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Cureus Aug 2022Acute gastroenteritis is one of the common diseases of childhood. Dehydration is the most frequent consequence of acute gastroenteritis, and vomiting is the most... (Review)
Review
Acute gastroenteritis is one of the common diseases of childhood. Dehydration is the most frequent consequence of acute gastroenteritis, and vomiting is the most distressing clinical manifestation. Various anti-emetic agents are used in practice to control vomiting. However, not all anti-emetic agents are safe and effective. This meta-analysis aims to compare the effectiveness of ondansetron and domperidone in the cessation of vomiting in children with acute gastroenteritis. The current meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search strategy was developed to identify prospective studies that compared the effectiveness of ondansetron and domperidone in the cessation of vomiting in children with acute gastroenteritis. The primary outcome was the number of children in whom there was a cessation of vomiting. The secondary outcomes included a number of children who required an additional dose of the assigned anti-emetic and the number of children who required intravenous rehydration therapy. Overall, seven randomized trials were included in the current meta-analysis. The pooled sample size of enrolled patients was 1,262, of which 639 patients were randomized to the ondansetron group and 623 were randomized to the domperidone group. In the ondansetron group, a higher number of children experienced cessation of vomiting (risk ratio [RR]: 1.22, 95% CI: 1.08-1.37, p-value=0.002), a lower proportion of children needed an additional dose of the assigned anti-emetic (RR=0.50, 95% CI: 0.33-0.77, p-value=0.002), and a lower number of children received intravenous rehydration (RR: 0.37, 95% CI: 0.16-0.83, p-value=0.02) as compared to domperidone group. Compared to domperidone, ondansetron was found to have better efficiency in aiming cessation of vomiting in children with gastroenteritis.
PubMed: 36072202
DOI: 10.7759/cureus.27636 -
Drug Design, Development and Therapy 2019[6]-gingerol is one of the main components of ginger with many biological activities. In this study, the effects of ondansetron and [6]-gingerol on pica and gut...
PURPOSE
[6]-gingerol is one of the main components of ginger with many biological activities. In this study, the effects of ondansetron and [6]-gingerol on pica and gut microbiota in rats injected with cisplatin were evaluated.
MATERIALS AND METHODS
Rat model of cisplatin-induced pica was established, and the effects of ondansetron and [6]-gingerol on the gut microbiota were further studied by 16S rDNA gene analysis.
RESULTS
The results showed that the total intake of kaolin of the rats injected with cisplatin was significantly increased, and treatment of ondansetron and [6]-gingerol in advance could significantly ameliorate the pica induced by cisplatin. The body weight of the rats injected with cisplatin was decreased compared with the control group. The 16S rDNA gene analysis has shown that ondansetron, [6]-gingerol and cisplatin could increase the relative abundance of and decrease on phylum level.
CONCLUSION
[6]-gingerol was as effective as ondansetron in the treatment of pica induced by cisplatin in rats, and it seemed that [6]-gingerol had the potential to ameliorate the alteration of gut microbiome, but it needs further study.
Topics: Animals; Antineoplastic Agents; Catechols; Cisplatin; Fatty Alcohols; Gastrointestinal Microbiome; Kaolin; Male; Ondansetron; Pica; Rats; Rats, Sprague-Dawley
PubMed: 31534312
DOI: 10.2147/DDDT.S211845 -
Medicine Sep 2023Propofol is the most commonly used intravenous anesthetic medication and is most commonly associated with post-operative pain. Several drugs are investigated to reduce... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Propofol is the most commonly used intravenous anesthetic medication and is most commonly associated with post-operative pain. Several drugs are investigated to reduce post-operative pain caused by propofol injection. Ondansetron is a potent anti-emetic drug showing promising results as an analgesic. This meta-analysis aims to compare the efficacy of ondansetron to placebo and lidocaine in reducing post-operative pain caused by propofol injection.
METHODS
PubMed, Embase, Cochrane Library, Web of Science, and Scopus were searched for relevant randomized controlled trials (RCTs) till May 2022. We conducted a meta-analysis using RevMan software version 5.4, and we assessed the quality of included RCTs using the Cochrane risk of bias tool.
RESULTS
In our study, we included 23 RCTs with 2957 participants. Compared to placebo, ondansetron significantly increased the rate of no pain [risk ratio (RR) = 2.36, 95% confidence interval (CI) (1.39-4.01)], and reduced moderate [RR = 0.39, 95% CI (0.30-0.52)] and severe pain [RR = 0.34, 95% CI (0.24-0.50)]. Furthermore, ondansetron significantly reduced PONV [RR = 0.73, 95% CI (0.58, 0.91)]. On the other hand, ondansetron showed an inferior efficacy to lidocaine regarding the incidence of no, moderate, and severe pain.
CONCLUSION
Ondansetron is effective in reducing post-operative propofol-induced pain. However, lidocaine is more effective than it.
Topics: Humans; Propofol; Lidocaine; Ondansetron; Randomized Controlled Trials as Topic; Pain, Postoperative
PubMed: 37746949
DOI: 10.1097/MD.0000000000035021 -
Lakartidningen Feb 2018
Review
Topics: Acute Disease; Adolescent; Antiemetics; Child; Child, Preschool; Fluid Therapy; Gastroenteritis; Hospitalization; Humans; Infant; Ondansetron; Treatment Outcome; Vomiting
PubMed: 29406558
DOI: No ID Found -
Anesthesiology Research and Practice 2016Background. Postoperative nausea and vomiting (PONV) is a significant complication after laparoscopic surgeries. Ondansetron and dexamethasone are most commonly used... (Review)
Review
Comparison of Ondansetron and Dexamethasone for Prophylaxis of Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Surgeries: A Meta-Analysis of Randomized Controlled Trials.
Background. Postoperative nausea and vomiting (PONV) is a significant complication after laparoscopic surgeries. Ondansetron and dexamethasone are most commonly used drugs for PONV prophylaxis. Comparisons of these two drugs have not been systematically reviewed till date. Methods. PubMed, PubMed Central, and CENTRAL databases were searched with the following words: "dexamethasone," "ondansetron," "laparoscopy," and "PONV" to identify randomized trials that compared ondansetron and dexamethasone for PONV prophylaxis after laparoscopic surgeries. Results. Data of 592 patients from 7 RCTs have been included in this meta-analysis. Incidence of postoperative nausea at 4-6 h is significantly lower when dexamethasone was used instead of ondansetron (p = 0.04; OR 0.49, 95% CI 0.24-0.98, M-H fixed). Incidence of nausea is similar at 24 hours (p = 0.08, OR 0.71, 95% CI 0.48, 1.05; M-H fixed); vomiting is also similar at 4-6 h (p = 0.43, OR 1.27, 95% CI 0.70-2.27; M-H fixed) and also at 24 h (p = 0.46, OR 0.92, 95% CI 0.73, 1.16; M-H fixed). Conclusion. Dexamethasone is superior to ondansetron in preventing postoperative nausea after 4-6 h of laparoscopic surgeries. However, both the drugs are of equal efficacy in preventing postoperative vomiting up to 24 h after surgery. However, results should be interpreted with caution due to clinical heterogeneity in the included studies.
PubMed: 27110238
DOI: 10.1155/2016/7089454 -
Hospital Pharmacy Nov 2015There have been 3 published reports (4 cases) of symptomatic sinus bradycardia occurring after intravenous (IV) administration of the selective 5-hydroxytryptamine 3...
PURPOSE
There have been 3 published reports (4 cases) of symptomatic sinus bradycardia occurring after intravenous (IV) administration of the selective 5-hydroxytryptamine 3 (5-HT) receptor antagonist ondansetron. We report a fifth case in which the patient developed asystole after rechallenge with ondansetron.
SUMMARY
A 36-year-old pregnant patient with no cardiac history, status post cerclage for cervical insufficiency, experienced nausea in the post ambulatory care unit after administration of morphine and indomethacin for pain. After IV administration of ondansetron, the patient's heart rate decreased to the 40s and improved spontaneously. The patient experienced a second episode of nausea, another dose of ondansetron was administered, and the patient went into asystole. Advanced cardiac life support measures were initiated and chest compressions were conducted for 3 minutes with return of spontaneous circulation. The patient was monitored overnight with no development of new cardiac arrhythmias and was discharged from the hospital in stable condition.
CONCLUSIONS
Sinus bradycardia after IV administration of ondansetron was observed in a 36-year-old pregnant patient status post cerclage. On rechallenge, the patient went into asystole. This case report adds to the available literature regarding ondansetron-induced cardiac arrhythmias and the possibility of asystole upon rechallenge.
PubMed: 27729680
DOI: 10.1310/hpj5010-918 -
Local and Regional Anesthesia 2020Spinal anesthesia-induced hypotension (SAIH) occurs frequently, particularly in the elderly and in patients undergoing caesarean section. SAIH is caused by arterial and... (Review)
Review
Spinal anesthesia-induced hypotension (SAIH) occurs frequently, particularly in the elderly and in patients undergoing caesarean section. SAIH is caused by arterial and venous vasodilatation resulting from the sympathetic block along with a paradoxical activation of cardioinhibitory receptors. Bradycardia after spinal anesthesia (SA) must always be treated as a warning sign of an important hemodynamic compromise. Fluid preloading (before initiation of the SA) with colloids such as hydroxyethyl starch (HES) effectively reduces the incidence and severity of arterial hypotension, whereas crystalloid preloading is not indicated. Co-loading with crystalloid or colloid is as equally effective to HES preloading, provided that the speed of administration is adequate (ie, bolus over 5 to 10 minutes). Ephedrine has traditionally been considered the vasoconstrictor of choice, especially for use during SAIH associated with bradycardia. Phenylephrine, a α adrenergic receptor agonist, is increasingly used to treat SAIH and its prophylactic administration (ie, immediately after intrathecal injection of local anesthetics) has been shown to decrease the incidence of arterial hypotension. The role of norepinephrine as a possible alternative to phenylephrine seems promising. Other drugs, such as serotonin receptor antagonists (ondansetron), have been shown to limit the blood pressure drop after SA by inhibiting the Bezold-Jarisch reflex (BJR), but further studies are needed before their widespread use can be recommended.
PubMed: 32581577
DOI: 10.2147/LRA.S240753 -
Ondansetron-induced QT prolongation among various age groups: a systematic review and meta-analysis.The Egyptian Heart Journal : (EHJ) :... Jul 2023Ondansetron is a selective 5-hydroxytryptamine type 3 serotonin-receptor antagonist with antiemetic properties used inadvertently in the emergency department for...
BACKGROUND
Ondansetron is a selective 5-hydroxytryptamine type 3 serotonin-receptor antagonist with antiemetic properties used inadvertently in the emergency department for controlling nausea. However, ondansetron is linked with a number of adverse effects, including prolongation of the QT interval. Therefore, the purpose of this meta-analysis was to assess the occurrence of QT prolongation in pediatric, adult, and elderly patients receiving oral or intravenously administered ondansetron.
METHODS
A thorough electronic search was conducted on PubMed (Medline) and Cochrane Library from the databases' inception to August 10, 2022. Only those studies were considered in which ondansetron was administered orally or intravenously to participants for the treatment of nausea and vomiting. The prevalence of QT prolongation in multiple predefined age groups was the outcome variable. Analyses were conducted using Review manager 5.4 (Cochrane collaboration, 2020).
RESULTS
A total of 10 studies involving 687 ondansetron group participants were statistically analyzed. The administration of ondansetron was associated with a statistically significant prevalence of QT prolongation in all age groups. An age-wise subgroup analysis was conducted which revealed that the prevalence of QT prolongation among participants younger than 18 years was not statistically significant, whereas it was statistically significant among participants aged 18-50 years and among patients older than 50 years.
CONCLUSIONS
The present meta-analysis provides further evidence that oral or intravenous administration of Ondansetron may lead to QT prolongation, particularly among patients older than 18 years of age.
PubMed: 37395900
DOI: 10.1186/s43044-023-00385-y -
Pharmacogenomics 2015Drug addiction is a serious disease with damaging effects on the brain and physical health. Despite the increase in the number of affected individuals, there are few... (Meta-Analysis)
Meta-Analysis Review
Drug addiction is a serious disease with damaging effects on the brain and physical health. Despite the increase in the number of affected individuals, there are few effective pharmacological treatment options for substance use disorders. The study of the influence of an individual's genetic features on the treatment response may help to identify more efficacious treatment options. This systematic review focuses on the serotonergic system because of its relevant role in mood and impulse control disorders, and its contribution to the development and maintenance of drug use disorders. In particular, we examine the role of serotonergic genes in the response to pharmacotherapy for alcohol, cocaine and nicotine addiction. Current evidence suggests that genetic variability of the serotonergic biosynthesis enzyme tryptophan hydroxylase 2 (TPH2) and the serotonin transporter (SLC6A4) genes mediates the efficacy of several addiction treatments, such as ondansetron and disulfiram, and the antidepressants bupropion, nortriptyline and sertraline.
Topics: Genetic Variation; Humans; Serotonin; Serotonin Agents; Serotonin Plasma Membrane Transport Proteins; Substance-Related Disorders; Tryptophan Hydroxylase
PubMed: 26265436
DOI: 10.2217/pgs.15.72 -
British Journal of Clinical Pharmacology Oct 2022The objective of this study was to describe ondansetron drug utilization patterns during pregnancy to treat nausea and vomiting in pregnancy (NVP). Moreover, we aimed to...
AIMS
The objective of this study was to describe ondansetron drug utilization patterns during pregnancy to treat nausea and vomiting in pregnancy (NVP). Moreover, we aimed to describe the maternal factors associated with NVP and antiemetic use.
METHODS
The data consist of pregnancies with a live birth(s) within an IMRD-UK registered GP practice. Descriptive statistics were used to investigate patterns of ondansetron use in pregnancy and to describe maternal characteristics associated with NVP and antiemetic drug utilization. We differentiate first- from second-line use during pregnancy using antiemetic prescription pathways.
RESULTS
The dataset included 733 633 recorded complete pregnancies from 2005 to 2019. NVP diagnosis and ondansetron prescription prevalence increased from 2.7% and 0.1% in 2005 to 4.8% and 2.5% in 2019 respectively. Over the period 2015-2019, the most common oral daily dosages were 4 mg/d (8.5%), 8 mg/d (37.1%), 12 mg/d (37.5%) and between 16 and 24 mg/d (16.9%). Prescription of ondansetron was initiated during the first trimester of pregnancy in 40% of the cases and was moderately used as a first-line therapy (2.8%), but preferred choice of second-line therapy. Women with mental health disorders, asthma and/or prescribed folic acid were more likely to experience NVP and use antiemetics in pregnancy than their counterparts.
CONCLUSION
This study confirms that ondansetron is increasingly used off-label to treat NVP during pregnancy, also in the first trimester and before other prescription antiemetics have been prescribed. Several maternal comorbidities and folic acid use were more common among women experiencing NVP and using antiemetics, including ondansetron.
Topics: Antiemetics; Female; Folic Acid; General Practice; Humans; Nausea; Ondansetron; Pregnancy; Pregnancy Complications; Prescriptions; United Kingdom; Vomiting
PubMed: 35483963
DOI: 10.1111/bcp.15370