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POR FAVOR
From: rschiaffino_123mail (rschiaffino@123mail.cl)
Sun Sep 29 12:29:38 2002
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necesito que me saquen de este chat. no deseo seguir recibiendo correo gracias
>----- Original Message -----
De: jaider gomez diaz <dr_jaider@hotmail.com> Fecha: Sunday, September 22, 2002 9:37 pm Asunto: Re: Informe sobre ondansetron. Hiperemesis gravídica> Estimado colega, gracias por el aporte, pero el problema es que no
> contamos
> con este medicamento y persiste la hiperemesis, a pesar de los
> tratamientos
> que tenemos a la mano: metoclopramida, fenergan, esteroides, alimentacion
> parenteral. Hemos utilizado propofol, droperidol a bajas dosis por
> recomendación del serv. de anestesiologia, sin resultados. En reunión
> médica se decidió, mantener la hidratación parenteral por el tiempo que
> sea
> necesario. El menejo ha sido multidisciplinario: psiquiatría,
> gastroenterología, neurología,perinatológia y por nutrición y dietetica.
> Hasta el momento bienestar fetal conservado. Velocimetria doppler de
> arteria
> umbilical, venosa de vena hepática derecha y ducto venoso, arteria
> cerebral
> media y anterior, todo dentro de lo normal. Liquido amniótico dentro de lo
> normal. Determinación de b-HGC, dentro de lo normal, por lo que nos hace
> dudar si se trata de una mola parcial.... Gastroenterología, sugiere
> realizar endoscopia gástroduodenal....Primer caso que nos topamos
> así....bueno gracias por todo...saludos desde venezuela.
>
> >From: "Jorge Renzi" <jrenzi@satlink.com>
> >Reply-To: obgin-l@obgyn.net
> >To: Multiple recipients of list OBGIN-L <obgin-l@mail.medispecialty.com>
> >Subject: Informe sobre ondansetron. Hiperemesis gravídica
> >Date: Sun, 22 Sep 2002 16:32:31 -0500
> >
> >Queridos amigos: les envío información sobre el ondansetron y su empleo
> >durante la gestación. Como verán es una droga Categoria B que con
> >limitaciones y en caso de no responder a la terapéutica corriente se
> puede
> >utilizar durante la gestación.
> >
> >Siempre en estos casos tenemos que balancear riesgos y beneficios. Pero
> en
> >el caso com hace referencia el colega sería una droga de elección.
> >
> >Saludos
> >
> >Dr. Jorge Renzi
> >
> >Hypersensitivity reactions have been reported in patients who have
> >exhibited hypersensitivity to other selective 5-HT3 receptor antagonists.
> >
> >PRECAUTIONS
> >
> >Ondansetron is not a drug that stimulates gastric or intestinal
> >peristalsis. It should not be used instead of nasogastric suction. The
> use
> >of ondansetron in patients following abdominal surgery or in patients
> with
> >chemotherapy-induced nausea and vomiting may mask a progressive ileus
> >and/or gastric distention.
> >
> >Drug Interactions
> >
> >Ondansetron does not itself appear to induce or inhibit the cytochrome
> >P-450 drug-metabolizing enzyme system of the liver. Because ondansetron
> is
> >metabolized by hepatic cytochrome P-450 drug-metabolizing enzymes,
> inducers
> >or inhibitors of these enzymes may change the clearance and hence, the
> >half-life of ondansetron. On the basis of limited available data, no
> dosage
> >adjustment is recommended for patients on these drugs. Tumor response to
> >chemotherapy in the P 388 mouse leukemia model is not affected by
> >ondansetron. In humans, carmustine, etoposide, and cisplatin do not
> affect
> >the pharmacokinetics of ondansetron.
> >
> >Carcinogenesis, Mutagenesis, Impairment of Fertility
> >
> >Carcinogenic effects were not seen in 2-year studies in rats and mice
> with
> >oral ondansetron doses up to 10 and 30 mg/kg per day, respectively.
> >Ondansetron was not mutagenic in standard tests for mutagenicity. Oral
> >administration of ondansetron up to 15 mg/kg per day did not affect
> >fertility or general reproductive performance of male and female rats.
> >
> >Pregnancy
> >
> >Teratogenic Effects: Pregnancy Category B. Reproduction studies have been
> >performed in pregnant rats and rabbits at I.V. doses up to 4 mg/kg per
> day
> >and have revealed no evidence of impaired fertility or harm to the fetus
> >due to ondansetron. There are, however, no adequate and well-controlled
> >studies in pregnant women. Because animal reproduction studies are not
> >always predictive of human response, this drug should be used during
> >pregnancy only if clearly needed.
> >
> >Nursing Mothers
> >
> >Ondansetron is excreted in the breast milk of rats. It is not known
> whether
> >ondansetron is excreted in human milk. Because many drugs are excreted in
> >human milk, caution should be exercised when ondansetron is administered
> to
> >a nursing woman.
> >
> >Pediatric Use
> >
> >Little information is available about dosage in pediatric patients under
> 2
> >years of age (see DOSAGE AND ADMINISTRATION section for use in pediatric
> >patients 4 to 18 years of age receiving cancer chemotherapy or for use in
> >pediatric patients 2 to 12 years of age receiving general anesthesia).
> >
> >Use in Elderly Patients
> >
> >Dosage adjustment is not needed in patients over the age of 65 (see
> >CLINICAL PHARMACOLOGY). Prevention of nausea and vomiting in elderly
> >patients was no different than in younger age-groups.
> >
> >TABLETS
> >
> >Information for Patients
> >
> >Phenylketonurics: Phenylketonuric patients should be informed that ZOFRAN
> >ODT Orally Disintegrating Tablets contain phenylalanine (a component of
> >aspartame). Each 4 mg and 8 mg orally disintegrating tablet contains
> <0.03
> >mg phenylalanine. Patients should be instructed not to remove ZOFRAN ODT
> >Tablets from the blister until just prior to dosing. The tablet should
> not
> >be pushed through the foil. With dry hands, the blister backing should be
> >peeled completely off the blister. The tablet should be gently removed
> and
> >immediately placed on the tongue to dissolve and be swallowed with the
> >saliva. Peelable illustrated stickers are affixed to the product carton
> >that can be provided with the prescription to ensure proper use and
> >handling of the product.
> >
> >Use in Surgical Patients
> >
> >The coadministration of ondansetron had no effect on the pharmacokinetics
> >and pharmacodynamics of temazepam.
> >
> >Pediatric Use
> >
> >Little information is available about dosage in children 4 years of age
> or
> >younger (see CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION sections
> >for use in children 4 to 18 years of age).
> >
> >Use in Elderly Patients
> >
> >Dosage adjustment is not needed in patients over the age of 65 (see
> >CLINICAL PHARMACOLOGY). Prevention of nausea and vomiting in elderly
> >patients was no different than in younger age-groups.
> >
>
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