was superior to placebo in five studies (n = 305), and as effective as positive control (vitamin $B_6$ or dimenhydrinate) in four studies (n = 504). Ginger intake significantly reduced the episodes or severity of vomiting related to motion sickness compared to placebo or showed the same effect as several antiemetic drugs in two studies (n = 1,821). Conclusion: Our findings added evidence indicating that ginger powder supplements might improve the symptoms of nausea or vomiting related to early pregnancy or motion sickness without significant adverse events.

Evaluation of the Efficacy of Methylprednisolone, Etoricoxib and a Combination of the Two Substances to Attenuate Postoperative Pain and PONV in Patients Undergoing Laparoscopic Cholecystectomy: A Prospective, Randomized, Placebo-controlled Trial

  • Gautam, Sujeet;Agarwal, Amita;Das, Pravin Kumar;Agarwal, Anil;Kumar, Sanjay;Khuba, Sandeep
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.278-284
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    • 2014
  • Background: Establishment of laparoscopic cholecystectomy as an outpatient procedure has accentuated the clinical importance of reducing early postoperative pain, as well as postoperative nausea and vomiting (PONV). We therefore planned to evaluate the role of a multimodal approach in attenuating these problems. Methods: One hundred and twenty adult patients of ASA physical status I and II and undergoing elective laparoscopic cholecystectomy were included in this prospective, randomized, placebo-controlled study. Patients were divided into four groups of 30 each to receive methylprednisolone 125 mg intravenously or etoricoxib 120 mg orally or a combination of methylprednisolone 125 mg intravenously and etoricoxib 120 mg orally or a placebo 1 hr prior to surgery. Patients were observed for postoperative pain, fentanyl consumption, PONV, fatigue and sedation, and respiratory depression. Results were analyzed by the ANOVA, a Chi square test, the Mann Whitney U test and by Fisher's exact test. P values of less than 0.05 were considered to be significant. Results: Postoperative pain and fentanyl consumption were significantly reduced by methylprednisolone, etoricoxib and their combination when compared with placebo (P<0.05). The methylprednisolone + etoricoxib combination caused a significant reduction in postoperative pain and fentanyl consumption as compared to methylprednisolone or etoricoxib alone (P<0.05); however, there was no significant difference between the methylprednisolone and etoricoxib groups (P>0.05). The methylprednisolone and methylprednisolone + etoricoxib combination significantly reduced the incidence and severity of PONV and fatigue as well as the total number of patients requiring an antiemetic treatment compared to the placebo and etoricoxib (P<0.05). Conclusions: A preoperative single-dose administration of a combination of methylprednisolone and etoricoxib reduces postoperative pain along with fentanyl consumption, PONV, antiemetic requirements and fatigue more effectively than methylprednisolone or etoricoxib alone or a placebo.

Comparison of Sugammadex and Neostigmine on First Spontaneous Breathing and Adverse Effects for Laparoscopic Cholecystectomy (Laparoscopic Cholecystectomy 수술 후 Sugammadex와 Neostigmine 간에 첫 자발호흡과 부작용 발현 연구)

  • Park, HyunSuk;Park, Moon Soo;Kim, Min Jung;Kim, Kwi Suk;Cho, Yoon Sook;Bae, Seng Sim;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.2
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    • pp.101-106
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    • 2018
  • Objective: The purpose of the study was to investigate the time from the injection of muscle relaxants to the first spontaneous respiration between sugammadex and conventional reversal for patients undergoing laparoscopic cholecystectomy. Methods: This study was retrospectively conducted on patients who were diagnosed with gallbladder stone (N802) between January 2014 and April 2017. The data were collected from the electronic medical records of a total of 186 patients (84 patients in the neostigmine group and 102 patients in the sugammadex group). Results: The time required for the first spontaneous respiration in the sugammadex group was shorter than that in the neostigmine group (3.6 min vs 4.9 min; p<0.05). After the injection of intermediate muscle relaxants, the comparison of heart rate and mean arterial pressure in the sugammadex and neostigmine groups revealed that the heart rate in the neostigmine group was higher than in the sugammadex group after 5 min (p<0.05). The mean arterial pressure in the neostigmine group was higher than in the sugammadex group after 10 min (p<0.05). A significant adverse effect of tachycardia was observed in the neostigmine group (p<0.05), but the frequency of rescue antiemetic in the sugammadex group was significantly higher than in the neostigmine group (p<0.05). Conclusion: In this study, the unwanted effect of neostigmine group was tachycardia; therefore, in the case of patients with hemodynamic instability, sugammadex is recommended. At 12 hours after the injection of sugammadex to patients, more antiemetics were required than in the neostigmine group; therefore, more research should be conducted on postoperative nausea and vomiting.

Association of Pre- and Perinatal Risk Factors With Tourette Syndrome or Chronic Tic Disorders in a Korean School-Age Population

  • Wooseok Choi;Soon-beom Hong;Johanna Inhynag Kim;Jung Lee;Soomin Jang;Yebin D Ahn;You Bin Lim;Sumin Kim;Mee Rim Oh;Bung-Nyun Kim
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.1
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    • pp.37-44
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    • 2023
  • Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.

Evaluation of Scopolamine Patch Pharmacotherapy for Motion Sickness in S. Korean

  • Lim, Sung-Cil;Lee, Myung-Koo;Lee, Chong-Kil;Lee, Bo-Reum
    • Biomolecules & Therapeutics
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    • v.16 no.2
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    • pp.161-167
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    • 2008
  • Scopolamine patch is an effective anticholinergic and antiemetic agent for motion sickness in S. Korea. Since this medication is Over The Counter (OTC) medication and may cause serious side effects when misused. Therefore, we evaluate the safety and efficacy for scopolamine patch in this study. We selected and surveyed total 43 patients who purchased scopolamine patch from three different pharmacies located at S and C Express Bus terminals and P Port at Seoul, Cheongju, and Busan. In the result, 11 patients (8${\sim}$15 year old:25.6%) were correctly used scopolamine patch with a children dose and 2 patients were misused. 26 (15${\sim}$60 year old: 60.4%) and 4 (over 6o year old: 9.3%) patients were correctly used with a adult dose. 33 patients (69.9%)answered that they knew the directions well how to use scopolamine patch correctly. Only 24.2% (n=8) patients learned the directions by pharmacist's consultation. Most patients (45 frequencies with duplicate counts) had some experienced side effects and among those drowsiness is the most common one. In conclusion, scopolamine patch as a non-prescription drug (OTC) should be monitored by pharmacist with correct drug consultation.

Acupuncture Clinical Trial Study for Prevention of Postoperative Nausea and Vomiting in Children (소아의 수술 후 오심 및 구토에 대한 침술치료 임상연구 고찰)

  • Chang, Gyu-Tae;Kim, Jang-Hyun;Choi, Eun-Young
    • The Journal of Pediatrics of Korean Medicine
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    • v.19 no.1
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    • pp.173-183
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    • 2005
  • Background and objective : Postoperative nausea and vomiting(PONV) are frequent complications of general anesthesia in children. High cost and associated side effects of antiemetic drugs, have increased interest in nonpharmacological methods for treatment of PONV. The aim of this study was to report the effect of acupuncture for prevention of PONV in children. Material and Method : Randomized clinical trials retrieved by a search of articles indexed on the Medline and NDSL database. Key words to search were 'PONV', 'POV', 'acupuncture', 'children', 'pediatric'. Results : Eleven articles were selected and six of them showed significant effectiveness of acupuncture in preventing PONV in children. Acupuncture methods were needle acupuncture acupressure, electro-acupuncture, laser acupuncture, acupuncture point injection. The main acupuncture point was P6(Neiguan). Conclusion : The effectiveness of acupuncture for prevention of PONV in children has been shown in some, but not all trials. Further studies are needed.

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Prevention of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients

  • Shankar, Abhishek;Roy, Shubham;Malik, Abhidha;Julka, PK;Rath, GK
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6207-6213
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    • 2015
  • The supportive care of patients receiving antineoplastic treatment has dramatically improved over the past few years and development of effective measures to prevent nausea and vomiting after chemotherapy serves as one of the most important examples of this progress. A patient who starts cancer treatment with chemotherapy lists chemotherapy-induced nausea and vomiting as among their greatest fears. Inadequately controlled emesis impairs functional activity and quality of life, increases the use of health care resources, and may occasionally compromise adherence to treatment. New insights into the pathophysiology of chemotherapy-induced nausea and vomiting, a better understanding of the risk factors for these effects, and the availability of new antiemetic agents have all contributed to substantial improvements in emetic control. This review focuses on current understanding of chemotherapy-induced nausea and vomiting and the status of pharmacological interventions for their prevention and treatment.