Antivert
Delayed nausea and vomiting in children receiving antineoplastics.

Dupuis LL, Lau R, Greenberg ML.

Department of Pharmacy, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8. lee.dupuis sickkids.on.ca

BACKGROUND: The nature and prevalence of delayed antineoplastic-induced nausea and vomiting have not been well-described in children. This study describes the extent of delayed nausea and vomiting in children receiving antineoplastic agents as well as the drug therapies initiated in an attempt to prevent or manage it. PROCEDURE: All children receiving antineoplastics were eligible for study entry. The date and time of each emetic episode were recorded on each day antineoplastics were given and for 3 days thereafter. Nausea was self-assessed daily by children who were older than 3 years and were not developmentally delayed. Diet was also assessed daily. The emetic response, median nausea rating and median diet achieved were described. RESULTS: The emetic response of 124 children who received 174 antineoplastic cycles was evaluated. Most cycles (137/174;79%) were not associated with delayed vomiting. Cycles which included cisplatin, carboplatin, or cyclophosphamide; involved antineoplastic therapy given over 2 or more consecutive days; or were accompanied by vomiting during the acute phase were associated with a significantly higher incidence of delayed vomiting. Moderate to severe nausea was reported on 58% (267/459) of study days. No antiemetics were given on most study days (412/522;79%); nevertheless, most of the study days (381/412;93%) which were unaccompanied by antiemetic support during the delayed phase were completely free from vomiting. Antiemetics were most often given as single agents (ondansetron: 54 study days; dimenhydrinate: 17 study days; dexamethasone: 6 study days). Diet was largely unaffected during the study period. CONCLUSIONS: Antineoplastic-induced delayed nausea and vomiting may be less prevalent in children than in adults. Routine antiemetic administration during the delayed phase may not be warranted in all patients. Med Pediatr Oncol 2001;37:115-121. Copyright 2001 Wiley-Liss, Inc.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11496349&dopt=Abstract dimenhydrinate meclizine Antivert



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Transdermal therapeutic system scopolamine (TTSS), dimenhydrinate, and placebo--a comparative study at sea.

Noy S, Shapira S, Zilbiger A, Ribak J.

The efficacy of transdermally administered scopolamine was compared with the efficacy of oral dimenhydrinate and placebo therapy in the prevention of motion sickness at sea. Medication was administered on a controlled double blind basis to 140 subjects. A placebo effect reduced the motion sickness incidence (MSI) from 57.69% in the control group to 43.47%. Administration of dimenhydrinate reduced the MSI to 22.22% and the use of Transdermal Therapeutic System Scopolamine (TTSS) further reduced the MSI to 16.66%. TTSS afforded 61.67% protection against motion sickness at sea, compared to 48.88% protection with dimenhydrinate.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6508687&dopt=Abstract dimenhydrinate meclizine Antivert



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Serum levels of dimenhydrinate. Determination by HPLC with UV detection after intake of dimenhydrinate in a coated chewing gum dragee.

Skofitsch G, Lembeck F.

HPLC with UV detection allowed to separate dimenhydrinate and three major metabolites (diphenyl-methoxy-ethylamine, diphenyl-methoxy-acetic acid, diphenyl-methoxy-N-methyl-amine) in human serum without extraction procedure. Detection limit was 25 ng per 500 microliter injected sample, the recovery ranged from 70 to 95%. Serum levels of dimenhydrinate were measured in healthy volunteers 15, 30, 60 and 120 min after intake of two commercially available preparations, one of them a dimenhydrinate tablet, the other one a dimenhydrinate containing coated chewing gum dragee (Travel-Gum dragee). The rise of the serum concentration of dimenhydrinate up to 30 min was smaller after intake of the coated chewing gum preparation than after swallowing the tablet. The serum concentrations at 1 or 2 h after the intake of either a tablet or the chewing gum were comparable. The variability of the serum concentrations was considerable with both preparations and seemed to be influenced more by individual factors than by previous food intake.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6686772&dopt=Abstract dimenhydrinate meclizine Antivert



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Evaluation of drugs for arrest of premature labor in a new animal model.

Hahn DW, McGuire JL, Vanderhoof M, Ericson E, Pasquale SA.

Reported are pharmacologic data from a new animal model used for evaluating drugs from several therapeutic classes for their potential use in the treatment of premature labor. This model measures the spontaneous delivery time between the first and second rat pups in a term pregnancy. In control animals, this averaged 16.3 +/- 4.2 minutes. Ethanol (3.5 gm/kg) and the beta-agonists ritodrine (12.5 mg/kg) and albuterol (0.25 mg/kg) significantly delayed delivery of the second pup. The calcium blockers nifedipine, verapamil, and diltiazem were the most active of all compounds tested in this model. The nonsteroidal anti-inflammatory agents indomethacin and naproxen were inactive at doses as high as 5 and 25 mg/kg, respectively. Metiamide, an H2-antagonist, and dimenhydrinate, an H1-antagonist, were inactive.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6702947&dopt=Abstract dimenhydrinate meclizine Antivert