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Cesarean Delivery
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
A. Dhanya Mackeen, Meike Schuster
One RCT demonstrated decreased time to bowel sounds, first bowel movement, and time in bed with the use of acupuncture (20-minute sessions at 1 hour and 4 hours postoperatively) [315]. Similar results were seen with the administration of 10 mg of metoclopramide intraoperatively [316]. Another trial utilized ginger capsules, which helped decrease abdominal distension and allowed patients to eat quicker but did not affect the time to flatus or maternal satisfaction [317]. Another RCT showed that combining dexamethasone 8 mg and ondansetron 4 mg compared to just Zofran significantly decreased postoperative nausea and vomiting (9% versus 37%, p <0.01) [318]. In summary, these interventions are options to decrease postoperative nausea and vomiting.
Carbamylphosphate synthetase deficiency
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
The treatment of the acute hyperammonemic crisis of CPS1D is as outlined in Chapters 25 and 26 [30, 36, 37]. The acute and chronic management of this condition does not differ from that of OTCD (see Table 26.1). Doses of Na-benzoate and Na-phenylacetate begin with 250 mg/kg of each. Arginine is given at 250–500 mg/kg/day during acute crises and with 100–200 mg/kg/day long term. For oral treatment, citrulline is a good alternative. Adjustments are done according to the results of amino acid determinations ensuring high normal values. An antiemetic such as zofran (0.15–0.5 mg/kg) is sometimes useful. For chronic oral treatment, Na-phenylacetate has been employed in doses of 250 mg/kg per day. The dietary intake of protein is restricted and supplementation with a mixture of essential amino acids (cyclinex, EAMI, UCD) is usually helpful in maintaining reasonable concentrations of amino acids in plasma while minimizing nitrogen load.
Neurofeedback in an Integrative Medical Practice
Published in Hanno W. Kirk, Restoring the Brain, 2020
16-year-old boy with Tourette’s Syndrome, ADD, and social anxiety presented with constant, debilitating nausea and exacerbation of his tics that began 5 months prior during a stressful time at school. He had a multi-year history of anxiety about going to school that would crescendo at the end of a weekend and thus had a record of poor school attendance. On one Sunday evening he had an episode of extreme agitation and violence in which he physically tore apart portions of the house. He was hospitalized and medicated with Haldol for a “psychotic” episode. He had not attended school since that time. He spent all his time either in bed or in front of electronic media. He rarely left the house unless physically forced. Nausea is moderate and vaguely located in the abdomen. He vomited twice since symptoms began. Appetite was rarely compromised, and patient had gained about 40 lbs. Bowel movements were formed and occurred daily to every other day. Anti-nausea medications had been ineffective, including Zofran. At presentation his only medicine was Prilosec (40 mg. daily). Tourette’s syndrome had been diagnosed at 4 years of age. The patient expressed much embarrassment and distress about his tic disorder: “on a scale of 1 to 10, it is a 13.”
Formulation and evaluation of niosomal vesicles containing ondansetron HCL for trans-mucosal nasal drug delivery
Published in Drug Development and Industrial Pharmacy, 2020
Mahmoud H. Teaima, Ahmed M. El Mohamady, Mohamed A. El-Nabarawi, Amir I. Mohamed
Potassium hydrogen phosphate, disodium hydrogen phosphate, sodium chloride, potassium chloride, calcium chloride, polysorbate (Tween 80, Tween 20), and sodium carboxymethyl cellulose were purchased from El Nasr Pharmaceutical Chemicals Co., Cairo, Egypt. Sorbitan monostearate (Span 60, Span 80) and cholesterol were purchased from Loba Chemie, Mumbai, India. Ondansetron HCl was purchased from BMR Pharma & Chemicals, Hyderabad, India. Diethyl ether and 1-propane were purchased from Honeywell Riedel-de-Haën, Seelze, Germany. Poloxamer 407 purchased from Sigma-Aldrich, KGaA, Darmstadt, Germany. Acetonitrile and methanol (HPLC grade) were purchased from Fisher Chemicals, Geel, Belgium. SERVA Visking® Dialysis Tubing molecular weight cutoff 12,000–14,000 pore diameter 25 A° (SERVA Electrophoresis, Uetersen, Germany). Commercial product Zofran (4 mg) tablets were purchased from GSK, Egypt. Male New Zealand white rabbits were purchased from animal house (Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt).
Sustained release formulation of Ondansetron HCl using osmotic drug delivery approach
Published in Drug Development and Industrial Pharmacy, 2020
Ramakant Gundu, Sanjay Pekamwar, Santosh Shelke, Santosh Shep, Deepak Kulkarni
The formulation was optimized in terms of all in vitro evaluation parameters and then subjected for PK study in beagle dogs to establish the conceived concept. The study comparing Ondansetron HCl ER tablets 24 mg (Osmotic) and Zofran® tablet; Table 14 and Figure 7. As expected, the in vitro drug release and in vivo release rate profiles for once a day (o.d) extended release Ondansetron HCl osmotic tablet 24 mg provided typical order release and a constant plasma concentration of drug over 24 h period compared to thrice a day (t.i.d) immediate release commercially available OSH tablet 8 mg (Zofran® IR tablets 8 mg) in beagle dog. Initial loading dose of 4 mg Ondansetron HCl helps in achieving faster onset of therapeutic action by crossing the minimum effective concentration within one hour of administration. In this study, the advantage of osmotic formulations over immediate release are like constant and less fluctuating plasma concentration over 24 h, yet maintaining the desired safety, efficacy, and pharmacological effects of the drug. This was successfully demonstrated with the correlation of PK data obtained in these studies.
Spaceflight medical countermeasures: a strategic approach for mitigating effects from solar particle events
Published in International Journal of Radiation Biology, 2021
King et al. (1999) tested Ondansetron (Zofran®), a 5-HT3 serotonin antagonist, to treat nausea associated with prodromal effects. Ondansetron (Zofran®) is approved clinically for the treatment of nausea associated with radiotherapy, has demonstrated effectiveness in reducing emetic risk due to space-relevant ionizing radiation, and has been tested in crew on the ISS to alleviate motion sickness. Other potential anti-nausea medications that may be considered include granisetron (Kytril®), palonosetron (Aloxi®), and dolasetron (Anzemet®) – all 5-HT3 serotonin antagonists; prochlorperazine (Compro®), a dopamine receptor antagonist; and dexamethasone (Decadron®), a corticosteroid.