格拉斯琼、氟哌利多预防子宫肌瘤术后镇痛恶心呕吐的效果

目的观察格拉斯琼、氟哌利多联合应用预防子宫肌瘤术后镇痛恶心呕吐的疗效。方法90例行子宫肌瘤剔除术或子宫全切术病人随机分为三组：氟哌利多组（A组）、格拉斯琼纽（B组）、氟哌利多＋格拉斯琼组（C组），观察术后24h内恶心呕吐情况。结果C组恶心呕吐发生率明显降低（P〈0．05）。结论格拉斯琼联合应用氟哌利多能明显降低子宫肌瘤术后镇痛恶心呕吐的发生。     

卵巢癌术后化疗中不同止吐用药方案的疗效观察与护理

[目的]观察卵巢癌术后化疗中不同止吐用药方案的疗效,探讨其护理。[方法]采用自身对照法,选择72例上皮性卵巢癌术后化疗病人均使用3种止吐方法。[结果]甲氧氯普胺加维生素B6组、昂丹司琼Ⅰ组、昂丹司琼Ⅱ组的止吐有效率分别为50.0%、72.2%、86.1%。[结论]卵巢癌病人术后化疗中,昂丹司琼止吐效果优于甲氧氯普胺,化疗前后均使用昂丹司琼优于单纯化疗前使用。     

昂丹司琼联合安定治疗化疗所致恶心呕吐的疗效观察

目的探讨一种有效安全的减轻化疗所致恶心呕吐的治疗方案.方法将88例乳腺癌术后和肺癌化疗病人随机分为观察组和对照组,观察组采用昂丹司琼与安定联合止吐,对照组采用甲氧氯普胺与地塞米松联合止吐,观察两组疗效.结果观察组有效率为86.96%,对照组有效率为64.29%,差异有显著性(P<0.05).结论昂丹司琼与安定联合治疗对化疗所致恶心呕吐有明显的预防作用,具有临床应用前景.     

昂丹司琼联合安定治疗化疗所致恶心呕吐的疗效观察

目的探讨一种有效安全的减轻化疗所致恶心呕吐的治疗方案.方法将88例乳腺癌术后和肺癌化疗病人随机分为观察组和对照组,观察组采用昂丹司琼与安定联合止吐,对照组采用甲氧氯普胺与地塞米松联合止吐,观察两组疗效.结果观察组有效率为86.96%,对照组有效率为64.29%,差异有显著性（P〈0.05）.结论昂丹司琼与安定联合治疗对化疗所致恶心呕吐有明显的预防作用,具有临床应用前景.     

电子止吐仪联合盐酸阿扎司琼防治奈达铂化疗所致恶心、呕吐的疗效观察

[目的]探讨电子止吐仪联合盐酸阿扎司琼防治奈达铂化疗所致恶心、呕吐的临床疗效。[方法]将160例接受奈达铂化疗的病人随机分为试验组和对照组各80例。试验组应用电子止吐仪联合盐酸阿扎司琼止吐,对照组单用盐酸阿扎司琼止吐,记录两组病人化疗开始到化疗后第7天恶心、呕吐以及其他不良反应的发生情况。[结果]试验组病人呕吐的完全控制率和有效率分别为72.50%,93.75%,对照组为53.75%,81.25%;试验组恶心完全控制率和有效率分别为65.00%,91.25%,对照组为42.50%,77.50%,两组呕吐、恶心的完全控制率和有效率比较差异均有统计学意义(P0.05)。两组头晕、口渴、便秘等不良反应发生率比较差异无统计学意义(P0.05)。[结论]电子止吐仪与盐酸阿扎司琼联合用于预防奈达铂化疗所致呕吐、恶心效果优于单用盐酸阿扎司琼。     

醋酸甲地孕酮预防化疗引起的消化道反应的临床研究

目的：观察醋酸甲地孕酮（MA）在预防化疗引起的消化道反应中的作用。方法：收集2007年6月～2008年6月病理学和细胞学证实的消化道恶性肿瘤60例,采用自身前后交叉对照研究,随机分为AB和BA两组。AB组第一周期止吐方案用格拉司琼＋胃复安＋MA,第二周期止吐方案用格拉司琼＋胃复安;BA组第一周期止吐方案用格拉司琼＋胃复安,第二周期止吐方案MA＋格拉司琼＋胃复安。结果：化疗同时配合使用MA恶心、呕吐发生率下降（P〈0．05）;恶心、呕吐程度改善（P〈0．001）,并且可以预防化疗引起的急性期和延迟期恶心、呕吐反应（P〈0．05）。结论：化疗同时配合使用MA可以改善化疗患者的恶心呕吐反应。     

减量应用恩丹西酮防治化疗所致恶心呕吐反应的疗效观察

对1995年8月至1996年10月65例肿瘤内科应用同种化疗方案病人,随机分为正规组,减量组和胃复安组。分别采用不同剂量的恩丹西酮、胃复安及地塞米松进行止吐,并对其疗效进行了观察。结果显示:减量应用组与正规量应用组在止吐效果上无显著性差异(P>0.05),减量应用组止吐效果明显优于胃复安组(P<0.01).     

雷莫司琼治疗化疗所致恶心、呕吐的疗效观察

目的探讨一种有效安全的减轻化疗所致恶心、呕吐的治疗方法。方法将88例血液肿瘤患者随机分为观察组和对照组，观察组采用雷莫司琼止吐，对照组采用甲氧氯普胺与地塞米松联合止吐，观察两组疗效。结果观察组有效率为86．96％．对照组有效率为64．29％，两组差异有统计学意义（P〈0．05）。结论雷莫司琼对化疗所致恶心、呕吐有明显的预防作用，具有临床应用前景。     

氯丙嗪预防化疗引起的胃肠反应

我们自1989年始用氯丙嗪控制各种肿瘤患者由于联合化疗引起的恶心、呕吐,并与同期止吐剂胃复安的止吐效果作了比较。 1 临床资料 1.1 患者情况:各类肿瘤病人104例,分为3组,即Ⅰ组(单用氯丙嗪组),Ⅱ组(胃复安组),Ⅲ组(氯丙嗪+胃复安组)。共用联合化疗加止吐剂治疗     

格拉斯琼复合芬太尼与氟芬合剂抑制阑尾牵拉反应的效果比较

格拉斯琼是一种高度选择性的5-HT3受体拮抗剂，有强烈的止吐作用。我院以格拉斯琼复合芬太尼用于抑制阑尾牵拉反应，取得了良好的效果，现报告如下。     

国产格拉司琼预防大剂量顺铂化疗所致呕吐的临床观察

目的观察格拉司琼的止吐疗效和毒性.方法对100例接受大剂量顺铂化疗的患者,采用随机抽样的方法,比较国产格拉司琼和进口格拉司琼在相等剂量下的疗效和毒性.结果格拉司琼能有效地预防大剂量顺铂化疗引起的恶心、呕吐,其止吐效果与Granisetron康泉相同.两药的止吐效果分别为90%和92%,完全缓解率分别为82%和84%.两药的疗效无显著差异,并且不良反应小.结论格拉司琼为肿瘤化疗安全有效的止吐药,且价格便宜,值得临床推广应用.     

Metoclopramide kinetics in patients with impaired renal function and clearance by hemodialysis

Metoclopramide kinetics were examined in 24 adult patients with diminished renal function and in eight healthy subjects with normal renal function. Creatinine clearance correlated with metoclopramide plasma clearance, renal clearance, nonrenal clearance, and elimination t1/2. Regardless of renal function, renal clearance accounted for less than or equal to 21% of total plasma clearance. Nonrenal clearance was reduced in patients and accounted for most of the reduction in plasma clearance. The comparatively small plasma clearances in patients imply that maintenance doses should be reduced accordingly to avoid drug cumulation. Metoclopramide clearance by hemodialysis was also assessed in four patients. Metoclopramide losses from hemodialysis were relatively small compared to estimates of total body metoclopramide stores. Compensatory dosage increases are probably unnecessary for most patients. These data also suggest that hemodialysis is not likely to be effective in metoclopramide overdose.     

Assessment of glomerular filtration rate in diabetic nephropathy using the plasma clearance of 51Cr-EDTA

We determined the circulating dopamine levels in 17 patients with insulin-dependent diabetes mellitus (IDDM), of whom eight had amenorrhoea (DM-AM) and nine were normally menstruating (DM). Seven non-diabetic women with normoprolactinaemic, normogonadotrophic secondary amenorrhoea (AM) and nine normally menstruating women (controls) were studied. In all subjects basal blood concentrations of free dopamine (f-DA), conjugated dopamine (c-DA), epinephrine (E), norepinephrine (NE), prolactin (PRL), luteinizing hormone (LH), thyroid-stimulating hormone (TSH) and oestradiol-17β were determined and all subjects, except for three AM patients, had a Metoclopramide test performed for measurements of f-DA, c-DA, PRL, LH and TSH. Plasma c-DA was significantly (p<0.05) increased in patients with amenorrhoea compared to the respective control groups. In diabetic patients c-DA levels were significantly (p<0.05) lower compared to controls. The ratio between basal f-DA and c-DA concentrations was significantly (p<0.01) higher in diabetic patients compared with non-diabetic patients. After Metoclopramide stimulation DM-AM patients showed a significant (p<0.05) rise in c-DA, whereas this was not seen in other groups. DM-AM patients had significantly (p<0.05) lower basal PRL and LH levels than DM patients and controls. In addition DM-AM patients had a significantly (p<0.05) lower PRL response to Metoclopramide compared with DM patients. There were no significant correlations between catecholamines and basal as well as Metoclopramide stimulated pituitary hormones. This study suggests that. the abnormal pituitary hormone secretion in patients with amenorrhoea may in part be caused by an increased dopaminergic activity. In addition, we have found that diabetic patients may have abnormalities in the metabolism of dopamine.     

Association of positive direct antiglobulin test (DAT) with nonreactive eluate and drug-induced immune hemolytic anemia (DIHA)

Background and Objectives: Drug-induced immune hemolytic anemia is a rare condition that occurs primarily because of drug-induced antibodies, either dependent or independent and positive direct antiglobulin test. Our aim was to evaluate the association of positive DAT with nonreactive eluate and DIHA. Materials and Methods: From 2014–2018, we evaluated 159 patients who presented positive DAT with a nonreactive eluate. Laboratory and clinical analyses were performed including HIV, HBV and HCV testing. All patients were exposed to the following drugs: Dipyrone in 63.5 %, Furosemide in 28.9 %, Metoclopramide in 34.6 % and Ondansetron in 41.5 %. Results: Results of DAT showed IgG in 125 (78.4 %) patients and C3d in 24 (15.1 %) with reactions varying from 1+ to 4+. HIV test was positive in 10 (16.1 %) patients, HBV was positive in 3 (4.7 %) and HCV was positive in, 1 (1.5 %). There was no clinical significance when the parameters of hemoglobin, hematocrit, reticulocytes and LDH were evaluated, only a slight increase in bilirubin, especially, in patients with positive DAT reacting 3+/4+ due to IgG and C3d sensitization. Clinical evaluations showed that all patients were asymptomatic. Conclusions: The association of drugs with positive DAT can be a challenge to transfusion services and immunohematology reference laboratories. There was no evidence of any case of severe hemolysis with clinical repercussion through the clinical and laboratory findings analyzed with the drugs associated with positive DAT. Dipyrone and Furosemide have already been associated with DIHA but there are no studies reporting the association of Metoclopramide and Ondansetron with DIHA.     

Abnormal conjugated dopamine levels in patients with normoprolactinaemic amenorrhoea and in insulin-dependent diabetic patients

We determined the circulating dopamine levels in 17 patients with insulin-dependent diabetes mellitus (IDDM), of whom eight had amenorrhoea (DM-AM) and nine were normally menstruating (DM). Seven non-diabetic women with normoprolactinaemic, normogonadotrophic secondary amenorrhoea (AM) and nine normally menstruating women (controls) were studied. In all subjects basal blood concentrations of free dopamine (f-DA), conjugated dopamine (c-DA), epinephrine (E), norepinephrine (NE), prolactin (PRL), luteinizing hormone (LH), thyroid-stimulating hormone (TSH) and oestradiol-17 beta were determined and all subjects, except for three AM patients, had a Metoclopramide test performed for measurements of f-DA, c-DA, PRL, LH and TSH. Plasma c-DA was significantly (p less than 0.05) increased in patients with amenorrhoea compared to the respective control groups. In diabetic patients c-DA levels were significantly (p less than 0.05) lower compared to controls. The ratio between basal f-DA and c-DA concentrations was significantly (p less than 0.01) higher in diabetic patients compared with non-diabetic patients. After Metoclopramide stimulation DM-AM patients showed a significant (p less than 0.05) rise in c-DA, whereas this was not seen in other groups. DM-AM patients had significantly (p less than 0.05) lower basal PRL and LH levels than DM patients and controls. In addition DM-AM patients had a significantly (p less than 0.05) lower PRL response to Metoclopramide compared with DM patients. There were no significant correlations between catecholamines and basal as well as Metoclopramide stimulated pituitary hormones. This study suggests that the abnormal pituitary hormone secretion in patients with amenorrhoea may in part be caused by an increased dopaminergic activity.(ABSTRACT TRUNCATED AT 250 WORDS)     

Metoclopramide: a dopamine receptor antagonist

A dopamine receptor antagonist, metoclopramide has unique properties of increasing lower esophageal sphincter pressure and increasing the rate of gastric emptying. These gastrointestinal motility actions are useful in the treatment of diabetic gastroparesis and severe gastroesophageal reflux and in postoperative situations involving visceral atony. Metoclopramide is a useful adjunctive drug for intestinal intubation and radiologic examination. It has also been used intravenously to control the nausea and vomiting of intensive cancer chemotherapy, such as with cisplatin. Metoclopramide is a powerful antiemetic because of its combined actions on the chemoreceptor trigger zone and intestinal motility. This agent is generally not intended for long-term use. The oral preparations are recommended for four to 12 weeks of therapy. Use of parenteral metoclopramide should be limited to one or two days. The most common adverse reactions are restlessness, drowsiness, fatigue and lassitude. Extrapyramidal symptoms occur rarely and only with high dosage or prolonged use.     

Recurrent syncope, hypotension, asthma, and migraine with aura: role of metoclopramide

Migraine associated with asthma or symptomatic orthostatic hypotension is a particularly difficult subgroup to manage. Metoclopramide is a useful pharmacological agent for orthostatic hypotension. I present the case report of a migraine patient with asthma and recurrent hypotensive syncope. Metoclopramide relieved recurrent syncope as well as migraine attacks in this patient. Metoclopramide has a striking influence on arginine vasopressin (AVP) secretion. AVP promotes antinociception and influences vasomotor and behavior control, which actions possibly keep migraine in remission. Further studies are necessary to confirm the migraine prophylactic value of metoclopramide.     

妇科千金片联合莫西沙星治疗急性盆腔炎60例临床分析

目的：探讨妇科千金片联合莫西沙星治疗急性盆腔炎的临床效果。方法：将2009年2月至2011年2月收治的急性盆腔炎患者120例随机分为观察组和对照组各60例，观察组采用妇科千金片联合莫西沙星治疗，对照组采用头孢三嗪联合替硝唑治疗，比较两组临床效果。结果：观察组疗效明显优于对照组（P〈0．05），两组不良反应发生率无显著性差异（P〉0．05）。结论：妇科千金片联合莫西沙星治疗急性盆腔炎的效果优于头孢三嗪联合替硝唑，且不良反应少，建议临床推广应用。     

Metoclopramide aborts cough-induced headache and ameliorates cough--a pilot study

Metoclopramide (MTCL) can abort attacks of migraine headache. I report swift resolution of cough-induced headache as well as suppression of cough in six male patients following parenteral administration of MTCL. A similar unexpected rapid antitussive action of MTCL was also observed in 12 of 14 other patients (13 male and 1 female) with severe paroxysmal cough without headache. Use of MTCL primarily for analgesia is reviewed, and the pharmacological basis for its antinociceptive action is proposed. As a nonopiate agent with potential to stimulate endogenous opiate-mediated mechanisms, MTCL appears to have additional valuable roles in clinical practice. This is the first report of an antitussive action of MTCL. Further controlled studies are required to confirm the therapeutic role of MTCL in cough-induced headache as well as its potential antitussive and general analgesic actions.     

Dopaminergic regulation of aldosterone secretion: assessment in different subtypes of primary aldosteronism and in essential hypertension.

The inhibitory effect of dopamine on aldosterone secretion was investigated in patients with different types of primary aldosteronism, six with idiopathic hyperaldosteronism (IHA) and four with dexamethasone-suppressible hyperaldosteronism (DSH), and in 10 patients with essential hypertension. The effects of 10 mg metoclopramide given intravenously, 10 mg bromocriptine given orally and 100 micrograms adrenocorticotrophic hormone given intravenously on plasma aldosterone and renin activities were investigated in all patients. Metoclopramide induced a rise in plasma aldosterone activity only in patients with IHA and not in those with DSH and essential hypertension. After bromocriptine plasma aldosterone concentrations decreased in patients with IHA only, and after adrenocorticotrophic hormone plasma aldosterone concentrations increased in patients with DSH only. Plasma renin activity was unaffected in all cases. These results provide evidence of increased endogenous dopaminergic inhibition of aldosterone secretion in IHA and of a blunted aldosterone response in both DSH and essential hypertension.