• The Korean Journal of Physiology and Pharmacology
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• 제18권2호
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• pp.149-153
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• 2014

Nausea and emesis are a major side effect and obstacle for chemotherapy in cancer patients. Employ of antiemetic drugs help to suppress chemotherapy-induced emesis in some patients but not all patients. Ginger, an herbal medicine, has been traditionally used to treat various kinds of diseases including gastrointestinal symptoms. Ginger is effective in alleviating nausea and emesis, particularly, for cytotoxic chemotherapy drug-induced emesis. Ginger-mediated antiemetic effect has been attributed to its pungent constituents-mediated inhibition of serotonin (5-HT) receptor activity but its cellular mechanism of action is still unclear. Emetogenic chemotherapy drugs increase 5-HT concentration and activate visceral vagal afferent nerve activity. Thus, 5-HT mediated vagal afferent activation is essential to provoke emesis during chemotherapy. In this experiment, water extract of ginger and its three major pungent constituent's effect on 5-HT-evoked responses were tested on acutely dispersed visceral afferent neurons with patch-clamp methods. The ginger extract has similar effects to antiemetic drug ondansetron by blocking 5-HT-evoked responses. Pungent constituents of the ginger, [6]-shogaol, [6]-gingerol, and zingerone inhibited 5-HT responses in a dose dependent manner. The order of inhibitory potency for these compounds were [6]-shogaol>[6]-gingerol>zingerone. Unlike well-known competitive 5-HT3 receptor antagonist ondansetron, all tested ginger constituents acted as non-competitive antagonist. Our results imply that ginger and its pungent constituents exert antiemetic effects by blocking 5-HT-induced emetic signal transmission in vagal afferent neurons.

• 대한수의학회지
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• 제45권3호
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• pp.399-403
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• 2005

This study was performed to elucidate the effect of acupuncture and aqua-acupuncture in dogs. Each group was divided into control (18 dogs), PC-6 (6 dogs) and BL-21 (6 dogs) group for the antiemetic effect of acupuncture, respectively. And, the animals were divided into control (18 dogs), PC-6 (18 dogs) and BL-21 (18 dogs) group for the antiemetic effect of aqua-acupuncture with metoclopramide, respectively. 2% xylazine was injected to the all dogs to induce the emesis, and acupuncture and aqua-acupuncture treatment (0.5% metoclopramide) were applied to animals for 20 min. before xylazine injection, respectively. Emetic rates in PC-6 (33.3%) and BL-21 (16.7%) were lower than that of control group (44.4%) in acupuncture groups, respectively. Emetic rates in PC-6 (16.7%) and BL-21 (0.0%) were lower than that of control group (38.9%) in aqua-acupuncture groups, respectively. Based on these findings, it was considered that the antiemetic effects of acupuncture and aqua-puncture at BL-21 were more effective than those of PC-6 groups, and aqua-acupuncture with metoclopramide at BL-21 was the most effective among them.

• 셀메드
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• 제9권2호
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• pp.3.1-3.5
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• 2019

Zingiber officinale is a spice which is having a strong historical medicinal background and used by different systems of medicine for various ailments. It is also used to maintain the characteristic sharpness and tangy essence of food and beverages and used in carbonated drinks, as a conserve in sugar syrup. Ginger considered as an incredible drug for inflammation, gastrointestinal problems, pain and sexual problems since centuries. There are many studies carried out in recent years, which proves that the active constituents of ginger shows a variety of pharmacological effects like antiemetic, hepatoprotective, anti hyperlipidemic and antibacterial. The most momentous among all the nutraceutical aspects of ginger are its positive control on gastrointestinal tract including digestive stimulant action, anticancer effect and anti-inflammatory effect.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권2호
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• pp.84-89
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• 2016

Objectives: To compare the efficacy of intravenous ondansetron (4 mg, 2 mL) and granisetron (2 mg, 2 mL) for preventing postoperative nausea and vomiting (PONV) in patients during oral and maxillofacial surgical procedures under general anesthesia. Materials and Methods: A prospective, randomized, and double blind clinical study was carried out with 60 patients undergoing oral and maxillofacial surgical procedures under general anesthesia. Patients were divided into two groups of 30 individuals each. Approximately two minutes before induction of general anesthesia, each patient received either 4 mg (2 mL) ondansetron or 2 mg (2 mL) granisetron intravenously in a double blind manner. Balanced anesthetic technique was used for all patients. Patients were assessed for episodes of nausea, retching, vomiting, and the need for rescue antiemetic at intervals of 0-2, 3, 6, 12, and 24 hours after surgery. Incidence of complete response and adverse effects were assessed at 24 hours postoperatively. Data was tabulated and subjected to statistical analysis using the chi-square test, unpaired t-test, or the Mann-Whitney U-test as appropriate. A P-value less than 0.05 was considered statistically significant. Results: There was no statistically significant difference between the two groups for incidence of PONV or the need for rescue antiemetic. Both study drugs were well tolerated with minimum adverse effects; the most common adverse effect was headache. The overall incidence of complete response in the granisetron group (86.7%) was significantly higher than the ondansetron group (60.0%). Conclusion: Granisetron at an intravenous dose of 2 mg was found to be safe, well tolerated, and more effective by increasing the incidence of complete response compared to 4 mg intravenous ondansetron when used for antiemetic prophylaxis in maxillofacial surgery patients receiving general anesthesia. Benefits of granisetron include high receptor specificity and high potency, which make it a valuable alternative to ondansetron.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9627-9630
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• 2014

Background: Although efficacy of aprepitant for suppressing emesis associated with single-dose cisplatin has been demonstrated, there are limited data on the antiemetic effect of this oral neurokinin-1 receptor antagonist during daily administration of cisplatin. Accordingly, we investigated the efficacy and safety of aprepitant in patients with head and neck cancer (HNC) receiving combination therapy with cisplatin and 5-FU (FP therapy). Materials and Methods: Twenty patients with HNC were prospectively studied who received a triple antiemetic regimen comprising granisetron ($40{\mu}g/kg$ on Days 1-4), dexamethasone (8 mg on Days 1-4), and aprepitant (125 mg on day 1 and 80mg on days 2-5) with FP therapy (cisplatin $20mg/m^2$ on days 1-4; 5-FU $400mg/m^2$ on days 1-5) (aprepitant group). We also retrospectively studied another 20 HNC patients who received the same regimen except for aprepitant (control group). Results: For efficacy endpoints based on nausea, the aprepitant group showed significantly better results, including a higher rate of complete response (no vomiting and no salvage therapy) for the acute phase (p=0.0342), although there was no marked difference between the two groups with regard to percentage of patients in whom vomiting was suppressed. There were no clinically relevant adverse reactions to aprepitant. Conclusions: This study suggested that a triple antiemetic regimen containing aprepitant is safe and effective for HNC patients receiving daily cisplatin therapy.

• 한국임상수의학회지
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• 제26권6호
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• pp.534-538
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• 2009

Medetomidine으로 마취된 개에 대한 dexamethasone의 항구토 효과를 평가하였다. 실험 당일, medetomidine($40\;{\mu}g$/kg, IM)을 주사하기에 앞서 dexamethasone을 0.25, 0.5, 1.0 mg/kg의 용량으로 정맥주사하였다. 대조군에는 dexamethasone을 대신하여 식염수 0.1 ml/kg를 주사했다. Dexamethasone 0.5, 1.0 mg/kg의 용량에서 구토가 크게 감소되는 것이 관찰되었고, 시각적 마취 점수(visual sedation score)로 측정된 마취의 깊이 정도는 dexamethasone의 전처치에 의해 영향을 받지 않는 것으로 평가되었다. 또한, CBC와 혈액화학분석 수치는 특징적인 변화를 보이지 않았고 실험 전과 하루 후의 수치가 정상범위내에 있었다. 따라서, 본 연구를 통해 medetomidine투여로 유발되는 구토증상을 0.5, 1.0 mg/kg 용량의 dexamethasone이 임상적으로 영향을 끼치지 않으면서 안전하고 효과적으로 예방할 수 있다는 것을 알 수 있었다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.4125-4129
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• 2016

Background: Chemotherapy-induced nausea and vomiting (CINV) places a significant burden on the patient. Herbal agents are the most commonly complementary therapies used among the public. This study was done to determine the effect of ginger and chamomile capsules on nausea and vomiting in cases undergoing chemotherapy for breast cancer (BC). Materials and Methods: In a randomized, double-blind and clinical trial study, 65 women with BC undergoing chemotherapy were referred to Breast Cancer Research Center, Tehran, Iran, between May 2013 to June 2014. Regimen for ginger group for 5 days before and 5 days after chemotherapy was: 2 times a day and 500 mg capsules of powdered ginger root in addition to a routine antiemetic regimen consisting of dexamethasone, metoclopramide and aprepitant (DMA) capsules. Chamomile group similarly was: 2 times a day and 500 mg capsules of Matricaria chamomilla extract in addition to a routine antiemetic regimen consisting of DMA capsules. Control group, routine antiemetic regimen consisting of DMA capsules. Results: There were no significant differences between the ginger, chamomile and control groups regarding age. Drugs used for chemotherapy were identical and duration of disease was also matched (1-4 months). Ginger and chamomile were both significantly effective for reducing the frequency of vomiting, there being no significant difference between the ginger and chamomile groups. Moreover, unlike the chamomile, ginger significantly influenced the frequency of nausea. Conclusions: According to the findings of this study, it should be declared that taking ginger capsules (1 g/day) might relieve CINV safely. Nurses dealing directly with cancer patients should be responsible for providing educational programs for patients and their families about how to deal with their drug regimens and associated side effects.

• The Korean Journal of Pain
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• 제9권1호
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• pp.178-182
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• 1996

Background: To evaluate the effect of prophylactic transdermal scopolamine in reducing nausea associated with postoperative epidural morphine. Methods: 30 healthy patients scheduled for cesarean section were given local anesthetics epidurally for surgical anesthesia. After delivery of the baby, transdermal scopolamine patch($Kimite^{(R)}$ Myung Moon Pharm. Co., Seoul, Korea) was applied to the study group(n=15) and placebo patch to the control group(n=15). Postoperative analgesia was provided soley with epidural morphine. Nausea was treated with metoclopramide. Results: During 24 hours postoperatively, the mean nausea score was significantly lower in the study group than in the control group. But the nausea incidence was not significantly different between the two groups. The mean number of times antiemetic drugs which were administered to patients were lower in the study group than in the control group($1.5{\pm}0.5$ vs $3.3{\pm}1.3$, p<0.05). Conclusion: Transdermal scopolamine patch provides antiemetic effect simply, continuously and safely, preventing nausea which could occur during administration of epidural morphine after cesarean section.

• The Korean Journal of Pain
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• 제10권2호
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• pp.203-207
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• 1997

Background: To date, there are no controlled studies assessing the effect of metoclopramide administered epidurally to prevent nausea and vomiting associated with epidural morphine for postoperative analgesia. This study was undertaken to determine the effectiveness of continuous epidural infusion of metoclopramide, combined with epidural morphine, in reducing nausea or vomiting associated with epidural morphine and minimizing the side effects of metoclopramide. Methods: Sixty patients undergoing elective gynecologic surgery were randomly assigned to one of two study groups. Patients received continuous epidural morphine infusion (6.0 mg/day) following a bolus loading dose of 3.0 mg (Group A), or epidural mixture of morphine (6.0 mg/day) plus metoclopramide (20 mg/day) following a bolus loading dose (morphine 3.0 mg, metoclopramide 10 mg)(Group B). For the first 24 postoperative hours, incidence of nausea or vomiting, need for antiemetic therapy, level of sedation, degree of pain and pruritus, and adverse effects associated with metoclopramide were evaluated. Result: Incidence of nausea or vomiting and number of patients who required antiemetic therapy were significantly less in Group B, than in Group A (P<0.05). There were no significant differences between groups with regard to adverse effects associated with metoclopramide such as sedation, extrapyramidal reaction and other side effects (P=NS). Conclusion: We conclude simultaneous titration of morphine and metoclopramide via epidural continuous infusion following epidural bolus injection of the mixture reduces nausea or vomiting associated with epidural morphine while preventing side effects of metoclopramide.

• 대한한방내과학회지
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• 제39권5호
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• pp.1032-1041
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• 2018

Despite a considerable improvement in antiemetic chemotherapy and the use of antiemetic prophylaxis for decades, there are still numerous cancer patients suffering from anorexia and nausea after chemotherapy, which forces them to postpone or refuse treatment. This case report is about a 66-year-old female patient diagnosed with malignant lymphoma of the small intestine who underwent right hemicolectomy. After the tumor and the colon adjacent to it were surgically removed, the patient continued to undergo chemotherapy. Chemotherapy-induced anorexia and nausea appeared but were well treated with administration of Dokhwaljihwang-tang-gamibang. During the treatment, no adverse effect related to this Korean medicine was reported. The outcome was evaluated by the functional assessment of anorexia/cachexia therapy (FAACT); the total score increased from 85 to 130 within 12 days, and the symptoms were alleviated. This improvement might suggest the feasibility of Dokhwaljihwang-tang-gamibang to help cancer patients suffering from chemotherapy-induced anorexia and nausea.