The Experts below are selected from a list of 6375 Experts worldwide ranked by ideXlab platform
David R Gandara - One of the best experts on this subject based on the ideXlab platform.
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advances in the control of chemotherapy induced emesis
Annals of Oncology, 1992Co-Authors: E A Perez, David R GandaraAbstract:Summary Cancer patients consistently rank nausea and vomiting as the most feared side effects of treatment. Cisplatin, one of the most active chemotherapeutic agents, causes acute emesis and a delayed emesis syndrome, which also results in considerable patient morbidity. Despite the use of metoclopramide-containing combination regimens, approximately one third of cisplatin-treated patients continue to experience emesis. In recent years, considerable progress has been made in managing chemotherapy-induced emesis. This review discusses several factors that have contributed to improved antiemetic control, including standardization of antiemetic trial methodology, insight into the pathogenesis of chemotherapy-induced emesis, and the development of a new class of antiemetic agents, the Serotonin Antagonists. In clinical studies performed to date, these agents have generally proven to be both effective and safe. Three multicenter trials of the selective Serotonin antagonist ondansetron in the prevention of nausea and vomiting from cisplatin are reviewed.
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Serotonin Antagonists: A New Class of Antiemetic Agents
Journal of the National Cancer Institute, 1991Co-Authors: Paul J Hesketh, David R GandaraAbstract:Despite a number of significant advances over the past decade, prevention and treatment of chemotherapy-induced emesis remain formidable problems, particularly with cisplatin-containing regimens. Nearly one third of patients receiving high-dose cisplatin still experience substantial emesis despite the best available conventional antiemetics, and the toxic effects of these agents remain quite troublesome. In recent years, a new class of agents, the Serotonin Antagonists, has been identified. These agents hold promise for clinical utility in a wide range of areas. Selective Antagonists of the Serotonin (5-hydroxytryptamine) type 3 (5-HT3) receptor have proven in early clinical trials to be potent antiemetic agents in patients receiving cytotoxic chemotherapy, with efficacy comparable to or superior to that of conventional antiemetics. Toxic effects to date with the 5-HT3 receptor Antagonists have been modest. The current state of knowledge with respect to these agents as antiemetics for patients receiving cytotoxic chemotherapy is summarized.
Ravi N Sharaf - One of the best experts on this subject based on the ideXlab platform.
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guidelines on management of cyclic vomiting syndrome in adults by the american neurogastroenterology and motility society and the cyclic vomiting syndrome association
Neurogastroenterology and Motility, 2019Co-Authors: Thangam Venkatesa, Kathlee Adams, William L Hasle, Robe M Issenma, David J Levinthal, Safwa Jaradeh, Christopher D Stave, Sally E Tarbell, Irene Sarosiek, Ravi N SharafAbstract:The increasing recognition of cyclic vomiting syndrome (CVS) in adults prompted the development of these evidence-based guidelines on the management of CVS in adults, which was sponsored by the American Neurogastroenterology and Motility Society (ANMS) and the Cyclic Vomiting Syndrome Association (CVSA). GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework was used and a professional librarian performed the literature search. The expert committee included the President of the CVSA who brought a patient perspective into the deliberations. The committee makes recommendations for the prophylaxis of CVS, treatment of acute attacks, diagnosis, and overall management of CVS. The committee strongly recommends that adults with moderate-to-severe CVS receive a tricyclic antidepressant (TCA), such as amitriptyline, as a first-line prophylactic medication and receive topiramate or aprepitant as alternate prophylactic medications. Zonisamide or levetiracetam and mitochondrial supplements (Coenzyme Q10, L-carnitine, and riboflavin) are conditionally recommended as alternate prophylactic medications, either alone or concurrently with other prophylactic medications. For acute attacks, the committee conditionally recommends using Serotonin Antagonists, such as ondansetron, and/or triptans, such as sumatriptan or aprepitant to abort symptoms. Emergency department treatment is best achieved with the use of an individualized treatment protocol and shared with the care team (example provided). The committee recommended screening and treatment for comorbid conditions such as anxiety, depression, migraine headache, autonomic dysfunction, sleep disorders, and substance use with referral to appropriate allied health services as indicated. Techniques like meditation, relaxation, and biofeedback may be offered as complementary therapy to improve overall well-being and patient care outcomes.
Robert Gerlai - One of the best experts on this subject based on the ideXlab platform.
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Serotonin Antagonists induce anxiolytic and anxiogenic like behavior in zebrafish in a receptor subtype dependent manner
Pharmacology Biochemistry and Behavior, 2014Co-Authors: Magda Nowicki, Arrujyan Muraleetharan, Stefan Markovic, Steven Tran, Robert GerlaiAbstract:Abstract Motor function and anxiety-like responses are easily quantifiable in zebrafish, a novel model organism for behavioral pharmacology. Activation of Serotonin receptors through the use of selective agonists has been shown to alter anxiety-like behaviors in zebrafish. However, few studies have examined the effect of blockade of specific Serotonin receptors. In the current study, we examine the effect of 4 Serotonin receptor Antagonists selective for 5-HT1A, 5-HT1B/D, 5-HT2, and 5-HT3 receptors on zebrafish motor and anxiety-like responses. Exposure to the receptor Antagonists did not change baseline motor responses. However, when placed in a novel environment, zebrafish previously exposed to GR 55562 (5-HT1B/D antagonist) exhibited reduced anxiety-like behavior, whereas zebrafish previously exposed to p-MPPF (5-HT1A antagonist), Ketanserin (5-HT2 antagonist), or Ondasetron (5-HT3 antagonist) exhibited increased anxiety-like behaviors. These results show that drugs developed for mammalian Serotonin receptors are efficacious in the zebrafish too, a finding that demonstrates evolutionary conservation of the Serotoninergic system. The results also imply that zebrafish may be an appropriate animal model for examining the serotonergic neurotransmitter system in vertebrates.
Roy Corbett - One of the best experts on this subject based on the ideXlab platform.
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preclinical anxiolytic versus antipsychotic profiles of the 5 ht3 Antagonists ondansetron zacopride 3α tropanyl 1h indole 3 carboxylic acid ester and 1αh 3α 5αh tropan 3 yl 3 5 dichlorobenzoate
Drug Development Research, 1991Co-Authors: Robert W Dunn, William A Carlezon, Roy CorbettAbstract:In preclinical studies, the behavioral effects of Serotonin Antagonists at 5-HT3 receptor sites suggest potential efficacy in the treatment of anxiety and schizophrenia. The present study shows that 5-HT3 Antagonists were effective in disinhibiting behavior in non-conditioned rodent models which elicit a behavioral state presumed to be analogous to anxiety, but were generally not effective in conditioned rodent anxiety models or in assays that are traditionally predictive of antipsychotic agents. Ondansetron (0.01–0.1 mg/kg), zacopride (0.1–1.0 mg/kg), ICS 205–930 (3α-tropanyl-1H-indole-3-carboxylic acid ester; 0.5 and 1.0 mg/kg), and MDL 72222 (1αH, 3α, 5αH-tropan-3-yl-3,5-dichlorobenzoate; 10.0 and 20.0 mg/kg) demonstrated anxiolytic effects in the social interaction and elevated plus maze procedures, while having little or no effect in a modified Cook and Davidson conflict procedure. Ondansetron, zacopride, and ICS 205–930 had no effect in neuroleptic screening procedures, such as the apomorphine climbing mouse assay (CMA), the pole climb avoidance (PCA) procedure, and the intracranial self-stimulation of the medial forebrain bundle (ICSS-MFB) assay. MDL 72222 had no effect on CMA but dose-dependently antagonized PCA (ED50 = 10.9 mg/kg) and ICSS-MFB (ED50 = 8.8 mg/kg). The results of the present study suggest that MDL 72222 possesses a profile of activity that is different from the other 5-HT3 Antagonists tested and that, in general, 5-HT3 Antagonists may prove to be efficacious in the treatment of certain forms of anxiety in man.
Thangam Venkatesa - One of the best experts on this subject based on the ideXlab platform.
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guidelines on management of cyclic vomiting syndrome in adults by the american neurogastroenterology and motility society and the cyclic vomiting syndrome association
Neurogastroenterology and Motility, 2019Co-Authors: Thangam Venkatesa, Kathlee Adams, William L Hasle, Robe M Issenma, David J Levinthal, Safwa Jaradeh, Christopher D Stave, Sally E Tarbell, Irene Sarosiek, Ravi N SharafAbstract:The increasing recognition of cyclic vomiting syndrome (CVS) in adults prompted the development of these evidence-based guidelines on the management of CVS in adults, which was sponsored by the American Neurogastroenterology and Motility Society (ANMS) and the Cyclic Vomiting Syndrome Association (CVSA). GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework was used and a professional librarian performed the literature search. The expert committee included the President of the CVSA who brought a patient perspective into the deliberations. The committee makes recommendations for the prophylaxis of CVS, treatment of acute attacks, diagnosis, and overall management of CVS. The committee strongly recommends that adults with moderate-to-severe CVS receive a tricyclic antidepressant (TCA), such as amitriptyline, as a first-line prophylactic medication and receive topiramate or aprepitant as alternate prophylactic medications. Zonisamide or levetiracetam and mitochondrial supplements (Coenzyme Q10, L-carnitine, and riboflavin) are conditionally recommended as alternate prophylactic medications, either alone or concurrently with other prophylactic medications. For acute attacks, the committee conditionally recommends using Serotonin Antagonists, such as ondansetron, and/or triptans, such as sumatriptan or aprepitant to abort symptoms. Emergency department treatment is best achieved with the use of an individualized treatment protocol and shared with the care team (example provided). The committee recommended screening and treatment for comorbid conditions such as anxiety, depression, migraine headache, autonomic dysfunction, sleep disorders, and substance use with referral to appropriate allied health services as indicated. Techniques like meditation, relaxation, and biofeedback may be offered as complementary therapy to improve overall well-being and patient care outcomes.
