Combination of Transcutaneous Electrical Nerve Stimulation and Ondansetron in Preventing Cisplatin-Induced Emesis
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<i>Objective:</i> To find out whether the combination of transcutaneous electrical nerve stimulation (TENS) and ondansetron had an increased antiemetic effect. <i>Materials and Methods:</i> Fourteen testis and 11 bladder cancer patients were scheduled for 4 cycles of bleomycin-etoposide-cisplatin (BEP) or methotrexate-vinblastine-etoposide-cisplatin (MVEC) combination chemotherapy, respectively. At each cycle the whole cisplatin dose was given in 1 day that is 100 mg/m<sup>2</sup>/day in the BEP and 70 mg/m<sup>2</sup>/day in the MVEC protocols. Ondansetron was given at a dose of 12 mg/day and TENS was applied by commercially available ‘Relief Band’(Maven Labs, Inc., Citrus Heights, Calif., USA). The first 3 cycles of each case were blindly randomized to one of the following regimens; TENS vs. ondansetron vs. a combination of both. The regimens were applied during the administration of cisplatin and the patients were asked to report their nausea according to a scale between 0 to 10. Also for each regimen the number of emetic attacks experienced during the administration of cisplatin was recorded by the same observer. Then the scores of each regimen were compared. <i>Results:</i> The mean nausea scores for regimens TENS, ondansetron and TENS + ondansetron were found to be 5.12 ± 2.54, 3.0 ± 1.71 and 0.8 ± 0.96, respectively. Ondansetron was better than TENS in preventing nausea (p = 0.000). However the combination of TENS and ondansetron resulted in a significant decrease in nausea scores when compared to TENS alone (p = 0.000) or ondansetron alone (p = 0.000). The mean number of emetic attacks for the TENS, ondansetron and TENS + ondansetron regimens were 3.16 ± 1.84, 1.64 ± 1.44 and 0.56 ± 0.82, respectively. A statistically significant difference was present between the number of emetic attacks observed with the TENS + ondansetron combination and TENS alone (p = 0.000) or ondansetron alone (p = 0.001). Ondansetron was again better than TENS in preventing emetic attacks (p = 0.001). <i>Conclusion:</i> The use of TENS as an adjunct to ondansetron therapy has provided significant benefit in preventing nausea and emetic attacks caused by cisplatin.Keywords:
Ondansetron
Aim: To determine the efficacy of intravenous ondansetron in the prevention of postoperative nausea and vomiting (PONY) in patients undergoing ophthalmic surgeries under general anesthesia. Materials and methods: Five hundred patients, receiving endotracheal anesthesia were randomized either to no drug (group I , n=250) or single dose, intravenous ondansetron just prior to induction (group IIa, n=125) or prior to reversal at the conclusion of surgery (group IIb, n= 125). Results: In the first 24 hours postoperatively, the incidence of nausea and vomiting was 20% and 47.2% respectively in control group I, 23.3% and 42.4% in group IIa, and 5.6% and 31.2% in group IIb (p=0.001,0.003). The mean number of nausea and vomiting episodes per patient declined significantly in group IIb, compared to the controls (p=0.001, 0.004). No differences were observed in group IIa. Conclusion: Ondansetron administered intravenously at the conclusion of ophthalmic surgery reduces the occurrence of postoperative nausea and vomiting.
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The application 5-HT_3 antagonist in anti-vomiting treatment for hemato-logic neoplasms chemotherapy
Objective to understand and compare the clinical curative effect and sides effect of 5-HT3 antagonist. Methods kytril 3mg or navoban 5mg or nasea 0.3mg or ondansetron 8mg was used intravenous before chemotherapy after diluted with 0.9% sodium chloride. Then evaluate the incidence of nausea, vomiting and other side effects. Results anti-vomiting efficiency of kytril was 88.92%, which was equal to nasea and obviously better than ondansetron and navoban. About side effects, none of serious side effects was observed in kytril, ondansetron, navoban and nasea treatment group. The incidence of abdominal distension in kytril treatment group was lower than that of nasea and ondansetron treatment group. Conclusion Kytril is an ideal anti-vomiting drug which is good in controlling acute or delayed vomiting. And the acting time of kytril is longer and it can be used safely.
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OBJECTIVE: To describe the efficacy of ondansetron for the treatment of poisoning-associated vomiting in two patients following drug intoxication. PATIENTS: Two self-poisoned adolescent patients. INTERVENTION: Intravenous ondansetron. RESULTS: Resolution of nausea and vomiting in both patients. CONCLUSIONS: Ondansetron appears to be a very effective antiemetic drug for use in selected intoxicated patients.
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Acute gastroenteritis is one of the most common causes of emergency room visits. Although it is usually a self-limited infection, vomiting related to this illness can cause various degrees of dehydration, leading to intravenous insertion, electrolyte abnormalities and/or hospital admission. Ondansetron is a highly potent antiemetic drug that is effective in preventing chemotherapy-and radiation-induced nausea and vomiting with a very low risk of adverse effects. Recently, ondansetron has been used to control vomiting related to acute gastroenteritis. The present article examines evidence for the use of oral ondansetron for acute gastroenteritis-related vomiting in infants and children, and provides a recommendation for treatment based on the evidence-based review.
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In children presenting with vomiting associated with gastroenteritis, what are the benefits and harms of ondansetron?
A systematic review[1][1] of 6 RCTs (5 in emergency department [ED] setting and 1 inpatient; N = 745) examined oral and intravenous (IV) administration of ondansetron.
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Acute gastroenteritis
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The anti-emetic effect, safety and clinical usefulness of ondansetron for the treatment of nausea and vomiting caused by anticancer drugs including cisplatin, was evaluated by a multi-institutional study in patients with various malignancies. In this study, ondansetron was given intravenously with mainly a single dose of 4 mg to intervene nausea and vomiting. 1. Efficacy ratio of overall effects on nausea and emesis observed for 24 hours after treatment was 69.8%. 2. No side effect was observed. Laboratory tests showed temporary elevation of serum uric acid level in 1 patient in the group given 4 mg. 3. From these results, it seems that ondansetron, given intravenously after initial vomiting, was highly safe and clinically useful anti-emetic for the treatment of nausea and vomiting associated with anti-cancer drugs.
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At several out-of-hours services primary care, a single dose of ondansetron was compared with standard care (oral rehydration solution (ORS)) in young children with gastroenteritis and persistent vomiting. Although vomiting decreased more often in the ondansetron group compared to the control group in the first hours, ondansetron had no effect on ORS use and did not lead to fewer referrals to the hospital. Unfortunately, the outcome measure diarrhoea was missing as a possible adverse effect of ondansetron. Diarrhoea was reported around 2-3 times more often with ondansetron compared to placebo in four of five other studies in children with gastroenteritis and vomiting. It is therefore questionable whether the limited clinical benefit of ondansetron in children with vomiting due to gastroenteritis outweighs the possible (as yet insufficiently investigated) side effect diarrhoea.
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A randomized single blind study was done in the Department of Anaesthesiology, Rajshahi Medical College Hospital to demonstrate the role of ondansetron, a 5-HT3 receptor antagonist, in alleviating per and post operative nausea and vomiting in patients undergoing caeserian section (CS) under subarachnoid block (SAB). For the purpose, the incidence of per and post operative nausea and vomiting were compared between matched case (n=119) and control (n=121) groups undergoing CS under SAB. Cases received 16 mg ondansetron orally one hour prior to surgery. Anti emetic prophylaxis with single dose ondansetron resulted in significant reduction of per operative and immediate post operative (2 hours) nausea and vomiting. However, at sixth post operative hour difference in nausea and vomiting between case and control groups became less significant (<0.05). Incidence of nausea and vomiting during 1st post operative hour in ondansetron group was 4.2% and 0.84% respectively in comparison to 41.3% and 19.8% in control group. During 2nd post operative hour no incidence of nausea and/or vomiting were observed among subjects receiving ondansetron whereas in control group 29.2% and 5% subjects suffered from nausea and vomiting, respectively. Overall, ondansetron 16 mg is well tolerated and easy to use. Results of the present study revealed that ondansetron can be effectively used in preventing per operative and immediate post operative nausea and vomiting. doi: 10.3329/taj.v18i1.3294TAJ 2005; 18(1): 1-4
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Objective To evaluate the clinical effects of Ondansetron and Metoclopramid inpreventing vomiting induced by interventional chemotherapy.Methods 96 patients who underwent interventional chenotherapy were randomized into two groups :one group wrer treated with Ondansetron and another were treated with Metoclopramide.The effective rate of preventing vomiting were compared between two groups.Results There was obvious difference in preventing Vomitiong and influencing on diet comdition between teh two groups(P0.01).Conclusion Ondansetron is more effective than Metoclopramide in pre- venting vomiting induced by interventional Chemotherapy.
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Metoclopramide
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Objective To observe the effect of different administration mode of ondansetron on preventing nausea and vomiting caused by patient controlled analgesia.Methods 60 cases orthopaedic patients with elective surgical procedures were randomly divided into three groups of A,B,C,each of 20 cases.3 groups were given conventional anesthesia.A group were given intravenous ondansetron 4mg after operation,and added ondansetron 4mg to PCEA pump at the same time;B group added ondansetron 8mg to PCEA pump after operation;C group were given intravenous ondansetron 8mg after operation.Observed the nausea and vomiting occurrence rate 24h after operation,and classified their degree.Results The nausea and vomiting occurrence rate of A,B group were lower than that of C group,the diffenence was statistically significant(P0.05),and there was no difference between A group and B group.The nausea and vomiting degree of A group were lighter than that of B group,B group were lighter than C group,the diffenence was statistically significant(P0.05).Conclusion Ondansetron can effectively preventing nausea and vomiting after operation,the therapy of intravenously combine with PCEA pump application of ondansetron 4mg can get the best effect.
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