Antiemetic Properties Research Articles

Synergistic Antiemetic Effects of Nerolidol on Domperidone, Hyoscine, and Ondansetron: In Vivo and in Silico Investigations on Receptor Binding Affinity.

The present study was designed to measure the potential antiemetic properties of nerolidol (NDL) via in vivo and in silico studies. To induce emesis copper sulfate pentahydrate (CuSO4.5H2O) was administered at a dose of 50 mg/kg (orally) to 2-day-old chicks. The test sample (NDL) was given at two doses of 50 and 100 mg/kg. b.w. orally. Additionally, aprepitant (16 mg/kg), domperidone (6 mg/kg), hyoscine (21 mg/kg), ondansetron (5 mg/kg), and diphenhydramine (10 mg/kg) were given also orally as positive controls. To observe the modulatory effects of the test sample, combination therapies with reference drugs were also administered to three different groups of animals. Molecular docking and visualization of ligand-receptor interaction were performed against several emesis-inducing receptors (5HT3, D2, D3, H1, and M1-M5) using diverse computational tools. Pharmacokinetics and drug-likeness of the selected ligands were also calculated. Findings demonstrated that NDL significantly (p <0.05) dose-dependently lessens the mean number of retches and delays the emetic onset in the chicks. The combined drug therapy with ondansetron exposed better antiemetic activity. In addition, in silico analysis, NDL has greater binding affinity (-7.3 kcal/mol) against M2 and M3 receptors. In conclusion, NDL exerted mild antiemetic activity with synergistic properties through muscarinic receptors.

Effects of adding intravenous midazolam to a dual postoperative nausea and vomiting regimen in patients undergoing breast surgery: A pragmatic randomized controlled trial.

For high-risk patients, adding a third antiemetic drug to dual postoperative nausea and vomiting (PONV) prophylaxis is controversial. Given the established antiemetic properties of midazolam, this study compared the combination of low-dose dexamethasone-ondansetron and midazolam with high-dose dexamethasone-ondansetron. A total of 300 female patients scheduled for breast surgery were recruited and randomly assigned to two groups. The DO group received dexamethasone 8 mg and ondansetron 4 mg, whereas the DOM group received dexamethasone 4 mg, ondansetron 4 mg, and midazolam 0.04 mg/kg. The primary outcome was the incidence of PONV within 24 h. Secondary outcomes were PONV severity, antiemetic requirement, blood glucose levels, satisfaction and sedation scores, time to eye opening and extubation, pain outcome, and sore throat. Primary outcome analysis included 298 patients. Incidence of PONV within the first 24 h after surgery occurred in 52 of 150 (35%) patients in the DO group and 33 of 148 (22%) patients in the DOM group (adjusted risk ratio, 0.63; 95% confidence interval, 0.45-0.88; P = 0.007). The antiemetic requirement was significantly greater in the DO group compared with the DOM group (P = 0.034). However, a significantly higher sedation level and longer time for eye-opening and extubation were observed in the DOM group (P < 0.05). Compared to high-dose dexamethasone and ondansetron alone, midazolam combined with low-dose dexamethasone and ondansetron decreased the incidence of PONV in patients undergoing breast surgery; however, it increased the sedation level in the early postoperative period.

THERAPEUTIC POTENTIAL OF BHANGA IN KASHTARTAVA: A LITERATURE REVIEW

Kashtartava (Dysmenorrhea) is a prevalent co-morbidity in women. The name "Kashtartava" might be inferred as the condition in which Artava sheds pain, which can be associated with Dysmenorrhea. Around the world, 50-90% of women in their reproductive years report having painful periods, a disorder known as Dysmenorrhea. In this review article, we delved into the traditional uses, pharmacological properties and challenges associated with using Bhanga (Cannabis sativa Linn) for managing Kashtartava and its related effects. Research expedition sheds light on the potential therapeutic benefits, mainly focusing on its active component, tetrahydrocannabinol (THC), which exhibits analgesic, anti-inflammatory, antiemetic, and neuroprotective properties. This review highlights the challenges in conducting rigorous research on using the herb during menstruation and pregnancy, owing to study design limitations and confounding variables. This legal ambiguity underscores the importance of understanding and addressing the cultural and legal context surrounding its use in contemporary healthcare prac-tices. Moreover, the psychoactive nature of THC raises concerns regarding its impact on mood and cognition, warranting cautious consideration in clinical applications.

Role of Ginger in management of nausea among patients receiving chemotherapy.

Cancer patients treated with chemotherapy often face variety of side effects, with nausea and vomiting being the most frequent. Ginger (Zingiber officinale), contains natural compounds that can speed up the metabolism and increase intestinal motility. It is traditionally used to treat gastrointestinal disorders. The objective of this study was to evaluate the role of ginger in management of nausea among patients receiving chemotherapy. This crossover interventional study was conducted to evaluate the role of ginger in management of nausea among patients receiving chemotherapy. Study was carried out at chemotherapy daycare of Shifa International Hospital Islamabad, with a sample size of 90 patients, using non-probability convenient sampling. Patients undergoing chemotherapy were given the dose of ginger (550 mg twice a day) for five consecutive days. On the next chemo cycle the same patients were given the placebo capsules of same color and weight for two times a day for five days. Patients and attendants were contacted for five days and being asked about post-chemotherapy nausea. Nausea and vomiting were measured by Rhodes scale. Results showed that Rhodes score of patients taking Ginger capsules was significantly lower than those taking placebo (p-value < 0.05) in all the five days. Ginger significantly managed the nausea among patients receiving chemotherapy. Its natural antiemetic properties provide a convenient and safe way to reduce the post-chemotherapy nausea and vomiting.

6-Shogaol improves sorafenib efficacy in colorectal cancer cells by modulating its cellular accumulation and metabolism

Carcinoma of the colon and rectum, also known as colorectal cancer, ranks as the third most frequently diagnosed malignancy globally. Sorafenib exhibits broad-spectrum antitumor activity against Raf, VEGF, and PDGF pathways in hepatocellular, thyroid, and renal cancers, but faces resistance in colorectal malignancies. 6-Shogaol, a prominent natural compound found in Zingiberaceae, exhibits antioxidant, anti-inflammatory, anticancer, and antiemetic properties. We investigated the influence of 6-shogaol on sorafenib’s cytotoxic profile against colorectal cancer cell lines (HT-29, HCT-116, CaCo-2, and LS174T) through its effects on cellular accumulation and metabolism. Cytotoxicity was assessed using the sulpharodamine B assay, caspase-3 and c-PARP cleavage, cell cycle distribution analysis, and P-gp efflux activity. 6-Shogoal showed considerable cytotoxicity with decreased IC50 in colorectal cancer cell lines. Combining sorafenib and 6-shogaol increased c-PARP and pro-caspase-3 concentrations in HCT-116 cells compared to sorafenib alone. In combination, pro-caspase-3 concentrations were decreased in CaCo-2 cells compared to alone. Sorafenib combinations with 6-shogaol showed a significant drop in cell cycle distribution from 16.96±1.10 % to 9.16±1.85 %, respectively. At 100 µM, sorafenib and 6-shogaol showed potent and significant activity with intra-cellular rhodamine concentration on P-gp efflux activity in CRC cell lines. In conclusion, 6-shogaol substantially improved the cytotoxic profile of sorafenib by affecting its cellular uptake and metabolism. Future research should focus on dosage optimization and formulation and evaluate the efficacy and safety of the combination in animal models with colorectal cancer.

Cannabis use patterns and association with hyperemesis: A comprehensive review.

Cannabis use in the general population is prevalent and is rising because of increased acceptance of its use, legalization in most US states, and perceived health benefits. Cannabis product potency has dramatically increased with higher delta-9-tetrahydrocannabinol content. Cannabis has documented antiemetic properties and cannabinoid pharmaceuticals are used in disorders like chemotherapy-induced nausea and vomiting. Forty to eighty percent of cyclic vomiting syndrome (CVS) patients use cannabis products, which reportedly reduce stress as well as nausea and vomiting. Cannabinoid hyperemesis syndrome (CHS) has a presentation similar to CVS, but is associated with longstanding, high dose cannabis use, and is thought to be relieved by sustained cannabis abstinence. Most CHS patients have used cannabis on a daily or near-daily basis for more than 2 years. Compulsive hot-water bathing behaviors are reported by most CHS patients, but are not specific for this disorder as they are also noted by about half of CVS patients. Episodic vomiting associated with cannabis use contributes to extensive health resource use, including emergency department visits and inpatient hospitalizations, and impacts patients and their families negatively. Treatment for CHS overlaps with CVS although cannabis abstinence remains the cornerstone of its management. Challenges associated with cannabis use cessation in CHS include patient skepticism of the role of cannabis as a cause of symptoms, perceived benefits of cannabis, and a lack of other effective therapies. In this review, we highlight cannabis use patterns in the US and discuss diagnosis and management of CHS and gaps in knowledge about this disorder.

Comparison of the Efficacies of Dexmedetomidine and Clonidine in Preventing Postoperative Nausea and Vomiting in Paediatric Patients Undergoing Abdominal Surgeries.

Background Postoperative nausea and vomiting (PONV) is a common complication in paediatric patients undergoing abdominal surgeries. Dexmedetomidine and clonidine, both α2-adrenergic agonists, have been proposed as potential treatments for PONV due to their antiemetic properties. This study aimed to compare the efficacies of dexmedetomidine and clonidine in the prevention of PONV in paediatric patients following abdominal surgeries Methods Eighty patients, aged five to 12 years undergoing abdominal surgeries under general anaesthesia were enrolled in this study. Patients were randomly assigned to receive either a single intravenous dose of 0.5 µg/kg of dexmedetomidine (Group D; n=40) or 1 µg/kg of clonidine (Group C; n = 40) 10 minutes before extubation. PONV was recorded for the next 24 hours. Results The baseline characteristics of patients were comparable. A higher proportion of patients in the clonidine group developed PONV as compared to the dexmedetomidine group (27.5% vs 20.0%, p=0.189). The visual analogue scale (VAS) score of group C was higher than that of group D (1.38±1.55 vs 1.00±1.26) but was not statistically significant. The Paediatric Anaesthesia Emergence Delirium (PAED) scale score or emergence agitation (EA) score was higher in group C during recovery time. The mean arterial pressures and the heart rates were comparable in both groups. No significant side effects were reported. Conclusion Our study concludes that dexmedetomidine and clonidine effectively control PONV in paediatric abdominal surgery, with no significant difference in incidence or severity. Dexmedetomidine significantly reduced PAED scale scores during recovery, indicating better control of EA. The two treatments showed comparable mean arterial pressures and heart rates without significant side effects.

GINGER CANDY CONSUMPTION AND ITS IMPACT ON FIRST TRIMESTER NAUSEA

Pregnancy brings changes to a woman's body, including in the digestive system which can cause nausea and vomiting, which generally occurs in the first trimester. Morning sickness is a common complaint in pregnancy, but there are also more severe conditions, such as hyperemesis gravidarum. Treatment for nausea and vomiting can be done with pharmacological or non-pharmacological therapy. Ginger, with its antiemetic properties, is a popular choice. Ginger candy is an effective way to consume ginger to reduce nausea and vomiting in first trimester pregnant women. Ginger steeping has also been proven effective in reducing symptoms of nausea and vomiting in first trimester pregnant women. This study aims to analyze the effect of giving ginger candy on nausea and vomiting in pregnant women. This research is a national literature review that was searched using Google Scholar with the keywords "nausea, vomiting", "ginger candy", and "pregnant women". Next, 5 national articles were selected. From all the articles it is known that there is an effect of ginger candy on reducing the level of nausea and vomiting in pregnant women.

A new spectrophotometric method for the quantitative determination of Metopimazine based on the absorbance of its sulfoxide

Metopimazine (MPZ) is a dopamine antagonist from the phenothiazine class of drugs. It has antiemetic properties and is used to treat nausea and vomiting, including those associated with cancer chemotherapy. We have proposed a new method for the quantitative determination of Metopimazine by spectrophotometry. The drug is determined using a difference spectrophotometric technique based on the absorbance of its previously prepared sulfoxide derivative (λmax = 355 nm, ε = 4.5 × 103 L/mol cm) relative to a solution of a non-derivatised drug. The sulfoxide derivative is formed quickly and quantitatively at room temperature by adding potassium caroate solution. The difference in the absorbance of solutions at 355 nm is proportional to the concentration of MPZ in the drug. The method is specific for an intact drug in the presence of oxidative and photochemical decomposition products and excipients. The linearity range is 0.9–30.0 μg/mL. Regression line equation: ΔA = 0.0061 × c (r = 0.999), where c is the MPZ concentration in μg/mL. The limit of quantitation, LOQ (10S), is 2.8 μg/mL. The possibility of quantitative determination of MPZ content in the bulk drug and tablets of Vogalen Lyok 7.5 mg with a relative standard deviation of 1.21% (δ = + 0.05%) and 1.38% (δ = – 0.67%), respectively, was shown. │δ│ < tα (0.95, n = 7) × RSD/√n, where δ = (x¯\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\overline{x}$$\\end{document}–μ) × 100%/μ (μ—quantification data, given in the Certificate of Quality).

Phytocannabinoids: Exploring Pharmacological Profiles and Their Impact on Therapeutical Use.

Phytocannabinoids, a diverse group of naturally occurring compounds extracted from the Cannabis plant, have attracted interest due to their potential pharmacological effects and medicinal uses. This comprehensive review presents the intricate pharmacological profiles of phytocannabinoids while exploring the diverse impacts these substances have on biological systems. From the more than one hundred cannabinoids which were identified in the Cannabis plant so far, cannabidiol (CBD) and tetrahydrocannabinol (THC) are two of the most extensively studied phytocannabinoids. CBD is a non-psychoactive compound, which exhibits potential anti-inflammatory, neuroprotective, and anxiolytic properties, making it a promising candidate for a wide array of medical conditions. THC, known for its psychoactive effects, possesses analgesic and antiemetic properties, contributing to its therapeutic potential. In addition to THC and CBD, a wide range of additional phytocannabinoids have shown intriguing pharmacological effects, including cannabichromene (CBC), cannabigerol (CBG), and cannabinol (CBN). The endocannabinoid system, made up of the enzymes involved in the production and breakdown of endocannabinoids, cannabinoid receptors (CB1 and CB2), and endogenous ligands (endocannabinoids), is essential for preserving homeostasis in several physiological processes. Beyond their effects on the endocannabinoid system, phytocannabinoids are studied for their ability to modify ion channels, neurotransmitter receptors, and anti-oxidative pathways. The complex interaction between phytocannabinoids and biological systems offers hope for novel treatment approaches and lays the groundwork for further developments in the field of cannabinoid-based medicine. This review summarizes the state of the field, points out information gaps, and emphasizes the need for more studies to fully realize the therapeutic potential of phytocannabinoids.

Cannabinoid hyperemesis syndrome: a case report and literature review

IntroductionCannabis is the most used recreational drug worldwide. Cannabinoids have long been known for their anti-emetic properties. Paradoxically, chronic cannabis consumption has been linked to inducing refractory nausea and vomiting, a condition called cannabinoid hyperemesis syndrome (CHS). CHS remains inadequately acknowledged by clinicians.ObjectivesReport a CHS case and discuss this syndrome’s diagnosis, pathophysiology, and management.MethodsCollection of clinical information and review of the literature.ResultsWe share the case of a 38-year-old male who repeatedly recured to the emergency department (ED) due to persistent vomiting, nausea, and abdominal pain. The patient had experienced similar intermittent episodes over the past 12 years. Interestingly, the use of hot showers provided symptomatic relief. Urine drug tests consistently showed positive results for cannabinoids. During acute phases, he required supportive treatment involving fluid therapy. Long-term treatment included cannabis abstinence. CHS is defined by episodic vomiting, following prolonged excessive cannabis consumption, which is alleviated by sustained cessation of cannabis. During the acute phase of the condition, patients often find relief using hot baths and showers, which is a common behavior observed. CHS-related complications encompass acute kidney injury and severe electrolyte disturbances. CHS can result in multiple ED visits, frequent hospitalizations, extensive diagnostic evaluations, and elevated healthcare expenditures. Although the exact pathophysiology of CHS remains unclear, some mechanisms have been proposed. These include reduced gastric motility by gastrointestinal cannabinoid receptors 1 (CB1) overriding, cannabinoid lipid buildup, endocannabinoid system dysregulation, dysregulated stress response, changes in thermoregulation, modifications in the transient receptor potential vanilloid system and genetic polymorphisms in the P450 system. In the acute phase, the foremost concern is providing supportive care including intravenous hydration and electrolyte corrections. The most effective treatment for CHS is cannabis cessation. Nevertheless, there are alternative treatments that have shown promise in alleviating symptoms, such as hot water hydrotherapy, topical capsaicin, haloperidol, benzodiazepines, propranolol and aprepitant.ConclusionsAs cannabis usage becomes increasingly prevalent, it becomes imperative for healthcare providers to acknowledge the long-term effects of cannabinoids, specifically regarding CHS. This diagnosis should be contemplated when evaluating patients who experience recurrent and incoercible vomiting coupled with a history of cannabis consumption. The compulsion to take hot baths or showers can serve as a noteworthy indicator for diagnosing CHS.Disclosure of InterestNone Declared

Standardization and Pharmacological Evaluation of Ziziphus mauritiana Extract for Sedative and Anticonvulsant Activity in Mice and Rat.

Ziziphus mauritiana, sometimes called Indian jujube or Ber, belongs to the Rhamnaceae group of plants. The aqueous and ethanolic Ziziphus mauritiana formulations were shown to have analgesic, antipyretic, potent analgesic, anti-inflammatory, and anti-emetic properties. The aim of this study is to investigate the sedative and anticonvulsant activities of Ziziphus mauritiana extract by governing 200 and 400 mg/kg body weight orally. The leaves are extracted with ethanol and lukewarm water with a soxhlet apparatus for 72 hours. After that acute extract toxicity study was performed and then locomotor activity, pentobarbital induced sleeping time and anticonvulsant activity were performed with the extract. Oral administration of extract at dosages of 200 & 400 mg/kg was employed after an immediate toxicity test. At a dosage of 400 mg/kg, the number of locomotions was reduced significantly lengthened the period of time spent sleeping and there was showed a dosage-dependent reduction in all phases of an epileptic episode. In this study, the extract reduced locomotor activity, however, it had a superior profile for an antiepileptic action than phenytoin since it decreased locomotor activity to a lesser level. The considerable increase in pentobarbitone sleep hours with the extracts at a higher dose supported the sedative action of Z. mauritiana.

FORMULATION AND EVALUATION OF ORODISPERSIBLE TABLET OF PROCHLORPERAZINE MALEATE

In the present work, fast disintegrating tablets of prochlorperazine maleate were designed with a view to enhance patient compliance by effervescent method. Prochlorperazine Maleate, a potent antipsychotic medication with antiemetic properties, holds significance in treating various conditions such as nausea, vomiting, and vertigo. The decision to formulate it into orodispersible tablets aimed to address issues related to patient compliance and convenience, particularly for individuals who experience difficulty swallowing conventional tablets. Formulation F10, enriched with 10% Croscarmellose sodium as a superdisintegrant and an effervescent mixture for taste masking, exhibited remarkable characteristics. Croscarmellose sodium, chosen for its exceptional disintegration properties, ensures rapid breakdown upon contact with saliva, facilitating swift drug release and subsequent onset of action. Moreover, the incorporation of an effervescent mixture not only aids in masking the potentially unpleasant taste of Prochlorperazine Maleate but also holds the potential to enhance palatability and overall patient acceptance. Physicochemical characterization of Prochlorperazine Maleate unveiled favorable attributes, including a loss on drying of 0.413±0.002%, a melting point range of 234-236°C, and a moisture content of 0.0354%, affirming its suitability for formulation into orodispersible tablets. Through dissolution profile comparisons, formulation F10 demonstrated superior drug release kinetics compared to the commercial formulation, underscoring its potential therapeutic advantages.

Cannabinoid Hyperemesis Syndrome: Literature Review

CHS is characterized by cyclic episodes of severe nausea, vomiting, and abdominal pain in individuals with a history of chronic cannabis use. Despite being paradoxical to the widely known antiemetic properties of cannabis, CHS continues to challenge healthcare professionals due to its often elusive diagnosis and mismanagement. The pathophysiology of CHS remains incompletely understood, but current research suggests that prolonged exposure to cannabinoids may disrupt the endocannabinoid system, resulting in dysregulated thermoregulation, gastrointestinal motility, and emesis. Additionally, genetic factors and individual variations in cannabis use patterns may contribute to the development of CHS. Diagnosis of CHS remains challenging, primarily based on clinical criteria, including a history of regular cannabis use, characteristic cyclic vomiting episodes, and symptom relief with hot showers or baths. Differential diagnosis must exclude other causes of cyclic vomiting, making CHS a diagnosis of exclusion. Management of CHS centers around discontinuing cannabis use, which typically leads to symptom resolution over time. Supportive care, including hydration and antiemetic medications, may be necessary during acute episodes. Capsaicin cream, a topical analgesic, has shown promise in alleviating symptoms in some cases. Behavioral therapy and substance abuse counseling may be essential to prevent relapse.

Antidiarrhoeal and anti-emetic activities of aqueous leaf extract of &lt;i&gt;Ficus thonningii&lt;/i&gt; Blume in young chicks

Treatments for diarrhoeal and vomiting with modern drugs have been associated with unwanted effects such as sedation and extrapyramidal effects. In this study, Ficus thonningii Blume leaf extract (FTE) was investigated for its anti-diarrhoeal and anti-emetic properties. Two study groups, namely anti-diarrhoeal and anti-emetic groups (n=36), were sorted into: placebo; drug-treatment, and 3 plant-extract treatment (FT100, FT200 and FT300) subgroups (n = 6). In the placebo group, chicks were administered only saline solution (0.9 %) while chlorpromazine (150 mg/kg) and loperamide (2.5 mg/kg) served as positive control in the anti-emetic and antidiarrhoeal study groups, respectively. The plant-extract treatment groups (FT100, FT200 and FT300) were treated with 100, 200, and 300 mg/kg doses of FTE, respectively. Vomiting was induced using oral copper sulphate solution (50 mg/kg) and chicks were observed for latency as-well-as number of retches. In the anti-diarrhoea study group, 30 mins after treatment with extracts, diarrhoea was induced with oral castor oil and latency as-well-as number of defecation was observed. Results revealed that treatment with 200 and 300 mg/kg of FTE, similar to chlorpromazine, inhibited the number of retching in chicks by 71% and 78%, respectively. Treatment with 100, 200 and 300 mg/kg of FTE, similar to loperamide, reduced the number of droppings in chicks by 45.4%, 42.9%, and 58.4%, respectively. Thus, the results showed that FTE possess anti-emetic and anti-diarrhoeal properties which qualifies it a potential research candidate in search of new drugs.

Study of Total Intravenous Anaesthesia in laparoscopic Surgery

Background: Total intravenous anaesthesia in laparoscopic surgery is safer than open laparotomy operationsbecause propofol, a sedative hypnotic agent with excellent recovery drug and having anti-emetic properties, andnew synthetic opioids (fentanyl congeners) provide excellent analgesia; hence, TIVA has become more popular inlaparoscopic surgery.Method: 45 adult patients aged between 18 to 65 undergoing laparoscopic surgery were studied. A solutionof propofol containing different concentrations of sufentanil (1 μgm per ml and 2 μgmper ml) was infused.Patient’s HR, SBP, DBP, MAP, and peripheral O2 saturation from the anaesthesia monitor was taken as a baselinemeasurement. All the hemodynamic parameters were recorded intra-operatively at different intervals of duration.Results: The changes in mean values of hemodynamic values were insignificant, and only significant parameterswere noted. 158.12 (± 80.9) mean value time to rescue analgesia (in minutes) Post-surgical complications are 3(6.6%) Nausea and vomitingConclusion: Propofol, containing different concentrations of sufentanil, provides hemodynamic stability withthe least post-surgical complications; hence, total intravenous anaesthesia is an ideal substitute for inhalationanaesthesia in laparoscopic surgery because inhalation anaesthesia has a higher risk of hemodynamic instability.

Comparison of oral olanzapine versus oral ondansetron for prevention of postoperative nausea and vomiting in female patients undergoing laparoscopic cholecystectomy under general anaesthesia

Introduction: Postoperative nausea and vomiting is one of the significant problem in anaesthesia practice The incidence is even high following laparoscopic surgeries. 5HT3 receptor antagonists are routinely used to prevent postoperative nausea and vomiting (PONV). Olanzapine, an atypical antipsychotic drug with its activity on multiple receptor sites particularly at D2 and 5HT3 receptors, has potential antiemetic properties. This study aimed to compare the efficacy of ondansetron with olanzapine in prevention of PONV following laparoscopic cholesystectomy under general anaesthesia. Materials and methods: This randomized double blind controlled study was done by recruiting 120 female patients belonging to ASA I/II posted for laparoscopic cholecystectomy under general anaesthesia. Patients were assigned to one of the two groups. Group A received tablet Olanzapine 5mg, 4 hrs before surgery and Group B received tablet ondansetron 16mg 1hr before surgery. Postoperatively nausea, retching, vomiting complete response and sedation were assessed for 24hrs at the interval of 0-4hrs, 4-8hrs, 8-12hrs and 12-24hrs. Results: There was no statistical difference in the incidence of postoperative nausea, retching and vomiting between the groups at 0-4hrs, 4-8hrs. Statistical difference between the groups were seen at 8-12hr interval (nausea p=0.048, retching=0.042, vomiting p=0.042) and at 12-24 hr (nausea p=0.028, retching p=0.001, vomiting p=0.006). There was a significant difference in the use of rescue drug at 8-12hrs (6.7% patients required rescue drug in Group B whereas none required in Group B). Conclusion: Olanzapine 5 mg can be used safely and effectively for prophylaxis against PONV and is more effective in preventing PONV during the late postoperative period compared to ondansetron.

Tolerance to cannabinoids in mice

The Cannabis sativa plant, for its analgesic, anti-inflammatory, antiemetic, and anticonvulsant properties, has been used for thousands of years in Chinese, Indian, and Greek cultures and was introduced into Western medicine in the 19th century. There has been a rise in interest in cannabinoids since the main substances of cannabis were identified, as well as the recognition that the endocannabinoid system (ECS) controls multiple processes in pain treatment and neurologic and mental illnesses. However, the ECS has also been associated with negative effects, including harmful effects on emotional and cognitive functions, the development of tolerance and dependence, and withdrawal symptoms after drug cessation in humans. We recently found that repeated intraperitoneal administration of the two main components of cannabis, delta-9-tetrahydrocannabinol (THC) and cannabinolic acid (CBNA), led to the development of tolerance in male mice. In this review, we focus on the evidence demonstrating cannabinoid tolerance in animals. The common mechanisms and main signaling pathways for cannabinoid tolerance, including neuroadaptations primarily at cannabinoid 1 (CB1) receptors, such as desensitization and downregulation, which are mediated by several signaling pathways, are discussed.

Formulation and Evaluation of Sublingual Tablets of Meclizine Hydrochloride

The aim of the present research is to formulate sublingual tablet of Meclizine Hydrochloride using direct compression method. Moreover the purpose of developing this dosage form is to provide rapid onset of action beneficial in managing conditions of nausea, vomiting and vertigo, and also overcome the problems of solubility of drug by inclusion complexes. The disease like nausea and vomiting required fast onset of action which is necessary for the fast pharmacological action. So, the sublingual route of administration were better way of medication and overcome the problems like dysphagia. The Meclizine hydrochloride is histamine H1 receptor antagonist with antiemetic and antivertigo properties. The oral bioavailability is low (25%), with low solubility (BCS class 2 drug), and metabolized by Hepatic CYP2D6 enzyme by the process of hepatic hydroxylation. Sublingual tablet of antiemetic drug meclizine hydrochloride will be prepared by direct compression method. The Solubility of sublingual tablets will be enhanced by Inclusion complexes. These are prepared by weighed amount of drug mixed with β-cyclodextrin in different dose ratios [1:1,1:2] was wetted with small drops of water to form kneaded like paste and triturated in mortar pestle for several hours resulting in evaporation of solvent. The inclusion complexes was collected and dried for 48 hours and pulverized using mortar and pestle and then sieved through mesh #60. Then properly mixed with other excipients in polybag for 1 hour. The powder like complex was used for further evaluation studies and to form sublingual tablets by direct compression method.

Cannabis use in the United States and its impact on gastrointestinal health.

In recent years, the legalization and social acceptability of cannabis use have increased in the United States. Concurrently, the prevalence of cannabis use has continued to rise, and cannabis products have diversified. There are growing concerns regarding the health effects of regular and high-potency cannabis use, and new research has shed light on its potentially negative effects. Here, we review evidence of the gastrointestinal (GI) effects of cannabis and cannabinoids. Dysregulation of the endocannabinoid system might contribute to various GI disorders, including irritable bowel syndrome and cyclic vomiting syndrome, and endocannabinoids have been found to regulate visceral sensation, nausea, vomiting, and the gut microbiome. Cannabis has been shown to have antiemetic properties, and the US Food and Drug Administration has approved cannabis-based medications for treating chemotherapy-induced nausea and vomiting. Yet, chronic heavy cannabis use has been linked to recurrent episodes of severe nausea and intractable vomiting (cannabinoid hyperemesis syndrome). Given the considerable heterogeneity in the scientific literature, it is unclear if cannabinoid hyperemesis syndrome is truly a distinct entity or a subtype of cyclic vomiting that is unmasked by heavy cannabis use and the associated dysregulation of the endocannabinoid system. The changes in cannabis legalization, availability, and public risk perceptions have outpaced research in this area and there is a need for robust, prospective, large-scale studies to understand the effects of cannabis use on GI health.