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Topic: Emesis

In the News (Wed 7 Jan 09)

Rod Blagojevich

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Mitchell Johnson

Darren Sproles

	Sao Paulo Medical Journal - Contribution to the treatment of nausea and emesis induced by chemotherapy in children and ...
		Emesis assessment was done on the basis of the following observations: anticipatory nausea and vomiting, nausea (presence or absence), dry heaving (number of episodes) and vomiting (frequency, duration and severity).
		Emesis: The patients in the metoclopramide and granisetron groups presented with emesis in 33 (85%) and 13 (32.5%) chemotherapy treatments, or at rates of 2.175 and 0.500 episodes/treatment, respectively.
		The mean number of emesis episodes in their chlorpromazine plus dexamethasone group was 3.5 times higher than the mean found in the metoclopramide plus dimenhydrinate group in our study, which also showed lower incidence of side effects.
	www.arabmedmag.com /issue-15-10-2006/rheumatology/main01.htm (4186 words)

	A neurokinin-1 receptor antagonist reduced hypersalivation and gastric contractility related to emesis in dogs -- ...
		in the induction of emesis (1, 11-13, 25-27, 29).
		The tachykinin NK receptor antagonist CP-99,994 attenuates cisplatin-induced emesis in the ferret.
		Enantioselective inhibition of apomorphine-induced emesis in the ferret by the neurokinin 1 receptor antagonist CP-99,994.
	ajpgi.physiology.org /cgi/content/full/275/5/G1193 (0 words)

	U.S. Pharmacist
		Non—patient-related factors that influence a patient's susceptibility to emesis during treatment include the specific chemotherapy agent being used, dose (especially high doses), schedule, and route in which the suspected agent is given, as well as frequent-interval dosing and intravenous administration.
		Acute Emesis (0 to 24 hours after chemotherapy): In terms of treating nausea and vomiting in patients who experience symptoms due to chemotherapy of high emetic risk (cisplatin and noncisplatin groups) within 24 hours after treatment, three agents are included in the 2006 guidelines.
		For the prevention of anticipatory emesis, antiemetic treatment should be administered with initial chemotherapy and should be the most appropriate choice in terms of emetic risk for that particular chemotherapy agent.
	www.uspharmacist.com /index.asp?show=article&page=8_1945.htm (3200 words)

	Nausea and Vomitting in Cancer
		For the prevention of acute emesis induced by a high single dose of cisplatin (> or = 50 mg/m2) or by low doses (20 to 40 mg/m2) repeated for 4 to 5 days, the combination of ondansetron plus dexamethasone is the most efficacious and least toxic antiemetic therapy.
		Chemotherapy-induced emesis is one of the most common and severe side effects of systemic cancer therapy.
		Tropisetron, a new 5-HT3 receptor antagonist, was compared in a randomized multicenter trial with a high-dose metoclopramide-dexamethasone cocktail for the prevention of nausea and emesis during cisplatin-containing chemotherapy.
	www.whocancerpain.wisc.edu /eng/8_2/Nausea.html (2232 words)

	AACT/AACT - Position Statements: Ipecac Syrup
		Emesis was also investigated in fasting puppies using two barium sulfate 1 g gelatin capsules as a marker.
		They demonstrated that the induction of emesis by ipecac before administration of activated charcoal and a cathartic (n = 214) did not significantly alter the clinical outcome of patients who were awake and alert on presentation to the ED as compared to those who received activated charcoal and a cathartic without ipecac (n = 262).
		Emesis is not delayed by the ingestion of phenothiazines, antihistamines, antiemetics, the administration of milk, or the use of outdated ipecac.
	www.clintox.org /Pos_Statements/Ipecac.html (5363 words)

	Steroids and emesis after tonsillectomy
		The number needed to treat to prevent one child with emesis was 3.7 (2.9 to 5.3).
		Emesis during the first 24 hours occurred in 73/259 (29%) of children given steroid and in 152/275 (55%) of children given placebo (Figure 1).
		The relative risk was 0.5 (0.4 to 0.6) and the number needed to treat to prevent one child with emesis was 3.7 (2.9 to 5.3).
	www.jr2.ox.ac.uk /bandolier/booth/ENT/steremes.html (282 words)

	CancerNetwork:
		The third type of chemotherapy-related emesis is anticipatory emesis, which begins prior to the administration of chemotherapy, usually in patients whose emesis was poorly controlled during a previous chemotherapy cycle.
		Since anticipatory emesis is believed to be a conditioned response that usually occurs in patients in whom emesis was poorly controlled during previous chemotherapy, good control of emesis during the first chemotherapy course remains the most effective means of prevention.
		Be aware of the chemotherapy- and patient-related factors that influence the patterns and intensity of emesis, and choose the antiemetic regimen accordingly.
	www.cancernetwork.com /textbook/morev41.htm (7264 words)

	Portable receptacle for receiving and containing emesis - Patent 5599332
		The portable receptacle for receiving and containing emesis as defined in claim 1 wherein said baffle means comprises a plurality of baffle plates positioned within said neck conduit means and extending angularly toward said neck outlet means thereof to facilitate control of splashing and spilling outwardly from said emesis containment chamber means.
		The portable receptacle for receiving and containing emesis as defined in claim 1 further comprising a mouthpiece cap means detachably positionable selectively in engagement with said mouthpiece means and extending thereover for closing thereof to facilitate retaining of emesis within said emesis containment chamber of said main body member.
		The portable receptacle for receiving and containing emesis as defined in claim 13 further comprising a mouthpiece cap attachment line means secured to said mouthpiece cap means and attached with respect to said neck means to facilitate retainment of said mouthpiece cap means with respect to the portable receptacle.
	www.freepatentsonline.com /5599332.html (0 words)

	NEL, Neurochemical Markers of Emesis Induced by Anti-Cancer Drugs
		Emesis is an instinctive defense reaction caused by the somato-autonomic nerve reflex, which is integrated in the medulla oblongata.
		Neurochemical and neuronal mechanisms involved in the emetic response and relevant receptors seem to be rather complicated relative to emetic stimuli.
		Emesis, a distress side effects of cancer chemotherapy, may lead to a patient's refusal of therapy.
	www.nel.edu /18_23/182397R03_Parvez.htm (588 words)

	Comparison of ondansetron with metoclopramide in prevention of acute emesis associated with low dose & high dose ...
		Results: In low dose cisplatin regimen, complete suppression of acute emesis occurred in 65 per cent patients receiving ondansetron versus 30 per cent receiving metoclopramide, while in high dose regimen, complete response rate was 20 per cent with ondansetron versus O per cent with metoclopramide.
		Cisplatin, a commonly used cytotoxic drug, induces emesis in 78-100 per cent of patients within the first 24 h with the median number of emetic episodes between 5-122.
		In view of the paucity of information in Indian patients the present study was undertaken to compare the efficacy and tolerability of ondansetron with metoclopramide in acute emesis induced by 60mg/m^sup 2^ cisplatin either given as a single dose (high dose regimen) or in doses of 20mg/ m^sup 2^/day over 3 days (low dose regimen).
	www.findarticles.com /p/articles/mi_qa3867/is_200307/ai_n9290984 (0 words)

	General Measures in the Management of Acute Pesticide Poisoning
		Induction of emesis and gastric lavage are the two most commonly employed means of gastric emptying.
		Emesis must be considered only when there are no absolute contraindications, and when anticipated definitive treatment will be delayed.
		Usually, emesis is done in the home setting before the patient is transported to the hospital.
	www.wpro.who.int /hse/pages/general10.html (345 words)

	Vomiting - Wikipedia, the free encyclopedia
		Vomiting (or emesis) is the forceful expulsion of the contents of one's stomach through the mouth.
		Stimulation of different receptors are involved in different pathways leading to emesis, in the final common pathway substance P appears to be involved.
		Fecal vomiting is often a consequence of intestinal obstruction, and is treated as a warning sign of this potentially serious problem ("signum mali ominis"); such vomiting is sometimes called "miserere".
	en.wikipedia.org /wiki/Emesis (1836 words)

	Morning sickness, "Pregnancy Sickness" or Emesis?
		The physiology of emesis has been studied for several hundred years, focusing on the different centres involved and the mechanics of expulsion.
		Emesis is a common disabling effect in motion sickness, postoperative conditions and in radio- and chemotherapy.
		Different animal and human models are available to study the physiology of emesis and to evaluate the antiemetic activity of new compounds, but they need to be predictors of clinical situations.
	www.morningwell.co.uk /morningsickness.htm (753 words)

	"Information resources on ferrets"
		The mechanism of emesis mediated by tachykinin NK-1 receptors in ferrets.
		Induction of emesis in ferrets by 2,2'-azobis (2-amidinopropane) dihydrochloride, a free radical initiator.
		Tachykinin NK sub(1) receptor antagonists act centrally to inhibit emesis induced by the chemotherapeutic agent cisplatin in ferrets.
	www.nal.usda.gov /awic/pubs/ferrets/emesis.htm (588 words)

	Nutritional Supplementation for Nausea and Emesis in a Breast Cancer Patient
		Depending upon the chemotherapeutic regimen, the degree of nausea and emesis reported by patients may variable, ranging from mild with lowly emetogenic regimens to severe with highly emetogenic regimens.
		Although significant progress has made in developing more effective means of preventing nausea and vomiting induced by chemotherapy, incomplete or uncontrolled emesis remains a problem for a significant percentage of cancer patients (a, i).
		While newer agents such as the 5H3 receptor antagonists (Ondanesetron, granisetron, and dolasetron) are very effective in controlling emesis during the acute phase, they are less effective during emesis that occurs during the delayed phase (b).
	www.propax.com /Research/CaseStudies/Case-Studies-breastcancer.html (0 words)

	Emesis
		VC receives many excitatory inputs from: nerve endings of vagal sensory fibers in the G-I tract; the labyrinths via the vestibular nuclei; higher centers in the cortex (when vomiting is produced by disgusting experience or in anticipation of such occurrence); CTZ; and intracranial pressure receptors.
		He received radiotherapy to the lumbar spine which produced emesis almost immediately, with 4 episodes of emesis in the first 2 hrs.
		Mechanisms of emesis are probably different from those that cause acute vomiting.
	www.tchain.com /otoneurology/treatment/emesis.html (831 words)

	Oncology Nursing Society
		Emesis occurs through several mechanisms including stimulation of enterochromaffin cells in the duodenum, leading to release of serotonin.
		In addressing acute emesis, Perez and colleagues (1998) showed that, in patients receiving moderate-risk chemotherapy agents, complete acute emesis control results were equivalent between oral granisetron and intravenous (IV) ondansetron.
		If patients have emesis, they are not to repeat the dose, but are to notify their provider.
	www.cmecorner.com /macmcm/ons/ons2002_10.htm (2412 words)

	Ondansetron Decreases Gastroenteritis-Associated Emesis in Children
		If otherwise healthy children are diagnosed with acute gastroenteritis and require IV fluids, one dose of intravenous ondansetron shortens the duration of emesis.
		Of the patients who did not cease vomiting following drug/placebo administration, there was no statistically significant difference in the median number of episodes of emesis between the groups (2 times in the ondansetron group, compared to 4 times in the placebo group; P=0.25).
		Although the researchers were successful in contacting all patients for follow-up, the study may have been limited by inaccuracies in recall of symptoms by family members.
	www.med.umich.edu /pediatrics/ebm/cats/gastro.htm (635 words)

	UpToDate Prevention and treatment of chemotherapy-induced nausea and vomiting
		Acute emesis is defined as emesis occurring during the first 24 hours after chemotherapy.
		In the absence of antiemetic prophylaxis, delayed emesis after cisplatin peaks at approximately 48 to 72 hours after therapy, then gradually subsides over the next two to three days [3].
		Anticipatory emesis is a conditioned response in patients who have developed significant nausea and vomiting during previous cycles of chemotherapy.
	patients.uptodate.com /topic.asp?file=chemagen/2403 (0 words)

	Magellan's Log: The Age of Emesis
		Humbled by the spilled blood and raped enviornment of the 20th century, we will slowly learn to see that the nightmares that were real for for the 20th century are only savage stories.
		The art, the music, the poetry, the novels, the drama, and even the politics of emesis will mostly produce a future reaction of, well, emesis.
		The thin, bright thread of mystical truth and beauty woven almost invisibly through the vast, filthy shroud of the age of emesis.
	www.texaschapbookpress.com /magellanslog16/emesis.htm (501 words)

	Pediatrics \| Paediatrics \| Pediatric Education \| Paediatric Education - PediatricEducation.org (Site not responding. Last check: 2007-10-25)
		During a lactation consultant's visit, he had a large yellow-green emesis that the lactation consultant felt had feculent material in it.
		In the emergency room, the patient had another emesis that was clearly bilious.
		Bilious emesis is also always abnormal and indicates ileus or obstruction distal to the common bile duct insertion into the duodenum.
	www.pediatriceducation.org /2006/12/04 (1068 words)

	Tratamiento de la émesis inducida
		Múltiples estudios sobre la emesis en pacientes en tratamiento con quimioterapia han identificado ciertas características dependientes de los pacientes que influyen en el grado de emesis.
		Llamamos emesis anticipatoria al episodio de emesis que se produce antes de la administración de quimioterapia.
		Double-blind, randomised comparision of the antiemetic efficacy of intravenous dolasetron mesylate and intravenous ondansetron in the prevention of acute cisplatin-induced emesis in patients with cancer.
	www.cfnavarra.es /salud/anales/textos/vol27/sup3/suple12a.html (2724 words)

	Centers for Medicare & Medicaid Services (Site not responding. Last check: 2007-10-25)
		Breakthrough emesis occurs in spite of prophylactic treatment and is treated with rescue therapy.
		The authors concluded that although the combination of the aprepitant prodrug and dexamethasone reduced acute emesis relative to historic rates, it was inferior to the combination of ondansetron and dexamethasone.
		In patients receiving cisplatin treated with a combination of aprepitant, a 5-HT antagonist and dexamethasone to prevent acute vomiting and nausea, the combination of dexamethasone and aprepitant is suggested to prevent delayed emesis, on the basis of its superiority to dexamethasone alone.
	www.cms.hhs.gov /mcd/viewdecisionmemo.asp?id=133 (7056 words)

	Nausea and Vomiting - National Cancer Institute
		The incidence of acute and delayed nausea and emesis was recently investigated in highly and moderately emetogenic chemotherapy treatment regimens.
		The incidence and severity of acute emesis in persons receiving chemotherapy varies according to many factors, including the particular drug, dose, schedule of administration, route, and individual patient variables.
		All predicative characteristics for acute emesis should be considered risk factors for delayed emesis.
	www.nci.nih.gov /cancertopics/pdq/supportivecare/nausea/HealthProfessional/page5 (560 words)

	Chemotherapy-Induced Nausea and Vomiting: The Importance of Acute Antiemetic Control -- Schnell 8 (2): 187 -- The ...
		Serotonin receptor antagonists in prophylaxis of acute and delayed emesis induced by moderately emetogenic, single-day chemotherapy: a randomized study.
		Predictive factors of delayed emesis in cisplatin-treated patients and antiemetic activity and tolerability of metoclopramide or dexamethasone.
		Ondansetron (GR38032) in the prophylaxis of acute and delayed cisplatin-induced emesis.
	theoncologist.alphamedpress.org /cgi/content/full/8/2/187 (5733 words)

	Clinical Trial: Oral Neurokinin-1 Antagonist, Aprepitant, in Combination With Ondansetron and Dexamethasone in Patients ...
		Acute and delayed chemotherapy induced emesis remains a persistent problem in the setting of autologous bone marrow transplantation despite premedication with the combination of dexamethasone and serotonin antagonists or metoclopramide.
		In the acute and delayed phase of emesis, the addition of the neurokinin-1 antagonist significantly reduced the incidence of nausea and vomiting compared to placebo.
		Newer agents, such as a neurokinin-1 receptor antagonist, when administered in combination with a corticosteroid and serotonin antagonist, appears to be beneficial in reducing the incidence and severity of acute and delayed emesis associated with moderately and highly emetogenic chemotherapy.
	clinicaltrials.gov /ct/show/NCT00285272 (2232 words)

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