Dexamethasone is a synthetic glucocorticoid that is widely used in clinical due to its multiple pharmacological effects. Recently, dexamethasone is increasingly utilized in anti-cancer therapy. It is frequently used to prevent side effects of chemotherapy such as nausea, vomiting and pain, as well as to increase the anti-tumor activity of the cancer chemotherapeutic agents as a chemosensitizer and to inhibit tumor growth as an anti-cancer agent in some certain cancers. Dexamethasone produces the effects in anti-inflammation, anti-angiogenesis, control of estrogen activity and so on, by binding to glucocorticoid receptor to regulate gene expression of some important bio-signal molecules. Those signal pathways could interfere with the transcription of various factors which can regulate proliferation, invasion and metastasis of tumors.
Antiemetics ; Antineoplastic Agents ; therapeutic use ; Dexamethasone ; therapeutic use ; Humans ; Nausea ; Neoplasms ; drug therapy ; Signal Transduction ; Vomiting

AIMTo establish a new, reliable vomiting model in minks.

METHODSAdult male minks (Mustela vison) were randomly divided into groups (n = 6). Cisplatin, apomorphine, copper sulfate and X-radiation were used to establish vomiting model. Retching and vomiting were observed after the vomiting models were given anti-vomiting agents. After the behavioral experiment, assay of 5-HT in the ileum was performed by immunohistologic method.

RESULTSCisplatin 7.5 mg.kg-1 i.p., apomorphine 1.6 mg.kg-1 s.c. and copper sulfate 40 mg.kg-1 ig were shown to evoke vomiting. Retching and vomiting were significantly inhibited in ondansetron and metoclopramide pretreated minks (P < 0.05, P < 0.01).

CONCLUSIONAs a new vomiting model, minks may be of great value in studying vomiting mechanism and screening new antiemetic drugs.

Animals ; Antiemetics ; therapeutic use ; Apomorphine ; Cisplatin ; Copper Sulfate ; Disease Models, Animal ; Male ; Metoclopramide ; therapeutic use ; Mink ; Ondansetron ; therapeutic use ; Vomiting ; chemically induced ; drug therapy

Objective To evaluate the effect of methylprednisolone sodium succinate combined with tropisetron on postoperative nausea and vomiting(PONV)under microvascular decompression of hemifacial spasm.Methods From January to June 2019,485 patients undergoing microvascular decompression for facial spasm at Department of Neurosurgery,Peking University People's Hospital were randomly assigned into two groups with random number table method.For group A(n=242),2 ml saline was administrated by intravenous drip before induction and 5 mg tropisetron after operation.For group B(n=243),40 mg methylprednisolone sodium succinate was administrated by intravenous drip before induction and 5 mg tropisetron after operation.The anesthesia time,operation time,and incidence of PONV in 0-24 h and 24-48 h were recorded for the comparison of the remedial treatment rate of nausea and vomiting between the two groups.Results There was no significant difference in age,gender,smoking history,body mass index value,American Society of Anesthesiologists score,medical history,surgical side,PONV history,operation time or anesthesia time between the two groups(all P > 0.05).The incidence of PONV in group A was 35.5% and 18.2% during 0-24 h and 24-48 h,respectively,which was significantly higher than that(18.5%,χ
Antiemetics ; Double-Blind Method ; Hemifacial Spasm/surgery* ; Humans ; Indoles ; Methylprednisolone Hemisuccinate/therapeutic use* ; Microvascular Decompression Surgery ; Tropisetron

This study aimed to evaluate the efficacy and safety of various oral Chinese patent medicines in the adjuvant treatment of rotavirus gastroenteritis(RVGE) in children based on network Meta-analysis. Randomized controlled trial(RCT) of oral Chinese patent medicine in the adjuvant treatment of RVGE in children was retrieved from the databases such as CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, EMbase, and Web of Science from database inception to October 22, 2022. The quality of the included RCT was evaluated according to the Cochrane risk-of-bias tool, and the data were analyzed by RevMan 5.4 and Stata 16 software. Sixty-three RCTs were included, with 11 oral Chinese patent medicines involved, including Xingpi Yanger Granules, Weichang'an Pills, Qiuxieling Mixture, Erxieting Granules, and Changyanning Granules/Syrup. The results of the network Meta-analysis showed that in terms of clinical total effective rate, the top 3 optimal interventions were Changyanning Granules/Syrup, Xiaoer Guangpo Zhixie Oral Liquid, and Xiaoer Shuangjie Zhixie Granules combined with conventional western medicine. In terms of the anti-diarrheal time, the top 3 optimal interventions were Shenling Baizhu Granules, Qiuxieling Mixture, and Shuangling Zhixie Oral Liquid combined with conventional western medicine. In terms of the antiemetic time, the top 3 optimal interventions were Changyanning Granules/Syrup, Xingpi Yanger Granules, and Xiaoer Shuangjie Zhixie Granules combined with conventional western medicine. In terms of the antipyretic time, the top 3 optimal interventions were Shenling Baizhu Granules, Xiaoer Shuangjie Zhixie Granules, and Qiuxieling Mixture combined with conventional western medicine. In terms of the negative conversion rate of rotavirus, the top 3 optimal interventions were Xingpi Yanger Granules, Erxieting Granules, and Cangling Zhixie Oral Liquid combined with conventional western medicine. In terms of reducing creatine kinase isoenzyme MB(CK-MB) level, the top 3 optimal interventions were Weichang'an Pills, Xingpi Yanger Granules, and Xiaoer Shuangjie Zhixie Granules combined with conventional western medicine. In terms of adverse reactions, no se-rious adverse reactions were reported in all studies. Oral Chinese patent medicines in the adjuvant treatment of children with RVGE have their own advantages, Specifically, Changyanning Granules/Syrup + conventional western medicine focuses on improving the clinical total effective rate and shortening the antiemetic time, Shenling Baizhu Granules + conventional western medicine on shortening the anti-diarrheal time and antipyretic time, Xingpi Yanger Granules + conventional western medicine on improving the negative conversion rate of rotavirus, and Weichang'an Pills + conventional western medicine on reducing the CK-MB level. Limited by the quantity and quality of literature included in this study, the results need to be verified by high-quality RCT with a larger sample size.
Child ; Humans ; Adjuvants, Pharmaceutic ; Antiemetics ; Antipyretics ; Drugs, Chinese Herbal/therapeutic use* ; Enteritis/drug therapy* ; Network Meta-Analysis ; Nonprescription Drugs/therapeutic use* ; Rotavirus ; Randomized Controlled Trials as Topic

OBJECTIVETo compare the efficacy of different 5-hydroxytryptamine 3 receptor antagonists in the prevention of postoperative nausea and vomiting (PONV) in patients undergoing general anesthesia.

METHODSTotally 360 patients, American Society of Anesthesiologists (ASA) grade I - II, aged 18-75 years, and having received elective operation with endotracheal intubation general anesthesia, were randomly divided into three double-blind groups: ondansetron group, tropisetron group, and granisetron group, with 120 patients in each group. Before anesthesia induction, patients were intravenously given ondansetron (4 mg), tropisetron (5 mg), or granisetron (3 mg), respectively. The episodes of nausea and vomiting were recorded for 24 hours after operation.

RESULTSNo significant differences were observed in the terms of complete inhibition rate of PONV among ondansetron group (70.0%), tropisetron group (68.6%), and granisetron group (72.9%) within 24 hours postoperatively (P >0.05), and so did postoperative nausea incidences (22.5%, 25.4%, and 20.3%, respectively), and postoperative vomiting incidences (10.0%, 13.6%, and 8.5%, respectively) (P > 0.05). No remarked antiemetic-related adverse effects were observed within 24 hours postoperatively.

CONCLUSIONIntravenous ondansetron (4 mg), tropisetron (5 mg), or granisetron (3 mg) before anesthesia induction can prevent PONV with similar efficacy and safety.

Adolescent ; Adult ; Aged ; Anesthesia, General ; adverse effects ; Antiemetics ; therapeutic use ; Double-Blind Method ; Female ; Granisetron ; therapeutic use ; Humans ; Indoles ; therapeutic use ; Male ; Middle Aged ; Ondansetron ; therapeutic use ; Postoperative Nausea and Vomiting ; etiology ; prevention & control ; Young Adult

OBJECTIVETo observe the therapeutic efficacy of Hewei Zhiou Recipe (HZR) combined ondansetron hydrochloride (OH) in treating vomiting in children patients with solid tumor.

METHODSEighty children patients with solid tumor at the Department of Tumor, Beijing Children's Hospital from January 2007 to January 2010 were randomly assigned to the treatment group and the control group by the random digit table method, 40 in each group. OH 4 mg was intravenously dripped to patients in the control group. Those in the treatment group took HZR on the basis of the same treatment as for the control group. The vomiting score and degree of the two groups were collected and compared by the end of the 1st to the 6th therapeutic course.

RESULTSThere was no statistical difference in the vomiting degree between the two groups by the end of the 1st therapeutic course (Z = -0.470, P>0.05). The vomiting degree was lessened in the treatment group by the end of the 2nd to the 6th therapeutic course, showing statistical difference when compared with the control group (Z = - 2.966, -3.256, -3.453, -4.870, -3.627, respectively, P<0.01).

CONCLUSIONHZR combined OH could effectively relieve the vomiting of children patients with solid tumor during chemotherapy.

Antiemetics ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Neoplasms ; drug therapy ; Ondansetron ; therapeutic use ; Phytotherapy ; Vomiting ; chemically induced ; drug therapy

OBJECTIVETo investigate clinical effects and mechanism of Tangweikang (TWK) in treating diabetic gastroparesis.

METHODSNinety diabetic gastroparesis patients were randomly assigned to 3 groups. Besides conventional hypoglycemic treatment, the 30 patients in the treated group were given TWK and the 30 in the control group were given Domperidone additionally, while to the 30 in the blank group, no additional drug was given. The clinical efficacy and the changes in level of motilin and gastric emptying rate were observed.

RESULTSTWK showed significant effects in improving clinical symptoms of patients, increasing gastric emptying rate, promoting gastrointestinal kinetics, shortening gastric emptying time and was beneficial to the control of blood sugar, including the 2 h post-prandial blood sugar and fructosamine. The curative rate and total effective rate in the treated group were 63.33% (19/30) and 93.33% (29/30) respectively, significantly different to those in the control group 26.67% (8/30) and 63.33%, also different to those in the blank group 23.33% (3/ 30) and 10.00%, respectively (P < 0.01). The clinical efficacy in the treated group was superior to that in the other two groups.

CONCLUSIONTWK has favorable therapeutic efficacy in treating DGP.

Aged ; Antiemetics ; therapeutic use ; Diabetes Complications ; drug therapy ; Domperidone ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastroparesis ; drug therapy ; etiology ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome

OBJECTIVETo compare the efficacy of ondansetron and granisetron in the prevention of postoperative nausea and vomiting (PONV) in high-risk patients.

METHODSTotally 200 patients with three key risk factors for PONV (female, non-smoking and postoperative opioid use) were equally randomized into ondansetron group and granisetron group. Ondansetron (4 mg) or granisetron (3 mg) was intravenously administered upon the completion of surgery. The episodes of nausea and vomiting were observed for 24 hours after surgery.

RESULTSA significantly greater proportion of patients in granisetron group achieved a complete response (i.e., no PONV or rescue medication) during the first 24 hours postoperatively versus those in ondansetron group (62.6% vs. 46.9%, respectively; P=0.048). There were no significant differences in terms of postoperative nausea incidences (42.9% vs. 34.3%, respectively), postoperative vomiting incidences (25.5% vs. 20.2%, respectively) and postoperative rescue anti-emetics incidences (19.4% vs. 15.2%, respectively) (P>0.05).

CONCLUSIONGranisetron is more effective than ondansetron in preventing PONV in high-risk patients during the first 24 hours postoperatively.

Adolescent ; Adult ; Aged ; Antiemetics ; therapeutic use ; Double-Blind Method ; Female ; Granisetron ; therapeutic use ; Humans ; Male ; Middle Aged ; Ondansetron ; therapeutic use ; Postoperative Nausea and Vomiting ; prevention & control ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the efficacy and toxicity of palonosetron for prevention of vomiting induced by high dose cisplatin-based chemotherapy.

METHODSOne-hundred and twenty-eight patients received tropisetron 5 mg plus dexamethasone 10 mg at the first cycle or palonosetron 0.25 mg plus dexamethasone 10 mg, respectively, each administered 30 min before the initiation of high dose cisplatin-based chemotherapy. To observe the remission rate of acute emetic episodes and delayed emetic episodes, adverse effects and daily food-intake in the patients after the chemotherapy.

RESULTSThe complete response (CR) rates for acute vomiting were not significantly different between the tropisetron and palonosetron cycles (75.8% vs. 79.7%, P>0.05). The complete control rate of delayed vomiting in the palonosetron cycle was significantly higher than that in the tropisetron cycle (70.3% vs. 50.8%, P<0.01). The food-intake decrease rate of palonosetron cycle was 18.8%, significantly lower than the 53.1% of the tropisetron cycle (P<0.05). The toxicity in the two cycles was similar and no grade 3-4 toxicity was observed.

CONCLUSIONSPalonosetron is superior to tropisetron with a lower remission rate of delayed emesis induced by high dose cisplatin-based chemotherapy and with tolerable toxicity. Moreover, the apparent emesis control of palonosetron treatment seems to provide an adequate food-intake in these patients.

Aged ; Antiemetics ; therapeutic use ; Antineoplastic Agents ; administration & dosage ; adverse effects ; therapeutic use ; Cisplatin ; administration & dosage ; adverse effects ; therapeutic use ; Eating ; drug effects ; Female ; Humans ; Indoles ; therapeutic use ; Isoquinolines ; therapeutic use ; Male ; Middle Aged ; Neoplasms ; drug therapy ; Quinuclidines ; therapeutic use ; Vomiting ; chemically induced ; prevention & control

PURPOSE: We evaluated the incidence and risk factors of postoperative nausea and vomiting (PONV) in patients with fentanyl-based intravenous patient-controlled analgesia (IV-PCA) and single antiemetic prophylaxis of 5-hydroxytryptamine type 3 (5 HT3)-receptor antagonist after the general anesthesia. MATERIALS AND METHODS: In this retrospective study, incidence and risk factors for PONV were evaluated with fentanyl IV-PCA during postoperative 48 hours after various surgeries. RESULTS: Four hundred-forty patients (23%) of 1878 had showed PONV. PCA was discontinued temporarily in 268 patients (14%), mostly due to PONV (88% of 268 patients). In multivariate analysis, female, non-smoker, history of motion sickness or PONV, long duration of anesthesia (>180 min), use of desflurane and intraoperative remifentanil infusion were independent risk factors for PONV. If one, two, three, four, five, or six of these risk factors were present, the incidences of PONV were 18%, 19%, 22%, 31%, 42%, or 50%. Laparoscopic surgery and higher dose of fentanyl were not risk factors for PONV. CONCLUSION: Despite antiemetic prophylaxis with 5 HT3-receptor antagonist, 23% of patients with fentanyl-based IV-PCA after general anesthesia showed PONV. Long duration of anesthesia and use of desflurane were identified as risk factors, in addition to risk factors of Apfel's score (female, non-smoker, history of motion sickness or PONV). Also, intraoperative remifentanil infusion was risk factor independent of postoperative opioid use. As the incidence of PONV was up to 50% according to the number of risk factors, risk-adapted, multimodal or combination therapy should be applied.
Adult ; Aged ; Analgesia, Patient-Controlled/*adverse effects ; Analgesics, Opioid/*adverse effects/therapeutic use ; Antiemetics/administration & dosage/therapeutic use ; Female ; Fentanyl/*adverse effects/therapeutic use ; Humans ; Incidence ; Isoflurane/adverse effects/*analogs & derivatives/therapeutic use ; Male ; Middle Aged ; Piperidines/*adverse effects/therapeutic use ; Postoperative Nausea and Vomiting/chemically induced/*epidemiology ; Retrospective Studies ; Risk Factors