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学术急诊医学档案

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  3. 卷 3 编号 4 (2015): Autumn (November)
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卷 3 编号 4 (2015)

十一月 2015

Comparing the Antiemetic Effects of Ondansetron and Metoclopramide in Patients with Minor Head Trauma

  • Majid Zamani
  • Behnam Namdar
  • Reza Azizkhani
  • Omid Ahmadi
  • Mehrdad Esmailian

学术急诊医学档案, 卷 3 编号 4 (2015), 1 十一月 2015 , 第 137-140 页
https://doi.org/10.22037/aaem.v3i4.286 已出版: 2018-12-26

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摘要

Introduction: Nausea and vomiting are the most common complications after minor head trauma that increases the risk of intracranial pressure rising. Therefore, the present study was aimed to compare the antiemetic effects of metoclopramide and ondansetron in the treatment of post-traumatic nausea and vomiting. Methods: The study was a controlled, randomized, double blind clinical trial, which was conducted in the first 6 months of 2014 in emergency department Al-Zahra and Kashani Hospitals in Isfahan, Iran. The patients with minor head trauma associated with nausea and vomiting were randomly divided into 2 groups: treatment with metoclopramide (10mg/2ml, slow injection) and treatment with ondansetron (4mg/2ml, slow injection). The comparison between the 2 groups was done regarding antiemetic efficacy and side effects using SPSS 21 statistical software. Results: 120 patients with minor head trauma were distributed and studied into two groups of 60 patients (mean age 35.6±14.1 years; 50.0% male). Administration of both ondansetron and metoclopramide significantly reduced the severity of nausea (P<0.001). Changes in the severity of nausea in both groups before and after the treatment revealed that nausea had been decreased significantly in both groups (P < 0.001). The incidence of fatigue (p=0.44), headache (p=0.58) and dystonia (p=0.06) had no significant difference in the two groups but the incidence of drowsiness and anxiety in the metoclopramide group was significantly higher (P < 0.001). Conclusion: The present study indicated that the treatment effectiveness of ondansetron and metoclopramide are similar. However, incidence of drowsiness and anxiety in the metoclopramide was considerably higher. Since these complications can have adverse effects on the treatment of patients with brain injury, it is suggested that it may be better to use ondansetron in these patients.
关键词:
  • Head injuries
  • closed
  • nausea
  • vomiting
  • multiple trauma
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Zamani M, Namdar B, Azizkhani R, Ahmadi O, Esmailian M. Comparing the Antiemetic Effects of Ondansetron and Metoclopramide in Patients with Minor Head Trauma. Arch Acad Emerg Med [网际网络]. 2018年12月26日 [见引于 2026年7月8日];3(4):137-40. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/286
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参考

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Carlisle JB, Stevenson CA. Drugs for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2006 (3):Cd004125.

Naumann CR, Zelig C, Napolitano PG, Ko CW. Nausea, vomiting, and heartburn in pregnancy: a prospective look at risk, treatment, and outcome. J Matern Fetal Neonatal Med. 2012;25(8):1488-93.

Keller K, Beule J, Dippold W. Cyclic vomiting syndrome in adults. Wien Med Wochenschr. 2013;163(21-22):514-6.

Hejazi RA, McCallum RW. Cyclic vomiting syndrome: treatment options. Exp Brain Res. 2014;232(8):2549-52.

Yadav Deepak R, Ayyappan T, Shanmugam S, Sundaramoorthy K, Vetrichelvan T. Development and in-vitro evaluation of buccoadhesive Metoclopramide hydrochloride tablet formulations. Development. 2011;3(1):516-25.

Olver I, Clark-Snow RA, Ballatori E, Espersen BT, Bria E, Jordan K. Guidelines for the control of nausea and vomiting with chemotherapy of low or minimal emetic potential. Support Care Cancer. 2011;19(1):33-6.

Snow V, Weiss K, Wall EM, Mottur-Pilson C. Pharmacologic management of acute attacks of migraine and prevention of migraine headache. Ann Intern Med. 2002;137(10):840-9.

Yi HS, Kim HS, Seo MR. Trial of Oral Metoclopramide on Diurnal Bruxism of Brain Injury. Ann Rehabil Med. 2013;37(6):871-4.

Faridaalaee G, Rahmani SH, Mehryar H, et al. Comparison of Intravenous Metoclopramide and Acetaminophen in Primary Headaches: a Randomized Controlled Trial. Emergency. 2015;3(2):67-71.

Livezey MR, Briggs ED, Bolles AK, Nagy LD, Fujiwara R, Furge LL. Metoclopramide is metabolized by CYP2D6 and is a reversible inhibitor, but not inactivator, of CYP2D6. Xenobiotica. 2013;44(4):309-19.

Al-Ansari K, Alomary S, Abdulateef H, Alshawagfa M, Kamal K. Metoclopramide versus ondansetron for the treatment of vomiting in children with acute gastroenteritis. J Pediatr Gastroenterol Nutr. 2011;53(2):156-60.

Pitts SR. Neither ondansetron nor metoclopramide reduced nausea and vomiting in the emergency department. Ann Intern Med. 2014;161(12):JC3.

Egerton-Warburton D, Meek R, Mee MJ, Braitberg G. Antiemetic Use for Nausea and Vomiting in Adult Emergency Department Patients: Randomized Controlled Trial Comparing Ondansetron, Metoclopramide, and Placebo. Ann Emerg Med. 2014;64:526-32.

Barrett TW, DiPersio DM, Jenkins CA, et al. A randomized, placebo-controlled trial of ondansetron, metoclopramide, and promethazine in adults. Am J Emerg Med. 2011;29(3):247-55.

Patanwala AE, Amini R, Hays DP, Rosen P. Antiemetic Therapy for Nausea and Vomiting in the Emergency Department. J Emerg Med. 2010;39(3):330-6.

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