Pica as an adaptive response: Kaolin consumption helps rats recover from chemotherapy-induced illness

Clay consumption can occur during illness but there has been little work to understand why. To investigate whether consuming clay confers an advantage to the sick animal, we compared the recovery from illness of adult male rats with or without access to kaolin. Illness was induced by injection of 6 mg/kg, ip, cisplatin, a toxic chemotherapy agent, and recovery was assessed by changes in daily food intake, water intake, and body weight. Relative to saline-injected controls, cisplatin-injected rats reduced food and water intake and lost weight. However, those with access to kaolin ate more food and lost less body weight than did those without access to kaolin. Thus, clay consumption appeared beneficial in that it either protected the rats from illness or enhanced recovery and might prove useful as an adjunct therapy for other animals, including humans, experiencing visceral malaise.     

托烷司琼预防吗啡硬膜外自控镇痛引起恶心呕吐的效果观察

目的观察托烷司琼用于预防术后吗啡硬膜外自控镇痛（PCEA）引起恶心呕吐的效果。方法选择在腰麻与硬膜外联合麻醉下行开腹妇科手术患者120例,随机分成两组,每组60例。A组为托烷司琼4mg,B组为生理盐水4ml,分别加入PCEA药盒注入硬膜外间隙。术毕行吗啡PCEA镇痛,PCEA药液为吗啡8mg、0．75％左旋布卡因25ml。加生理盐水至100ml。观察两组术后48h内的镇痛效果及恶心呕吐的发生率。结果两组患者术后镇痛效果比较差异无统计学意义（P〉0．05）。两组患者术后48h内恶心呕吐发生率A组显著低于B组。恶心：A组7例（11．7％）B组16例（26．7％）;呕吐：A组3例（5．0％）B组19例（31.6％）（P％0．05或P％0．01）,差异有统计学意义。结论托烷司琼能够安全有效地减少硬膜外吗啡术后镇痛引起的恶心呕吐。     

Tropisetron, ondansetron, and granisetron for control of chemotherapy-induced emesis in Turkish cancer patients: a comparison of efficacy, side-effect profile, and cost

Background: Tropisetron, ondansetron, and granisetron are considered equally efficacious, supported by several international studies. However, there are interindividual variations in their metabolism that could affect efficacy. The clustering of such variations may change from one to another nation. Therefore, their equality must be validated in Turkish patients. The aim of this study was to compare their efficacies, side-effect profiles, and costs in the prophylaxis of emesis induced by moderate to high emetogenic chemotherapies. Methods: A total of 158 patients with a median age of 48 years, 115 (72.8 percent) female and 43 (27.2 percent) male, were included, respectively. Fifty-one, 61, and 46 patients were allocated to tropisetron (5 mg), ondansetron (8 mg), and granisetron (3 mg IV) in combination with 8 mg dexamethasone, which were continued 5 mg once a day, 8 mg b.i.d. and 1 mg b.i.d. PO for 5 days, respectively. Results: The complete response (CR) rates in the control of acute emesis were 80.4 percent with tropisetron, 72.1 percent with ondansetron, and 71.7 percent granisetron (p = 0.877). CR rates in delayed emesis (Days 2-5) were 68.6 percent, 68.9 percent, and 76.1 percent, respectively (p = 0.527). Rates of freedom from nausea in the same period were 37.3 percent, 35.9 percent, and 33.9 percent (p = 0.949). Nausea control rates, side-effect profile did not differ. However, headache seemed to be encountered higher (45.6 percent) in Turkish patients than others (3.9-9 percent). Tropisetron is the least expensive one ($95.3 per cycle) according to current prices in Turkey. Conclusions: There were no differences among the 3 serotonin antagonists with respect to efficacy and frequency of side-effects in our patients. Tropisetron is the least expensive at current prices. The choice may be based on other parameters, such as ease of administration and patient preference.     

药学干预对肺癌患者化疗期间恶心呕吐和生活质量影响的研究

目的：探讨药学干预对肺癌患者化疗期间恶心呕吐（CINV）和生活质量的影响。方法：选取本院住院化疗的肺癌患者作为观察对象,分为干预组和对照组,比较两组化疗后恶心、呕吐、食欲减退、生活质量的差异。结果：两组在化疗后发生的恶心、呕吐、食欲减退程度有显著性差异,干预组有效防治高于对照组。结论：针对肺癌患者化疗引起的恶心呕吐,临床诊疗联合药学干预共同治疗能够显著改善患者CINV的发生情况及其生活质量。     

Usefulness of the dopamine system-stabilizer aripiprazole for reducing morphine-induced emesis

In the management of pain, nausea and vomiting are some of the most distressing adverse effects induced by opioids. In the present study, we investigated the effect of the dopamine system-stabilizer aripiprazole on morphine-induced emesis. Morphine induced retching and vomiting in a dose-dependent manner in ferrets. The emetic effect of morphine was significantly suppressed by pretreatment with either the dopamine receptor antagonist haloperidol or aripiprazole. These results suggest that the co-administration of aripiprazole may be useful for reducing the severity of morphine-induced emesis.     

单用托烷司琼对硬膜外麻醉下子宫全切术患者围术期恶心、呕吐的影响

目的 探讨单用托烷司琼不同给药对子宫全切术患者围术期恶心、呕吐的疗效差异.方法 选择硬膜外阻滞麻醉下择期子宫全切术患者120 例,ASAⅠ～Ⅱ级,随机分为四组.①对照组(control组)、②切皮前用药组(A组)、③切皮前和缝皮后联合用药组(B组)和④缝皮后用药组(C组).分别记录术中以及术后24h内恶心、呕吐发生情况...     

托烷司琼配合格拉司琼对恶性肿瘤化疗所致恶心、呕吐的疗效

目的观察托烷司琼配合格拉司琼对恶性肿瘤化疗所致恶心、呕吐的临床疗效。方法选取近年来该院就诊的恶性肿瘤化疗患者82例作为研究对象,分成对照组和观察组各41例。对照组患者采取格拉司琼防治化疗导致的恶心、呕吐症状,观察组采取托烷司琼配合配合格拉司琼进行治疗;对两组患者临床治疗效果进行观察,并分析两种治疗方案的安全性。结果观察组患者治疗有效控制率和完全控制率分别为85.4%和58.5%;明显优于对照组73.2%和43.9%,并差异有统计学意义(均P<0.05)。治疗期间均未发生严重不良反应情况,观察组身体疲倦和头晕头痛发生率分别为19.5%和17.1%,明显低于对照组34.1%和29.3%,并具有显著差异(均P<0.05);两组其余不良反应发生情况无显著差异(均P>0.05)。结论采取托烷司琼配合格拉司琼用于恶性肿瘤化疗所致恶心、呕吐的临床治疗,相对于单独使用格拉司琼效果更佳,能够在保证安全的情况下获得经济可靠的治疗效果。     

肝脏术后恶心呕吐的原因分析及护理

目的探讨肝脏术后出现恶心呕吐的原因，找到护理恶心呕吐的适当方法，提高护理质量。方法对131例肝脏术后恶心呕吐患者，根据不同原因所致的呕吐采取适当的预防与治疗措施。结果有效地控制了恶心呕吐。结论适当的生理、心理、饮食、药物治疗等护理，可防止病人恶心呕吐的发生，及时缓解患者的呕吐症状，防止发生严重并发症。     

Oral Ondansetron 8 mg Twice Daily is as Effective as 8 mg Three Times Daily in the Prevention of Nausea and Vomiting Associated with Moderately Emetogenic Cancer Chemotherapy

The efficacy and safety of ondansetron 8 mg BID compared with 8 mg TID for 3 days in the prevention of nausea and vomiting in 402 patients on cyclophosphamide (≧500 mg/m²)-based chemotherapy were evaluated in a multicenter, randomized, double-blind, stratified study. The percentage of patients with no emetic episodes over the 3-day study period was 61% in the ondansetron BID group compared with 58% in the ondansetron TID group. Among patients with at least one emetic episode, the mean time to emesis was 14 hr and 17 min in the ondansetron BID group compared with 12 hr and 48 min in the ondansetron TID group. Patients' daily appetite ratings and nausea scores were not significantly different between groups. Clinical laboratory and adverse event profiles were similar between groups. This study is the first large-scale, double-blind trial to demonstrate that ondansetron 8 mg BID for 3 days, a dosing regimen that may enhance patient convenience and compliance, is as effective as ondansetron 8 mg TID for 3 days in the prevention of nausea and vomiting associated with cyclophosphamide-based chemotherapy.     

托烷司琼不同给药方式对术后镇痛恶心、呕吐的预防作用

目的 比较托烷司琼的不同给药方式对术后曲马多静脉自控镇痛患者恶心、呕吐的预防作用.方法 选择气管内全麻下择期腹部手术患者240例，ASAI或Ⅱ级，随机均分为四组.Ⅰ组术毕静脉连接患者自控镇痛（PCA）泵；Ⅱ组术毕静注5 mg托烷司琼后连接PCA泵；Ⅲ组术毕静注2 mg托烷司琼后连接PCA泵（PCA泵内加托烷司琼3 mg）；Ⅳ组术毕连接PCA泵（PCA泵内加托烷司琼5 mg）.PCA泵药物配制：900 mg曲马多加生理盐水配至总容量为100 ml.分别于术后2、4、8、20、36和48 h观察患者恶心、呕吐的发生情况.结果 （1）与Ⅰ组比较，Ⅱ组和Ⅲ组在术后2、4 h恶心的发生率明显降低（P＜0.05）；与Ⅳ组比较，Ⅱ组和Ⅲ组术后2、4和8 h恶心的发生率明显降低（P＜0.05或P＜0.01）.（2）与Ⅰ组比较，Ⅱ组在术后2、4、8和36 h呕吐的发生率明显降低（P＜0.05）；Ⅲ组在术后2、4、8、36和48 h呕吐的发生率明显降低（P＜0.05）；与Ⅱ组比较，Ⅲ组在术后48h呕吐的发生率明显降低（P＜0.05）；Ⅳ组在术后2、4、8 h呕吐的发生率明显高于Ⅱ组（P＜0.05）；Ⅲ组在术后2、4和48 h呕吐的发生率明显低于Ⅳ组（P＜0.05）.结论 术毕单次注射2 mg托烷司琼，并通过PCA泵持续输注可在术后48 h内有效预防恶心、呕吐的发生；术毕单次注射5 mg托烷司琼，术后短时间内可预防恶心、呕吐，但术后48 h已无此作用；而通过PCA泵中持续输注5mg托烷司琼不能预防恶心、呕吐.