#antiemetic

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Gabe and Nathalie! 🔥🔥🔥➕➖

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Metoclopramide

Common Brand Names: Reglan

Therapeutic Class: A synthetic substituted benzamide that increases gastric motility and acts as a potent antiemetic.

Common Injectable Dosage Forms:

Injection (as monohydrochloride monohydrate): 5 mg/mL in various vials and ampoules

Dosage Ranges:

Dosage in diabetic gastroparesis and GERD is usually initiated at 10 mg four times daily, given 30 minutes before meals and at bedtime, for durations of 2-8 weeks. Parenteral therapy should be stopped when symptoms are suppressed sufficiently to allow oral therapy. For chemotherapy-induced emesis, doses are initiated at 2 mg/kg and given 30 minutes before administration of the agent, then repeated twice at 2-hour intervals. Doses may be continued at 3-hour intervals for 3 more doses if emesis persists, and again for 3 more doses at 1 mg/kg if no response is noted.

For postoperative nausea and vomiting: 10-20 mg doses may be repeated every 4-6 hours as necessary.

In intubation procedures and radiologic exams: 10 mg is usually given as a direct single injection.

Dosages in children for these procedures is generally 0.1 mg/kg when younger than 6 years of age, and 2.5-5 mg in children 6-14 years of age.

Administration and Stability: May be administered IM, direct IV injection, or by IV infusion. For IM or direct IV injection, the undiluted solution (5 mg/mL) may be used. Direct IV injection is administered slowly over 1-2 minutes. For IV infusion, metoclopramide is diluted with 50 mL of a compatible solution (NS) and slowly over at least 15 minutes. Solutions are stable up to 48 hours when further diluted with compatible solutions, and up to 4 weeks when frozen in NS only. pH 2.5-6.5

Pharmacology/Pharmacokinetics: The pharmacology of metoclopramide is complex and not fully elucidated, but it is thought to increase gastric motility by several means including increasing amplitude and duration of esophageal contractions, lowered resting tone of esophageal sphincter, and increasing peristalsis of duodenum and jejunum. Metoclopramide is thought to prevent emesis by blocking dopamine receptors in the chemoreceptor trigger zone (CTZ) which controls vomiting response. The drug is 13-22% protein bound and has a volume of distribution of 2-3 L/kg. It is 70-85% excreted in the urine and has an elimination half-life of 3-4 hours.

Drug and Lab Interactions: May alter the rate and extent of absorption of certain drugs by its effect on transit time in the stomach and small intestine. Concomitant use with other CNS DEPRESSANTS may have additive effects. Effects on GI motility are antagonized by opiate agonists and anticholinergics. May potentiate hypotension when used with hypotensive anesthetic agents.

Contraindications/Precautions: Contraindicated in patients who receive drugs which cause extrapyramidal symptoms (butyrophenones, phenothiazines), in patients with pheochromocytoma, known hypersensitivity to procainamide (structurally related), or mechanical bowel obstruction and/or perforation. Should be used with caution for prolonged therapy in patients with renal dysfunction, and in patients with mental depression, especially those with suicidal tendencies. Pregnancy Category B.

Monitoring Parameters: Dystonic reactions, signs of hypoglycemia, agitation, and confusion

Adverse Effects: The most common side effect is drowsiness, but extrapyramidal effects are often seen with high-dose therapy. Other reported effects include hypotension, diarrhea, galactorrhea, and visual disturbances.

Common Clinical Applications: Effective in treatment of diabetic gastroparesis, symptomatic gastroesophageal reflux, prevention of chemotherapy-induced nausea and vomiting, small bowel intubation, and radiological exams.

[bpod-bpod]

Exposing Hidden Enemies

A wanted criminal with a particularly recognisable hair-do might cut it off to avoid detection. Cancer cells in the body pull a similar trick, by absorbing unique markers on their surface that might alert other cells to their threatening presence. A new study has found that a drug called prochlorperazine, often used to treat nausea and psychosis, can prevent tumour cells from hiding their surface receptors by restricting endocytosis – a process for bringing substances inside a cell. In mice, and then patients, treatment with the drug led to increased clustering of these telltale markers on the surface of tumour cells. This in turn made it easier for the immune cells (white in the sample pictured) and the anticancer drug cetuximab (blue) to bind to and disable tumour cells (red), potentially giving a boost to the potency of these forms of treatments.

Written by Anthony Lewis

Image by Blerida Banushi and Fiona Simpson UQDI, University of Queensland, featured in Cell Picture Show

Image copyright held by the original authors

The University of Queensland Diamantina Institute, University of Queensland, Woolloongabba, Australia

Research published in Cell, March 2020

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[didanawisgi]

Ginger

Good for What Ails You

March 2011

By Robin Gettleman

Due to the powerful phenolic compounds found in ginger, this spice has been studied for its benefits for a wide range of ailments and health disorders. While often referred to as a root, ginger is in fact a spice that contains potent antioxidants such as shogaols, zingerone, and gingerols.1 These strong compounds have been linked to providing relief for dozens of issues, including cough, bronchitis, upper respiratory tract infections, migraine headaches, motion and morning sickness, rheumatoid arthritis, post-surgical pain, flatulence, loss of appetite, diarrhea, upset stomach, stomachache, colic, dyspepsia, and general and chemotherapy-induced nausea. It has even been used topically as an analgesic.1

Ginger has been used as a home remedy for thousands of years.

Ginger’s History

The health benefits of ginger have a history almost as old as civilization itself. Historians have found references to the use of ginger, known botanically as Zingiber officinale, in the writings of nearly every ancient society, including Chinese, Indian, and Roman. In fact, the ancient Roman Empire first started importing ginger nearly two thousand years ago.2 Due to its alluring smell, great taste, and medicinal properties, the spice became extraordinarily popular in Europe. This rise in demand, combined with the expensive cost of shipping the product from Asia, forced Europeans to find ways to make ginger less expensive and more readily available. They did this by introducing ginger to the West Indies, Mexico, and South America, and then exporting it back to Europe. Since ginger thrives in a tropical climate, it is produced in the United States in Hawaii, Florida, and California.1 Internationally, it is exported mainly from Jamaica, Fiji, India, China, and Australia.

Ginger’s Benefits

Motion Sickness

Many prescription or over-the-counter products on the market that are developed to combat motion sickness or nausea have side effects like drowsiness and dry mouth. Ginger has shown in several studies that it may provide significant relief to the above symptoms without the detrimental side effects.3

In one study comparing ginger to a placebo in an attempt to measure its ability to reduce symptoms associated with motion sickness, ginger was measured to be potentially more effective than placebo.3 This trial studied 80 beginner-level sailors who were prone to motion sickness. Half of the group took powdered ginger and the other half took placebo. The half who took ginger experienced a reduction in vomiting and cold sweats compared to placebo.

Morning Sickness

Ginger has been used as a home remedy for thousands of years, with one of the longest known uses as a treatment for morning sickness accompanying pregnancy. Researchers presented a study that finally put this folk remedy to the test. In a double-blind, randomized, placebo-controlled trial, a group of pregnant women ingested 125 mg of ginger extract four times a day for four days.4 All the women were less than 20 weeks pregnant, and the women who ingested the ginger showed significantly reduced symptoms of morning sickness, compared with women who consumed placebo.

Inflammation

Ginger contains ultra-potent anti-inflammatory compounds called gingerols, which are the substances that many scientists believe are responsible for the reduction in inflammation people experience when they start taking ginger supplements regularly. Case in point, a recent study involving patients who tried conventional drugs to alleviate painful symptoms found that 100% of patients with muscular discomfort experienced relief of pain or swelling when they consumed ginger on a daily basis.2

In a compelling study published in Osteoarthritis and Cartilage, 29 patients with debilitating arthritis in the knee participated in a placebo-controlled, double-blind, crossover study.5 The study had each patient start with placebo or ginger, and then switch after 3 months, writing down the results. At the end of the first half-year of the study, the patients who were taking ginger experienced significantly less pain than those on the placebo. Additionally, the patients using ginger reported improvements on a standardized scale used to assess mobility.

A separate study measuring the anti-inflammatory properties of red ginger in the Journal of Medicinal Food found positive results as well.6 In this study, Japanese researchers prepared a 40% ethanolic extract from dried red ginger and evaluated its anti-inflammatory activity. After confirming that antioxidant shogaols and gingerols suppressed production of inflammatory mediators, the researchers discovered that red ginger extract “has a potent suppressive effect on acute and chronic inflammation, and inhibition of macrophage activation seems to be involved in this anti-inflammatory effect.”6

Ginger Tips

Choose fresh ginger over dried ginger to preserve the high levels of gingerol content.

Fresh ginger root should be firm, smooth, and free of bruises and mold.

Fresh ginger can be stored in your refrigerator for up to three weeks if left unpeeled.

Dried ginger should be kept in a tightly sealed glass container in a dry, cool, and dark place.

The center of the ginger root is the most flavorful.

When shredding ginger, be sure to shred in the direction of the fibers.

Helps Reduce Chemotherapy-Induced Nausea

Chemotherapy-induced nausea is the type of stomach unease or discomfort that begins within 24 hours after the administration of chemotherapy. Many patients treated for cancer experience this awful side effect, which can lead to vomiting, dry heaving, and overall sickness. It is known that meals high in protein may offer some protection against the onset of nausea, and a study recently tested whether high-protein meals with added ginger had any beneficial effect.

A team at Siena College in Loudonville, New York, studied this hypothesis on 28 patients with cancer who were receiving chemotherapy for the first time.7 Control group patients ate their normal diets, while another group drank a high-protein shake with ginger twice daily. The results were striking.

Patients taking the high-protein shake with ginger reported significantly fewer instances of nausea, and electrical measurements of the stomach muscles revealed less gastric dysrhythmia, leading the researchers to conclude that high protein meals with ginger reduced the nausea that follows chemotherapy.7

Colon Cancer Prevention

In a study done by scientists at the University of Minnesota, gingerol exhibited anti-inflammatory and antitumorigenic effects.8 At first, scientists were unsure about why gingerol displayed such effectiveness against colon cancer, but the study revealed that the leukotriene A(4) hydrolase protein (LTA[4]H), whose activity can act as a catalyst for colon cancer cells, is targeted by gingerol.8

The researchers gave a group of specially bred mice an injection of gingerol three times a week before and after injecting human colorectal cancer cells into them. Tumors first appeared 15 days after mice were injected, but only 4 tumors were discovered in the gingerol group, as opposed to 13 in the control mice.

The findings revealed that “gingerol effectively suppressed tumor growth in mice by inhibition of LTA(4)H activity…these findings support the anticancer efficacy of gingerol for the prevention of colorectal cancer.”8

Fights Ovarian Cancer

While the effectiveness of ginger extracts against inflammation and tumors has been shown above, perhaps ginger has the most promising effect in the fight against ovarian cancer.

At the 97th Annual Meeting of the American Association for Cancer Research, Dr. Rebecca Liu and her team from the University of Michigan made a presentation about gingerol’s ability to kill ovarian cancer cells by inducing apoptosis (programmed cell death) and autophagocytosis (self-digestion).9

The presentation focused on Dr. Liu’s team’s experiments that examined the effects of a whole ginger extract containing 5% gingerol on several different ovarian cancer lines. While traditional chemotherapeutic agents suppress inflammation the same way ginger is purported to, the danger is that cancer cells may become resistant to the drugs. Dr. Liu believes that ginger may be unique in this respect because cancer cells show no sign of becoming resistant to its cancer-fighting properties. Her team’s data showing that exposure to ginger extract caused cell death in all ovarian cancer lines studied bolster this claim.9

References

1. Grotto D. 101 Foods That Could Save Your Life. New York: Bantam Bell; 2008.

2. Available at: www.whfoods.com/genpage.php?tname=foodspice&dbid=72. Accessed December 14, 2010.

3. Available at: www.umm.edu/altmed/articles/ginger-000246.htm. Accessed December 14, 2010.

4. Willetts KE, Ekangaki A, Eden JA. Effect of a ginger extract on pregnancy-induced nausea: a randomised controlled trial. Aust N Z J Obstet Gynaecol. 2003 Apr;43(2):139-44.

5. Wigler I, Grotto I, Caspi D, Yaron M. The effects of Zintona EC (a ginger extract) on symptomatic gonarthritis. Osteoarthritis and Cartilage. 2003 Nov;11(11):783-9.

6. Shimoda H, Shan SJ, Tanaka J, et al. Anti-inflammatory properties of red ginger (Zingiber officinale var. Rubra) extract and suppression of nitric oxide production by its constituents. J Med Food. 2010 Feb;13(1):156-62.

7. Levine ME, Gillis MG, Koch SY, Voss AC, Stern RM, Koch KL. Protein and ginger for the treatment of chemotherapy-induced delayed nausea. J Altern Complement Med. 2008 Jun;14(5):545-51.

8. Jeong CH, Bode AM, Pugliese A, et al. [6]-Gingerol suppresses colon cancer growth by targeting leukotriene A4 hydrolase. Cancer Res. 2009 Jul 1;69(13):5584-91.

9. Liu R. Presentation at the 97th Annual Meeting of the American Association for Cancer Research.

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Everyone ready for the wc final starting in fifteen?

[amcrasto]

Methiomeprazine

Methiomeprazine N,N,2-trimethyl-3-(2-methylsulfanylphenothiazin-10-yl)propan-1-amine CAS 7009-43-0 Molecular Formula, C19-H24-N2-S2, Molecular Weight, 344.5446, 10H-Phenothiazine-10-propanamine, N,N,β-trimethyl-2-(methylthio)-, (±)-Phenothiazine, 10-[3-(dimethylamino)-2-methylpropyl]-2-(methylthio)-, (±)-…

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[amcrasto]

DOMPERIDONE

DOMPERIDONE Molecular FormulaC22H24ClN5O2Average mass425.911 Da 1H-Benzimidazol-2-ol, 5-chloro-1-[1-[3-(2-hydroxy-1H-benzimidazol-1-yl)propyl]-4-piperidinyl]-260-968-7[EINECS]2H-Benzimidazol-2-one,…

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[hrpharmacist]

Rx Vomikind Injection IP-: It contains ondansetron as an active ingredient. It works by blocking the action of a NA. , , , Uses-: It is mainly used to control nausea and vomiting due to certain medical conditions like stomach upset. It is also used to prevent nausea and vomiting caused due to any surgery and cancer drug therapy or radiotherapy... , , , Side effects-: *Headache *Constipation , , #*WE DIDN'T SUPPORT SELF-MEDICATION SO PLEASE CONSULT YOUR DOCTOR BEFORE TAKING ANY MEDICINE 💊👨‍⚕️#* , ,*DO AS DIRECTED BY PHYSICIAN* , FOR MORE INFORMATION FOLLOW NOW-: @hr_pharmacist , ,#vomiting #nausea #antiemetic ,#vomikind , , #hrpharmacist #pharmacist #pharmacy #pharmd #medicalstudent #medlifestyle #pharmastudent #pharmakon #pharmaknowledge #pharma #doctor #drug #covid_19 #corona #vaccinationdone✔️ #vaccine #ondemsteroids #medicine #1mg #medlife #pharmeasy #medicalpages #neet #mbbs #neetug (at Bhopal, Madhya Pradesh) https://www.instagram.com/p/CP9ryrhDYVC/?utm_medium=tumblr