RESUMO
We report the first case presenting with successive anaphylactic reaction and extra-pyramidal syndrome after treatment with thiethylperazine maleate (thiethylperazine). Both reactions were caused due to this anti-emetic drug, but an additive effect of clemastine fumarate, prescribed to treat the anaphylactic reaction, is suggested by the sequence of events. We discuss the importance of knowing the pharmacological similitudes of common prescribed drugs in order to avoid the occurrence of side effects.
Assuntos
Anafilaxia/induzido quimicamente , Antieméticos/efeitos adversos , Hipersensibilidade a Drogas/etiologia , Tietilperazina/efeitos adversos , Adolescente , Antialérgicos/administração & dosagem , Antialérgicos/efeitos adversos , Antieméticos/administração & dosagem , Doenças dos Gânglios da Base/induzido quimicamente , Clemastina/administração & dosagem , Clemastina/efeitos adversos , Sinergismo Farmacológico , Feminino , Humanos , Tietilperazina/administração & dosagemAssuntos
Doenças dos Nervos Cranianos/tratamento farmacológico , Distonia/induzido quimicamente , Tietilperazina/efeitos adversos , Nervo Vestibular , Doença Crônica , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Tietilperazina/administração & dosagem , Nervo Vestibular/efeitos dos fármacosRESUMO
Twenty-six patients suffering from disseminated epithelial ovarian cancer (FIGO stages III and IV) under treatment with Cisplatin (80-100 mg/m2 in 8 hours) in combination on the same day with Cyclophosphamide (500 mg/m2 IV) and Adriamycin (50 mg/m2), a severely emetogenic regimen, entered a randomized, double-blind, cross-over trial comparing the antiemetic activity of high-dose IV Metoclopramide (1 mg/kg/dose X 5 doses) with that of a combination of Metoclopramide (same schedule) plus Nortriptyline (50 mg PO X 2 doses) plus Thiethylperazine (10 mg IV X 3 doses). The antiemetic combination was designed in an attempt to act simultaneously on gastrointestinal motility and neuroreceptors at the central emetic pathways (dopamine D-2, histamine H-1 and muscarinic cholinergic). This combination significantly reduced the emesis due to chemotherapy when compared with Metoclopramide alone and was also preferred by a significant number of patients after passing through both the antiemetic arms being compared.
Assuntos
Antieméticos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias Ovarianas/tratamento farmacológico , Adulto , Idoso , Antieméticos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/administração & dosagem , Cisplatino/efeitos adversos , Ensaios Clínicos como Assunto , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Método Duplo-Cego , Doxorrubicina/administração & dosagem , Doxorrubicina/efeitos adversos , Quimioterapia Combinada , Feminino , Humanos , Metoclopramida/administração & dosagem , Metoclopramida/efeitos adversos , Metoclopramida/uso terapêutico , Pessoa de Meia-Idade , Nortriptilina/administração & dosagem , Nortriptilina/uso terapêutico , Distribuição Aleatória , Tietilperazina/administração & dosagem , Tietilperazina/uso terapêuticoRESUMO
Male mixed-breed dogs were used to evaluate the effectiveness of cimetidine (Cim), promethazine (Pro), and thiethylperazine (Thi), singly and in combination, to raise the threshold for radiation-induced emesis. Cim was chosen as an H2 antihistamine, Pro as an H1 antihistamine, and Thi as a phenothiazine derivative dopamine blocker. Doses were: 167 mg/m2 i.v. for Cim; 13.9 mg/m2 i.m. for Pro; and 5.6 mg/m2 i.m. for Thi. These doses were calculated on a mg/m2 basis to approximate doses for an average human (1.8 m2) of 300 mg Cim, 25 mg Pro, and 10 mg Thi. Exposure was to 60Co at 60 rad (midline) per min. The dogs were fed 0.4 kg canned dog food 1 hour before exposure, and injected with the appropriate drugs 30 minutes prior to exposure. Emesis onset times, number of episodes, and time to last episode were recorded. The radiation dose (midline tissue rad) to cause a 50% incidence of emesis (ED50) was calculated using an up-and-down procedure. The ED50 (95% confidence limits) were: 258 (212-315) for controls; 240 (151-380) for Cim; 313 (256-384) for Pro; 405 (319-514) for Thi; 334 (284-394) for Cim + Pro; 446 (365-546) for Cim + Thi; 347 (306-399) for Pro + Thi; and 478 (428-539) for Cim + Pro + Thi.
Assuntos
Antieméticos/uso terapêutico , Lesões Experimentais por Radiação/prevenção & controle , Animais , Cimetidina/administração & dosagem , Cães , Quimioterapia Combinada , Masculino , Prometazina/administração & dosagem , Tietilperazina/administração & dosagemAssuntos
Fosfatase Ácida/metabolismo , Fosfatase Alcalina/metabolismo , Prenhez/metabolismo , Baço/enzimologia , Tietilperazina/farmacologia , Fosfatase Alcalina/antagonistas & inibidores , Animais , Relação Dose-Resposta a Droga , Ativação Enzimática/efeitos dos fármacos , Feminino , Linfócitos/enzimologia , Gravidez , Ratos , Baço/citologia , Tietilperazina/administração & dosagemAssuntos
Discinesia Induzida por Medicamentos , Face , Tietilperazina/efeitos adversos , Doença Aguda , Administração Oral , Adolescente , Biperideno/uso terapêutico , Discinesia Induzida por Medicamentos/tratamento farmacológico , Feminino , Humanos , Masculino , Tietilperazina/administração & dosagem , Tietilperazina/uso terapêuticoRESUMO
The absorption of effervescent aspirin was studied in three groups of patients during attacks of migraine. The first group received intramuscular thiethylperazine 10 min before effervescent aspirin; the second group received intramuscular metoclopramide 10 min before effervescent aspirin; and the third group received effervescent aspirin alone. Where possible each patient was retested when headache-free but under conditions which were otherwise as similar as possible to those during the acute attack. Intramuscular metoclopramide corrected the impairment of drug absorption that occurred during a migraine attack, whereas thiethylperazine did not. In the group of patients treated with thiethylperazine and aspirin, the impairment of absorption did not correlate with the duration of the symptoms, nor with the severity of the headache and nausea. Patients treated with thiethylperazine and aspirin tended to take longer to recover than those patients treated with metoclopramide and aspirin. However, in the thiethylperazine treated group, the time to recover did not correlate with the salicylate level achieved.