• Title/Summary/Keyword: antiemetic

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Effect of Evidence-based Clinical Practice Guidelines for Promotion of Postoperative Nausea and Vomiting of Patients with Laparoscopic Hysterectomy (복강경 수술 환자의 수술 후 오심과 구토 관리를 위한 근거중심 실무 가이드라인 적용 효과)

  • Lee, Sung-Hee;Hong, Sung-Jung;Kim, Hwa Sun;Jeon, Younghoon
    • Korean Journal of Adult Nursing
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    • v.27 no.5
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    • pp.481-492
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    • 2015
  • Purpose: The purpose of this study was to examine the effects of the evidence-based clinical practice guidelines on Postoperative Nausea and Vomiting (PONV). Methods: The research design was a non-equivalent control group with a non-synchronized design. The participants were the patients undergoing gynecologic laparoscopy. Data were collected from July, 2014 through January, 2015. The participants in the experimental group (n=35) received an assessment of risk factors of PONV, aroma therapy, and P6 acupressure method as recommended in the guidelines. Those in the control group (n=35) received usual nursing care. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test using SPSS/WIN 19.0 program. Results: The occurrence of nausea and vomiting, the level of nausea and vomiting, and the need for antiemetic medicine in the experimental group were significantly less than those in the control group after surgery. The levels of postoperative pain and the amounts of time for nursing activities in the experimental group were significantly reduced than those in the control group after surgery. The levels of satisfaction were significantly higher in the experiment group than that of the control group. Conclusion: The evidence-based guidelines is recommended for nursing practice as a guidance for managing PONV and helping the recovery of patients after laparoscopic surgery.

5-Lipoxygenase Inhibition of the Fructus of Foeniculum vulgare and Its Constituents

  • Lee, Je-Hyeong;Lee, Dong-Ung;Kim, Yeong-Shik;Kim, Hyun-Pyo
    • Biomolecules & Therapeutics
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    • v.20 no.1
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    • pp.113-117
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    • 2012
  • The fruits of Foeniculum vulgare (Foeniculi Fructus) have been widely used in Chinese medicine as an antiemetic, ameliorating stomach ailments and as an analgesic. In order to establish its potential for antiallergic use, inhibitory actions of the fruit on 5-lipoxgenase (5-LOX) and ${\beta}$-hexosaminidase release were evaluated. The 70% ethanol extract of this plant material (FR) considerably inhibited 5-LOX-catalyzed leukotriene production from A23187-induced rat basophilic leukemia (RBL)-1 cells. The $IC_{50}$ was $3.2{\mu}g/ml$. From this extract, 12 major compounds including sabinene, fenchone, ${\gamma}$-terpinene, ${\alpha}$-pinene, limonene, p-anisylacetone, panisylaldehyde, estragole (4-allylanisole), trans-anethole, scopoletin, bergapten and umbelliferone were isolated. And it was found that several terpene derivatives including ${\gamma}$-terpinene and fenchone as well as phenylpropanoid, trans-anethole, showed considerable inhibitory action of 5-LOX. In particular, the $IC_{50}$ of trans-anethole was $51.6{\mu}M$. In contrast, FR and the isolated compounds did not show considerable inhibitory activity on the degranulation reaction of ${\beta}$-hexosaminidase release from antigen-treated RBL-2H3 cells. Against arachidonic acid-induced ear edema in mice, FR and trans-anethole showed significant inhibition by oral administration at doses of 100-400 mg/kg. In conclusion, FR and several major constituents are 5-LOX inhibitors and they may have potential for treating 5-LOX-related disorders.

The Effect of Aprepitant Regimen on the Prevention of High-Dose Cisplatin-Induced Nausea and Vomiting (Aprepitant Regimen의 고용량 Cisplatin 유발 오심 및 구토 예방 효과)

  • Park, Su-Jin;Choi, Ji-Seon;Ahn, Jin-Seok;Shin, Ka-Young;Min, Kyoung-A;Chung, Seon-Young;In, Yong-Won;Sohn, Kie-Ho
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.1
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    • pp.17-23
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    • 2010
  • Aprepitant is a substance P/neurokinin-1 (NK1)-receptor antagonist that was approved in 2003 for prevention of CINV. In addition, updated anti-emetic guidelines that include the aprepitant regimen have been published by NCCN and ASCO. However there is scarce clinical data in Korea. The prospective study was performed to evaluate the prevention of high dose cisplatin induced nausea and vomiting in all patients who started high-dose cisplatin-based chemotherapy at our hospital. We checked the nausea severity and vomiting episodes by calling patients within 4 to 5 days after chemotherapy. The retrospective study was performed to compare the prevention of CINV in solid tumor patients who switched their anti-emesis regimen from the standard regimen to the aprepitant regimen. In aprepitant regimen, aprepitant was added to the same anti-emetic regimen used during previous cycles. We checked the nausea, vomiting grades and adverse events in electronic medical records (EMR). In prospective study, 195 patients were included in the analysis. 88.2% of patients achieved a complete response (no emesis and no rescue therapy). In retrospective study, 54 patients were reviewed. With aprepitant regimen, nausea and vomiting grades were improved in 22 patients (40.7%) and in 9 patients (16.7%), respectively. Compared with standard regimen, addition of aprepitant provided superior prevention against CINV in Korean patients receiving highly emetogenic cisplatin-based chemotherapy. Moreover, aprepitant significantly prevented CINV in patients who received the standard regimen to prevent CINV in previous chemotherapy cycles.

Management of Acute Gastroenteritis in Children: A Survey among Members of the Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition

  • Seo, Ji-Hyun;Shim, Jung Ok;Choe, Byung-Ho;Moon, Jin Su;Kang, Ki-Soo;Chung, Ju-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.5
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    • pp.431-440
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    • 2019
  • Purpose: No national survey has yet described the guidelines followed by Korean pediatricians to treat acute gastroenteritis (AGE). An online survey was performed to investigate the management of AGE followed by members of The Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and the results were compared between pediatric gastroenterologists (PG) and general pediatricians (GP). Methods: Questionnaires were sent to pediatricians between June 2 and 4, 2018 regarding the type of hospital, indications for admission, antiemetic and antidiarrheal drugs and antibiotics prescribed, and dietary changes advised. Results: Among the 400 pediatricians approached, 141 pediatricians (35.3%) responded to the survey. PG comprised 39% of the respondents and 72.7% worked at a tertiary hospital. Both PG and GP considered diarrhea or vomiting to be the primary symptom. The most common indication for hospitalization was severe dehydration (98.8%). Most pediatricians managed dehydration with intravenous fluid infusions (PG 98.2%, GP 92.9%). Antiemetics were prescribed by 87.3% of PG and 96.6% of GP. Probiotics to manage diarrhea were prescribed by 89.1% of PG and 100.0% of GP. Antibiotics were used in children with blood in diarrheal stool or high fever. Dietary changes were more commonly recommended by GP (59.3%) than by PG (27.3%) (p<0.05). Tests to identify etiological agents were performed primarily in hospitalized children. Conclusion: This survey assessing the management of pediatric AGE showed that the indications for admission and rehydration were similar between GP and PG. Drug prescriptions for diarrhea and dietary changes were slightly commonly recommended by GP than by PG.

The analgesic efficacy of the continuous adductor canal block compared to continuous intravenous fentanyl infusion with a single-shot adductor canal block in total knee arthroplasty: a randomized controlled trial

  • Kim, Min Kyoung;Moon, Hyoung Yong;Ryu, Choon Gun;Kang, Hyun;Lee, Han Jun;Shin, Hwa Yong
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.30-38
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    • 2019
  • Background: The adductor canal block (ACB) is an effective intervention for postoperative analgesia following total knee arthroplasty (TKA). However, the ideal ACB regimen has not yet been established. We compared the analgesic effects between a continuous ACB group and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) with a single-shot ACB group. Methods: Patients who underwent TKA were randomly allocated to either a continuous ACB group (Group CACB) or IV-PCA with a single-shot ACB group (Group IVACB). Before the surgery, ultrasound guided ACB with 0.5% ropivacaine 20 cc was provided to all patients. Before skin incision, the infusion system (0.2% ropivacaine through an adductor canal catheter in group CACB vs. intravenous fentanyl in group IVACB) was connected. The postoperative pain severity; the side effects of local anesthetics and opioids; administration of rescue analgesics and anti-emetics; and sensorimotor deficits were measured. Results: Postoperative pain severity was significantly higher in the IVACB group at 30 min, 4 h, 24 h, and 48 h after surgery. The averages and standard deviations (SD) of the NRS score of postoperative pain were $0.14{\pm}0.37$, $4.57{\pm}2.37$, $6.00{\pm}1.63$, and $4.28{\pm}1.49$, respectively in the IVACB group. Rescue analgesic requirements and quadriceps muscle strength were not statistically different between the groups throughout the postoperative period. Moreover, rescue antiemetic requirements were higher in group IVACB than group CACB. Conclusions: In this study, the continuous ACB provided superior analgesia and fewer side effects without any significant motor deficit than the IV-PCA with a single-shot ACB.

Clinical and inflammatory response to antiviral treatments in dogs with parvoviral enteritis

  • Nergis Ulas;Yunusemre Ozkanlar;Seckin Ozkanlar;Mehmet Ozkan Timurkan;Hakan Aydin
    • Journal of Veterinary Science
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    • v.25 no.1
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    • pp.11.1-11.16
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    • 2024
  • Background: Canine parvoviral enteritis (CPE) is a fatal disease worldwide. The treatment of CPE is based mainly on supportive and symptomatic treatment. Antiviral addition to the treatment may result in a higher survival. Objectives: This study evaluated the effects of antiviral treatments with a standardized treatment (ST) on the clinical and inflammatory response of dogs with naturally occurring CPE. Methods: Twenty-eight dogs with CPE caused by canine parvovirus type 2 were divided randomly into treatment groups. The ST group received fluid, antibiotic, antiemetic, and deworming treatments. The antiviral treatment groups received the same ST with an additional antiviral drug, recombinant feline interferon omega (rFeIFN-ω), oseltamivir (OSEL) or famciclovir (FAM). Results: Compared to the healthy control, the tumor necrosis factor-α, interleukin-1β, interferon (IFN)-α, IFN-γ, haptoglobin, and C-reactive protein values were high (p < 0.05) on day zero. At presentation, mild lymphopenia, neutropenia, and a high neutrophil to lymphocyte (LYM) ratio (NLR) were also observed. Adding rFeIFN-ω to the ST produced the best improvement in the clinical score with a decreased NLR, while leucocytes remained low and inflammatory markers stayed high on day three. The survival rates of the groups were 85.7% in ST+IFN, 71.4% in ST+OSEL, 71.4% in ST+FAM, and 57.1% in ST groups on day seven. Conclusions: Antiviral drugs may be valuable in treating CPE to improve the clinical signs and survival. In addition, the decrease in NLR in favor of LYM may be an indicator of the early prognosis before the improvement of leukocytes, cytokines, and acute phase proteins in CPE.

Antiemetic Effect of Dexamethasone in Dogs Sedated with Xylazine (Xylazine hydrochloride로 진정시킨 개에 대한 Dexamethasone의 항구토 효과)

  • Yang Jung-hoon;Kang Han-sem;Bae Jae-sung;Song Chang-hyun;Kim Jung-eun;Jin Hee-kyung;Jang Kwang-ho
    • Journal of Veterinary Clinics
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    • v.22 no.2
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    • pp.94-99
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    • 2005
  • This prospective study aimed to assess the efficacy of dexamethasone to prevent xylazine induced emesis in dogs. The antiemetic effect of graded, single high-dose intravenous dexamethasone against xylazine hydrochloride was studied. Clinically healthy mixed breed dogs that weighed $ 4.64\pm1.25kg$ were used in this study. Food and water were given 3 hours before the experiment. Venous blood specimens were collected from all experimental animals for hema-tological and blood chemical test pre- and post-experiment. Twenty-eight experimental animals were randomly divided into 4 groups; the group treated with 0.2ml/kg of normal saline (Control group), the groups treated with 1mg/kg (D1 group), 2mg/kg (D2 group) and 4 mg/kg of dexamethasone (D4 group). Three doses of the dexamethasone or normal saline was administered intravenousely to each group and after 5 minutes, xylazine (2.2 mg/kg) was administered intramuscularly. The time until onset of the first emetic episode and rate of emesis were investigated. At the same time, the extent of sedation was scored subjectively 5, 15, 30 and 60 minutes after injection of xylazine hydrochloride using Visual Sedation Score. The time until onset of the first emetic episode was $203.25\pm11.35$ sec in Control group, $187.33\pm48.0l$ sec in D1 group and 218.33± 13.58 sec in D2 group. The rate of xylazine induced emesis were $57\%$ in Control group and $43\%$ in D1 and D2 group respectively. On the other hand, any emetic episodes were not observed in 04 group. At extent of sedation score, all experimental animals especially including the animals in D1 group were highly sedated at 15 minutes after administration of xylazine hydrochloride. Hematological and blood chemical values showed normal ranges pre- and post-experiment. We concluded that prior treatment with 4 mg/kg of dexamethasone hardly caused xylazine-induced emesis without disturbing the sedative effect of xylazine in dogs.

Efficacy of Ginger in Control of Chemotherapy Induced Nausea and Vomiting in Breast Cancer Patients Receiving Doxorubicin-Based Chemotherapy

  • Ansari, Mansour;Porouhan, Pezhman;Mohammadianpanah, Mohammad;Omidvari, Shapour;Mosalaei, Ahmad;Ahmadloo, Niloofar;Nasrollahi, Hamid;Hamedi, Seyed Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3877-3880
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    • 2016
  • Nausea and vomiting are among the most serious side effects of chemotherapy, in some cases leading to treatment interruption or chemotherapy dose reduction. Ginger has long been known as an antiemetic drug, used for conditions such as motion sickness, nausea-vomiting in pregnancy, and post-operation side effects. One hundred and fifty female patients with breast cancer entered this prospective study and were randomized to receive ginger (500 mg ginger powder, twice a day for 3 days) or placebo. One hundred and nineteen patients completed the study: 57 of them received ginger and 62 received ginger for the first 3 chemotherapy cycles. Mean age in all patients was 48.6 (25-79) years. After 1st chemotherapy, mean nausea in the ginger and control arms were 1.36 (${\pm}1.31$) and 1.46 (${\pm}1.28$) with no statistically significant difference. After the $2^{nd}$ chemotherapy session, nausea score was slightly more in the ginger group (1.36 versus 1.32). After $3^{rd}$ chemotherapy, mean nausea severity in control group was less than ginger group [1.37 (${\pm}1.14$), versus 1.42 (${\pm}1.30$)]. Considering all patients, nausea was slightly more severe in ginger arm. In ginger arm mean nausea score was 1.42 (${\pm}0.96$) and in control arm it was 1.40 (${\pm}0.92$). Mean vomiting scores after chemotherapy in ginger arm were 0.719 (${\pm}1.03$), 0.68 (${\pm}1.00$) and 0.77 (${\pm}1.18$). In control arm, mean vomiting was 0.983 (${\pm}1.23$), 1.03 (${\pm}1.22$) and 1.15 (${\pm}1.27$). In all sessions, ginger decreased vomiting severity from 1.4 (${\pm}1.04$) to 0.71 (${\pm}0.86$). None of the differences were significant. In those patients who received the AC regimen, vomiting was less severe ($0.64{\pm}0.87$) comparing to those who received placebo ($1.13{\pm}1.12$), which was statistically significant (p-Value <0.05). Further and larger studies are needed to draw conclusions.

Cases of Green Tobacco Sickness: Occupational Nicotine Poisoning in Tobacco Harvesters in Korea (담배 재배 농부에서 발생한 담배잎농부병(green tobacco sickness) 증례)

  • Lim, Hyun-Sul;Lee, Kwan
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.7-14
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    • 2001
  • Cases of green tobacco sickness were described. During the cutting of tobacco plants throughout harvest, four cases of green tobacco sickness occurred in August 2001, Korea. The range of age was 42-55 years. The most frequent symptoms included dizziness, weakness, nausea, vomiting, abdominal cramps, headache, and difficulty breathing. All affected individuals worked in fields of wet tobacco, where their clothes became wet from moisture on the plants or sweating. They were all healthy, except one with hypertension. They are all non-smokers. They recovered after fluid and antiemetic administrations within two days. Most of doctors misdiagnosed their symptoms as a pesticide poisoning or heat injury. Green tobacco sickness is a condition that has long been known as an occupational health risk among tobacco harvesters. Nicotine poisoning by dermal absorption is reported to be the cause of green tobacco sickness. In Korea, there are many tobacco harvesters, and most of them may be sticken with green tobacco sickness. But, no case of green tobacco sickness has been reported. We report cases of green tobacco sickness occurred to the tobacco harvesters with a review of articles.

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Efficacy of Aprepitant in Patients with Advanced or Recurrent Lung Cancer Receiving Moderately Emetogenic Chemotherapy

  • Uchino, Junji;Hirano, Ryosuke;Tashiro, Naoki;Yoshida, Yuji;Ushijima, Shinichiro;Matsumoto, Takemasa;Ohta, Keiichi;Nakatomi, Keita;Takayama, Koichi;Fujita, Masaki;Nakanishi, Yoichi;Watanabe, Kentaro
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.4187-4190
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    • 2012
  • Aims and Background: To evaluate the efficacy of a combination of aprepitant and conventional antiemetic therapy in patients with advanced or recurrent lung cancer receiving moderately emetogenic chemotherapy (MEC). Methods: Patients with advanced or recurrent lung cancer who were treated with MEC regimens at the Department of Respiratory Medicine, Fukuoka University Hospital, were included and classified into the following groups: control group (treatment: 5-HT3 receptor antagonists + dexamethasone) and aprepitant group (treatment: 5-HT3 receptor antagonists + dexamethasone + aprepitant). The presence or absence of chemotherapy-induced nausea and vomiting (CINV) was evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.0; patients with grade 1 or above were considered positive for CINV. Food intake per day, completion of planned chemotherapy, and progression-free survival (PFS) achieved by chemotherapy were investigated. Results: The complete suppression rate of nausea in the aprepitant group was significantly higher than that in the control group (p = 0.0043). Throughout the study, the food intake in the aprepitant group was greater than that in the control group, with the rate being significantly higher, in particular, on day 5 (p = 0.003). The completion rate of planned chemotherapy was also higher in the aprepitant group (p = 0.042). PFS did not differ significantly, but tended to be improved in the aprepitant group. Conclusions: The aprepitant group showed significantly higher complete suppression of nausea, food intake on day 5, and completion of planned chemotherapy than the control group.