Antivert
[Metoclopramide and dexamethasone in prevention of postoperative nausea and vomiting after inhalational anaesthesia]

[Article in German]

Wallenborn J, Rudolph C, Gelbrich G, Goerlich TM, Dohnert J, Dorner J, Olthoff D.

Klinik und Poliklinik fur Anasthesiologie und Intensivtherapie, Universitat Leipzig. jan.walle t-online.de

OBJECTIVE: Because of its complex profile of action (binding to dopamine, serotonin and histamine receptors), low rate of adverse effects and low cost as a medicinal preparation, metoclopramide is an interesting substance for the prophylaxis of post-operative nausea and vomiting (PONV). As a single substance its antiemetic effects are slight at the usual dose, so the aim was to test the efficacy of a combination of metoclopramide and dexamethasone for the prevention of PONV on a group of patients with the same operative trauma. METHOD: All patients (n = 204) were recruited prospectively (January-October 2002) and were to undergo a lumbar disc operation. The anaesthetic was administered according to a standard procedure as a balanced anaesthetic with fentanyl and isoflurane in oxygen/air. 60 min before the end of the operation, all patients were given 10 mg of metoclopramide and 8 mg of dexamethasone intravenously. The Wurzburg-Oulu-Score served as an instrument for comparison, because no placebo group has been included. 24 hours after the operation, all patients were asked to report on nausea and vomiting, stating the time and the degree of discomfort (quantification by means of an analogue numerical scale from 0-10). The influence of age, height, weight, duration of the anaesthetic, operating position and increased dexamethasone dose was analyzed in addition to the risk factors according to the score. The cost analysis was based on the purchase prices of the hospital dispensary. RESULTS: The expected PONV incidence was 35.8%; 10% nausea (average intensity 4.3) and 3% emesis (4.8) was reported for the 24-hour period. The rescue medication (dimenhydrinate) was requested 8 times. Nausea was mainly during the early part of the period (0-6 hours). Of 42 patients with a history of PONV, 71% had no symptoms. The Odds Ratios for female sex (2.9), non-smoker status (2.0) and post-operative opioid administration (1.9) correspond to the data given in the literature; it was not possible to determine the significance of a history of PONV as an independent risk factor. None of the other factors investigated had a significant influence on PONV. For the chosen combination of antiemetic drugs the number-needed-to-treat is 3.9 (95% CI: 3.3-4.7). The direct costs of the PONV prophylaxis are 0.65 euro per patient. CONCLUSIONS: The metoclopramide/dexamethasone combination proved to be effective and inexpensive, on the basis of these findings it is used prophylactically at our hospital if only one PONV risk factor exists.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14600859&dopt=Abstract dimenhydrinate meclizine Antivert



Antivert
Equipment for drug release testing of medicated chewing gums.

Kvist LC, Andersson SB, Berglund J, Wennergren B, Fors SM.

Pharmacia and Upjohn, Consumer Healthcare, Helsingborg, Sweden.

An apparatus was specially designed and constructed for release testing of medicated chewing gums. The adjustable instrumental settings such as temperature, chewing frequency, chewing time, volume of test medium, distance between the jaws and twisting angle increased the versatility of the apparatus. Selection of the test medium was also an important parameter. Each sample was kneaded mechanically in separate test chambers and the drug release was followed by sampling and HPLC analysis. Different gum formulations were tested and the obtained results demonstrated satisfactory release curves for a variety of formulations and active ingredients. The tested gum formulations comprised nicotine, meclizine, dimenhydrinate and xylitol. The apparatus proved to be suitable in product control of commercial batches but also a useful tool in the research and development of medicated gum formulations.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10766358&dopt=Abstract dimenhydrinate meclizine Antivert



Antivert
[The effect of surface phenomena on the processing of solid materials. II. Experimental evaluation of surface phenomena of solid materials]

[Article in Hungarian]

Tuske Z, Bajdik J, Hodi K, Eros I.

Szegedi Tudomanyegyetem, Gyogyszertechnologiai Intezet, Szeged, Eotvos u. 6.-6723.

The functions of friction and adhesion in the processing of solid materials were evaluated in our work. The second part of our study dealt with some practical examples from our practice. Indomethacin was used for the examination of adhesion, dimenhydrinate for the study of friction, and metronidazole for the determination of the spreading coefficient. Several technological methods (coating, granulation, pelletization and tableting) were used. The positive effects of the processes on the various phenomena (surface free energy, adhesion force and spreading coefficient) were emphasized. The influences of alteration in the parameters on the flowability, compressibility, compact texture, etc. were assessed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14702688&dopt=Abstract dimenhydrinate meclizine Antivert



Antivert
Film coating as a method to enhance the preparation of tablets from dimenhydrinate crystals.

Bajdik J, Pintye-Hodi K, Planinsek O, Regdon G Jr, Dreu R, Srcic S, Eros I.

Department of Pharmaceutical Technology, University of Szeged, H-6720 Szeged, Eotvos u. 6, Hungary.

Crystals of dimenhydrinate as a model drug were used for crystal coating, a method that can be applied to increase the flowability of a material and facilitate the tablet making. An increase in particle size was observed during the film coating. The change in shape of the coated particles was also examined. Some physicochemical parameters changed during coating, e.g. the surface free energy parameters and the wetting of the samples. The amount of coating material (and therefore the coating time) influenced several parameters (the shape of the particles, the flow properties and surface free energy parameters, compressibility and compactibility). Several parameters of prepared tablet (porosity, breaking hardness) were examined. Accordingly, coating of the crystals can be performed in order to enhance the handling of a material with insufficient properties for tablet making.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14706251&dopt=Abstract dimenhydrinate meclizine Antivert