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Palliative Medicine Jul 1996
Topics: Carcinoma; Drug Storage; Humans; Infusions, Parenteral; Male; Methotrimeprazine; Middle Aged; Ultraviolet Rays; Vomiting
PubMed: 8817600
DOI: No ID Found -
British Journal of Anaesthesia May 1983Interactions between morphine and methotrimeprazine have been studied in mice and man with respect to analgesia or antinociceptive activity, respiratory effects and... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
Interactions between morphine and methotrimeprazine have been studied in mice and man with respect to analgesia or antinociceptive activity, respiratory effects and sedation. The volunteer study was a double-blind cross-over trial with 10 volunteers. In mice, methotrimeprazine only possessed antinociceptive activity in doses which caused marked sedation. However, small non-sedative doses of methotrimeprazine potentiated the analgesic action of morphine. The volunteer study did not confirm this finding in man. Methotrimeprazine 7.5 mg i.m. caused significant sedation, but did not alter the effects of morphine 5 mg on pain threshold or ventilatory response to carbon dioxide.
Topics: Adult; Analgesia; Animals; Drug Synergism; Female; Humans; Hypnotics and Sedatives; Male; Methotrimeprazine; Mice; Morphine; Motor Activity; Pain; Reaction Time; Respiration; Sensory Thresholds
PubMed: 6849726
DOI: 10.1093/bja/55.5.437 -
Journal of Pharmaceutical Sciences Jul 1987Two monohydroxylated metabolites of methotrimeprazine (levomepromazine), which previously have been identified in plasma and urine from psychiatric patients, were...
Two monohydroxylated metabolites of methotrimeprazine (levomepromazine), which previously have been identified in plasma and urine from psychiatric patients, were synthesized by nonenzymatic, FeCl2-catalyzed oxidation, isolated, and purified by preparative reversed-phase HPLC. Mass spectrometric analysis gave identical spectra for the two compounds, but did not reveal the positions of the OH groups. However, 1H NMR spectroscopy at 200 MHz demonstrated that one of the compounds, which had the shortest GC retention time on an OV-17 column, was hydroxylated in the 3-position on the phenothiazine nucleus, and that the other derivative was hydroxylated in the 7-position. The metabolism of methotrimeprazine differs, therefore, from that of its congener chlorpromazine, which is hydroxylated mainly in the 7-position in humans.
Topics: Biotransformation; Chlorpromazine; Humans; Hydroxylation; Magnetic Resonance Spectroscopy; Methotrimeprazine
PubMed: 3668814
DOI: 10.1002/jps.2600760710 -
Journal of Pharmaceutical Sciences Jun 1967
Topics: Animals; Brain Chemistry; Countercurrent Distribution; Methotrimeprazine; Mice; Movement; Spectrophotometry; Tissue Extracts
PubMed: 6039814
DOI: 10.1002/jps.2600560612 -
Palliative Medicine Jan 2019This case report describes a patient with known idiopathic Parkinson's disease, being managed with transdermal rotigotine, whose refractory nausea and vomiting was...
The combination of levomepromazine (methotrimeprazine) and rotigotine enables the safe and effective management of refractory nausea and vomiting in a patient with idiopathic Parkinson's disease.
BACKGROUND:
This case report describes a patient with known idiopathic Parkinson's disease, being managed with transdermal rotigotine, whose refractory nausea and vomiting was successfully controlled with subcutaneous levomepromazine. No drug-induced extrapyramidal side effects emerged.
CASE PRESENTATION:
A patient was found to have a locally advanced serous carcinoma, causing secondary bowel obstruction. Furthermore, due to compromised oral access, the patient's oral antiparkinsonian medications for motor control were converted to transdermal rotigotine. Unfortunately, the patient's nausea and vomiting was refractory to a number of recommended antiemetic options.
CASE MANAGEMENT:
Low dose levomepromazine was administered on a, 'when required' basis, via subcutaneous injection.
CASE OUTCOME:
After the first dose of levomepromazine, the patient's nausea and vomiting completely subsided and no extrapyramidal side effects were observed. This was confirmed by daily assessments, revealing no worsening of the motor symptoms associated with idiopathic Parkinson's disease.
CONCLUSIONS:
The pharmacology of rotigotine and levomepromazine appear complementary and may allow for the simultaneous use of both drugs, with favourable outcomes. This case report highlights that rotigotine may afford protection against antipsychotic induced extrapyramidal side effects, while preserving antiemetic effects. Such combinations may have a role in the end-of-life management of idiopathic Parkinson's disease.
Topics: Administration, Cutaneous; Aged; Antiparkinson Agents; Antipsychotic Agents; Dopamine Agonists; Female; Humans; Methotrimeprazine; Nausea; Parkinson Disease; Tetrahydronaphthalenes; Thiophenes; Transdermal Patch; Treatment Outcome; Vomiting
PubMed: 30404581
DOI: 10.1177/0269216318809569 -
The Journal of Neuropsychiatry and... 2012
Topics: Adult; Antipsychotic Agents; Ejaculation; Genital Diseases, Male; Humans; Male; Methotrimeprazine; Schizophrenia
PubMed: 22450639
DOI: 10.1176/appi.neuropsych.11020049 -
American Journal of Hospital Pharmacy May 1979Double-blind clinical trials involving the use of phenothiazines as analgesics or potentiators of analgesics (aspirin, meperidine, morphine sulfate) and adverse effects... (Clinical Trial)
Clinical Trial Review
Double-blind clinical trials involving the use of phenothiazines as analgesics or potentiators of analgesics (aspirin, meperidine, morphine sulfate) and adverse effects of phenothiazines are reviewed and evaluated. Promethazine, promazine and propiomazine were not found to possess analgesic or potentiating properties. One chlorpromazine study contained important design and reporting deficiencies which precluded a recommendation for use of chlorpromazine in the treatment of pain. Methotrimeprazine was determined by numerous authors to have analgesic properties; however, most of the studies also were deficient in design or data presented, or both. Adverse reactions to phenothiazines, including hypotension, sedation, drowsiness, extrapyramidal symptoms, tardive dyskinesia, cardiac toxicity and agranulocytosis, are often more common and severe than those attributed to narcotic analgesics. Because of the lack of data supportive of analgesic activity and the adverse reactions associated with phenothiazines, use of these agents in the management of pain should be discouraged. The prophylactic use of phenothiazine for narcotic analgesic-induced emesis also is, in most cases, a questionable practice.
Topics: Analgesics; Chlorpromazine; Clinical Trials as Topic; Double-Blind Method; Humans; Methotrimeprazine; Phenothiazines; Promazine; Promethazine
PubMed: 36754
DOI: No ID Found -
Anesthesia and Analgesia 1965
Clinical Trial Comparative Study
Topics: Adult; Anesthesia, General; Atropine; Clinical Trials as Topic; Humans; Meperidine; Methotrimeprazine; Morphine; Preanesthetic Medication; Scopolamine; Tranquilizing Agents
PubMed: 5318665
DOI: No ID Found -
Canadian Anaesthetists' Society Journal Jan 1972
Topics: Adolescent; Adult; Aged; Analgesia; Blood Pressure; Female; Humans; Male; Meperidine; Methotrimeprazine; Middle Aged; Pain; Postoperative Care; Pulse; Respiration
PubMed: 5009452
DOI: 10.1007/BF03006912 -
Lancet (London, England) Feb 1987
Topics: Humans; Infusions, Parenteral; Isotonic Solutions; Methotrimeprazine; Neoplasms; Terminal Care
PubMed: 2880208
DOI: 10.1016/s0140-6736(87)91779-x