Levonantradol, a new antiemetic with a high rate of side-effects for the prevention of nausea and vomiting in patients receiving cancer chemotherapy

1982 ◽  
Vol 9 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Rudolf A. Joss ◽  
Renato L. Galeazzi ◽  
Annakatharina Bischoff ◽  
Do D. Do ◽  
Aron Goldhirsch ◽  
...  
Keyword(s):  
Side Effects ◽  
Cancer Chemotherapy ◽  
Nausea And Vomiting ◽  
High Rate

scholarly journals Alternative Methods to Treat Nausea and Vomiting from Cancer Chemotherapy

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammad Ali Sheikhi ◽  
Ahmad Ebadi ◽  
Abdolhassan Talaeizadeh ◽  
Hossein Rahmani
Keyword(s):  
Side Effects ◽  
Cancer Chemotherapy ◽  
Massage Therapy ◽  
Nausea And Vomiting ◽  
Alternative Methods ◽  
Herbal Therapy ◽  
Patients With Cancer ◽  
Recent Advances ◽  
Patients Experience ◽  
Medicinal Therapy

Chemotherapy Induced Nausea and Vomiting (CINV) is among the most intensive side effects and critical concerns for patients with cancer. Most of these patients experience nausea and vomiting after chemotherapy. Sometimes, this is so annoying that it may prevent them from continuing the therapy. With the recent advances, a variety of therapeutic methods are innovated and applied to control CINV. Among them, the main methods include medicinal therapy, relaxation, and herbal therapy. Yet, using dexamethasone together with massage therapy and ginger is identified as the most effective method.

Sulfinpyrazone or Acetylsalicylic Acid to Prevent Postoperative Thrombus Formation in Arteriovenous Fistulas of Haemodialysis Patients

1979 ◽  
Author(s):  
F Albert ◽  
U Schmidt
Keyword(s):  
Side Effects ◽  
Acetylsalicylic Acid ◽  
Thrombus Formation ◽  
Significant Inhibition ◽  
High Rate ◽  
Controlled Clinical Trial ◽  
Arteriovenous Fistulas ◽  
Arteriovenous Shunts ◽  
Gastrointestinal Side Effects ◽  
Antithrombotic Efficacy

The effect of sulfinpyrazone (200 mg three times a day) and acetylsalicylic acid (500 mg three times a day) on the incidence of thrombosis of arteriovenous shunts was investigated in a controlled clinical trial. In 36 patients with chronic renal failure scheduled to begin haemodialysis the same operating team constructed a subcutaneous fistula in the distal forearm. During the first six weeks after the operation the antithrombotic efficacy proved to be good for both substances. No differences of thrombotic events between the two treatment groups were statistically significant. But in contrast to acetylsalicylic acid sulfinpyrazone made no significant inhibition of platelet - aggregation; sulfinpyrazone probably will prevent the clot formation by prolonging the shortened platelet survival in uraemic patients. In a high rate of patients given acetylsalicylic acid (10 out of 17) there were local bleeding and gastrointestinal side effects. In consequence we should prefer sulfinpyrazone, because in the sulfinpyrazone group side effects were minimal and in none patient withdrawal from the study was necessitated.

scholarly journals Peculiarities of Neurostimulation by Intense Nanosecond Pulsed Electric Fields: How to Avoid Firing in Peripheral Nerve Fibers

2021 ◽  
Vol 22 (13) ◽  
pp. 7051
Author(s):  
Vitalii Kim ◽  
Emily Gudvangen ◽  
Oleg Kondratiev ◽  
Luis Redondo ◽  
Shu Xiao ◽  
...  
Keyword(s):  
Side Effects ◽  
Electric Fields ◽  
Pulsed Electric Fields ◽  
Opposite Polarity ◽  
Nerve Fibers ◽  
High Rate ◽  
Excitation Threshold ◽  
Compound Action Potentials ◽  
Supramaximal Stimulation ◽  
The Impact

Intense pulsed electric fields (PEF) are a novel modality for the efficient and targeted ablation of tumors by electroporation. The major adverse side effects of PEF therapies are strong involuntary muscle contractions and pain. Nanosecond-range PEF (nsPEF) are less efficient at neurostimulation and can be employed to minimize such side effects. We quantified the impact of the electrode configuration, PEF strength (up to 20 kV/cm), repetition rate (up to 3 MHz), bi- and triphasic pulse shapes, and pulse duration (down to 10 ns) on eliciting compound action potentials (CAPs) in nerve fibers. The excitation thresholds for single unipolar but not bipolar stimuli followed the classic strength–duration dependence. The addition of the opposite polarity phase for nsPEF increased the excitation threshold, with symmetrical bipolar nsPEF being the least efficient. Stimulation by nsPEF bursts decreased the excitation threshold as a power function above a critical duty cycle of 0.1%. The threshold reduction was much weaker for symmetrical bipolar nsPEF. Supramaximal stimulation by high-rate nsPEF bursts elicited only a single CAP as long as the burst duration did not exceed the nerve refractory period. Such brief bursts of bipolar nsPEF could be the best choice to minimize neuromuscular stimulation in ablation therapies.

Effectiveness and safety of modern treatment against nausea and vomiting induced by chemotherapy and radiotherapy

2021 ◽  
Vol 14 (1) ◽  
pp. 11-15
Author(s):  
Łukasz Hajac ◽  
Martyna Hajac ◽  
Adam Maciejczyk
Keyword(s):  
Side Effects ◽  
Serotonin Syndrome ◽  
Nausea And Vomiting ◽  
Effective Prevention ◽  
Important Group ◽  
Life Threatening ◽  
Treatment Changes ◽  
Long Acting ◽  
Methods Of Treatment

Nausea and vomiting are one of most frequent side effects of chemotherapy and radiotherapy. Effective prevention and treatment of these symptoms is essential for better quality of life for patients undergoing oncological therapies. Nausea and vomiting can be acute, delayed or anticipatory. Leading mechanisms and methods of treatment are different for each of those. Most often used groups of drugs are: 5-HT3-antagonists, glucocorticosteroids, NK1-antagonists. Another important group are neuroleptics, which are therapy of choice for anticipatory vomiting. Modern antiemetic medications are in most cases safe and effective. But as every treatment it causes risks of adverse events which may be serious and difficult to manage. It applies in particular to long-acting drugs. Most common side effects are headache, constipation and sedation. But more severe or life-threatening symptoms may appear, like intestinal obstruction and serotonin syndrome. Some of the drugs also come with risk of interacting with other treatment. Changes in pharmacokinetics may lead to additional toxicities. In elderly, especially with cardiac disease, in risk of ileus or cachexia these drugs shall be used with caution.

scholarly journals Methotrexate Toxicity: Molecular Mechanisms and Management

2021 ◽  
pp. 204-217
Author(s):  
Riyadh S. Almalki ◽  
Hala Eweis ◽  
Fatemah Kamal ◽  
Dina Kutbi
Keyword(s):  
Side Effects ◽  
Cancer Chemotherapy ◽  
Pulmonary Toxicity ◽  
Molecular Mechanisms ◽  
Hematological Toxicity ◽  
Comprehensive Understanding ◽  
First Line ◽  
Cutaneous Toxicity ◽  
Gi Toxicity ◽  
Line Drug

Methotrexate (MTX) is the most widely used drug in cancer chemotherapy and is considered to be the first-line drug for the treatment of a number of rheumatic and non-rheumatic disorders. The pulmonary toxicity, hepatotoxicity of MTX are two of its major side effects. Other toxicities such as endocrinological toxicity, GI toxicity, cutaneous toxicity, hematological toxicity, fatal malfunction or loss, and malignancy can also occur, but at a significantly lower rate of prevalence. This review aims to provide a comprehensive understanding of the molecular mechanisms of methotrexate toxic effects and Lastly, we discussed the management of this toxicity.

scholarly journals Barriers to the Use of Endari™ in an Urban Adult Sickle Cell Center

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2287-2287
Author(s):  
Ugochi Olivia Ogu ◽  
Merin Thomas ◽  
Florence Chan ◽  
Gracy Sebastian ◽  
Caterina P. Minniti
Keyword(s):  
Side Effects ◽  
Sickle Cell ◽  
Patient Population ◽  
Severe Disease ◽  
High Rate ◽  
Phase Iii ◽  
Prior Authorization ◽  
Original Cohort ◽  
Fda Approval ◽  
Number Of Patients

Background In 2017, the US Food and Drug Administration (FDA) approved Endari (L-glutamine oral powder) for patients age five years and older with sickle cell disease (SCD) to reduce sickle cell-related acute pain events and hospitalizations1. This was applauded as the first medication approval for SCD in almost 20 years, following Hydroxyurea (HU) in 1998. We report our experience with barriers to accessibility to a new medication such as Endari, and patients' adherence in adults with SCD in an urban adult sickle cell center. Methods After prospectively establishing internal guidelines for the use of Endari, adult patients with SCD seen in clinic at a large urban adult SCD center were prescribed Endari via a local specialty pharmacy, over a 14 month period. Upon return to clinic, patients were asked about barriers to obtaining the medication and adherence to the twice a day dosing. Adherence was also evaluated by calculating the mean possession ratio (MPR) utilizing pharmacy records. Results 111 patients with SCD (57% females) were prescribed Endari over a 14 month period (Table 1): 83% with severe disease genotypes (Hb SS/Sβ0), 17% with "milder" genotypes (Hb SC/Sβ+). Mean age was 36 years old. 74% of patients were on concomitant HU and 1% on chronic transfusions (>6 months). At the end of the 14 month period, 21 patients (19%) were actively taking Endari, 47 (42%) had discontinued it, 39 (35%) never filled the prescription, and 4 (4%) had received but never initiated therapy. Of the 39 who never filled the initial prescription, barriers included denial of prior authorizations (38% of patients), high deductibles (21%), and inability of pharmacy to contact patient after approval was obtained (23%) (Table 2). Reasons for discontinuing Endari included poor adherence (36%), as defined by patients who did not refill after the initial/subsequent prescriptions (mean refill 1.79 times) and/or missed follow up appointments, side effects (13%), no perceived benefit (4%), and pregnancy/breastfeeding (4%) (Table 3). Average MPR for the 21 patients that are still taking Endari is 0.73, similar to the adherence reported in the landmark phase III trial (77.4%)1. Discussion This is the first study that addresses both acceptance of a new medication by the sickle cell population and the barriers to obtaining it. We identified significant barriers to the initiation of Endari in our urban adult SCD patient population and a high rate of self-discontinuation. Patients who discontinued Endari, did so after a median of 47 days after the initial prescription. The most common reasons for not initiating therapy, present in ~ 70% of the cases, were insurance-related issues, such as prior authorization denial or high deductible/co-pays. In 30% of the cases patients were not reachable or had other issues for not filling it, despite obtaining prior authorization, which may indicate a lack of interest on their part. A small number of patients (6) reported discontinuing due to side effects. After 14 months, only 21/111, ~20% of the original cohort of patients prescribed Endari, reported taking it. The MPR of the patients that were taking the medication was 0.73, similar to the adherence in the Endari study (77.4%)1. Prospective studies are needed to confirm if this pattern is reproducible in other patients' populations across the country and to investigate whether the introduction of a new drug affects adherence to HU. As experienced with HU, several years elapsed from initial FDA approval to its being more accepted and widely used, and adherence remains sub-optimal. From our report, it is critical to evaluate and mitigate barriers to initiation and adherence to Endari, to ensure it is available to and accepted by the patient population it gained approval and was intended for. 1. N Engl J Med.2018 Jul 19;379(3):226-235 Disclosures Ogu: Vertex Pharmaceuticals: Consultancy. Minniti:Doris Duke Foundation: Research Funding.

Selective potentiating effect of RS14203 on a serotoninergic pathway in anesthetized rats

2000 ◽  
Vol 78 (9) ◽  
pp. 708-713
Author(s):  
Chantal Savoie ◽  
Chi-Chung Chan ◽  
Ian W Rodger ◽  
Annette Robichaud
Keyword(s):  
Electrical Stimulation ◽  
Side Effects ◽  
Vagal Nerve ◽  
Nausea And Vomiting ◽  
Pulmonary Diseases ◽  
Selective Inhibitors ◽  
Anesthetized Rats ◽  
Afferent Fibers ◽  
Vagal Afferent

The usefulness of selective inhibitors of type 4 phosphodiesterase (PDE4) in the treatment of inflammation and pulmonary diseases is limited by their side effects: nausea and vomiting. We studied the effect of three structurally diverse PDE4 inhibitors on the vagal nerve afferent and efferent fibers in anesthetized rats. The effects of RS14203, (R)-rolipram, and CT-2450 were evaluated on the von Bezold-Jarisch reflex (vagal afferent fibers) and in a model of vagal electrical stimulation (vagal efferent fibers). All three PDE4 inhibitors were administered at 1, 10, or 100 µg/kg (iv) 15 min prior to the induction of bradycardia by an iv injection of 2-methyl-5-HT (von Bezold-Jarisch reflex) or by vagal electrical stimulation. At 100 µg/kg, RS14203 significantly potentiated the 2-methyl-5-HT response. No statistically significant effects were observed with (R)-rolipram or CT-2450 at the doses studied. RS14203, (R)-rolipram, or CT-2450 (1-100 µg/kg iv) did not affect the bradycardia induced by vagal electrical stimulation. Consequently, our results show that RS14203 selectively facilitates serotoninergic neurotransmission in vagal afferent fibers. The emetic action of RS14203 may be mediated by this mechanism.Key words: PDE4 inhibitors, von Bezold-Jarisch reflex, emesis, vagal afferent and efferent fibres, bradycardia.

Mucocutaneous side effects of cancer chemotherapy

1978 ◽  
Vol 5 (2) ◽  
pp. 67-84 ◽  
Author(s):  
Norman Levine ◽  
Edward S. Greenwald
Keyword(s):  
Side Effects ◽  
Cancer Chemotherapy

Thiethylperazine (Torecan)-Associated Dystonic Reactions in Children

PEDIATRICS ◽  
1979 ◽  
Vol 64 (6) ◽  
pp. 954-955
Author(s):  
Peter G. Lacouture ◽  
Allen A. Mitchell ◽  
Frederick H. Lovejoy
Keyword(s):  
Side Effects ◽  
Symptomatic Relief ◽  
Nausea And Vomiting ◽  
Extrapyramidal Side Effects ◽  
Beneficial Effects ◽  
Parkinsonian Syndromes ◽  
Therapeutic Doses

The phenothiazines are probably the most commonly used medications for the symptomatic relief of nausea and vomiting and may be effective irrespective of the primary cause.1,2 Along with their beneficial effects, these agents carry with them a risk of extrapyramidal side effects which may appear as parkinsonian syndromes, akathisias, acute dystonic reactions, and tardive dyskinesias.3 syptoympttoms commonly associated with acute dysic reactionsns with phenothiazines include oculogyri crisis, torticollis, trismus, facial grimace, protusion of the tongue, hyperreflexia, opisthotonos, and rigidity. The majority of these reactions have been reported in children taking the drugs in therapeutic doses.4-6 We wish to report four cases of acute dystonic reactions occurring in association with thiethylperazine (Torecan), a phenothiazine that has recently experienced increased pediatric usage.

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