Division of Emergency Medicine, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada.
Published: June 2012
AI Article Synopsis
Article Abstract
Objective: To evaluate the efficacy and safety of oral dimenhydrinate in the treatment of acute gastroenteritis.
Methods: This was a randomized, double-blind, placebo-controlled trial conducted in the emergency department of a pediatric university-affiliated center. Children 1 to 12 years old who presented to the emergency department with at least 5 episodes of vomiting in the previous 12 hours and diagnosed with acute gastroenteritis were block-randomized to receive oral dimenhydrinate (1 mg/kg; maximum: 50 mg) every 6 hours for 4 doses or placebo for 4 doses. The primary outcome measure was treatment failure as defined by the occurrence of ≥ 2 episodes of vomiting in the 24 hours after administration of the first dose of the study medication.
Results: During the study period, 209 patients met inclusion criteria, but 50 refused to participate and 7 were missed. Eight participants were lost to follow-up, and 144 were thus included in the primary analysis. Of these patients, 74 were randomized to receive dimenhydrinate and 70 placebo. The proportions of patients showing failure of treatment were similar for both treatment groups: dimenhydrinate, 31% (23 of 74); placebo, 29% (20 of 70) (difference: 0.02 [95% confidence interval: -0.12 to 0.17]). There were no differences between the 2 groups in rates of intravenous cathether insertion, mean number of episodes of vomiting or diarrhea, abdominal pain, nausea, duration of symptoms, revisit rates, or parental absenteeism. The proportions of adverse effects were similar in both groups (53% vs 54%).
Conclusions: The prescription of oral dimenhydrinate did not significantly decrease the frequency of vomiting in children with acute gastroenteritis compared with placebo.
Dimenhydrinate (DMH), used to alleviate motion sickness symptoms such as nausea, vomiting, dizziness, and vertigo, encounters limitations in oral pharmaceutical formulations due to its poor water solubility and bitter taste. Our research hypothesized that inclusion complexation with β-cyclodextrin (β-CD) might address these drawbacks while ensuring that the newly formed complexes exhibit no cytotoxic or genotoxic effects on peripheral blood mononuclear cells (PBMCs). Inclusion complexes were prepared using the kneading method and the solvent evaporation method.
Department of Hematology and Oncology, University of Halle-Wittenberg, Halle (Saale); Charité Center for ambulant health, Department of Hematology, Oncology and Tumor Immunology, Charité University Medicine, Campus Virchow, Berlin; Department of Hematology, Oncology, and Rheumatology, Heidelberg University Hospital; Pharmacy and Patient Advice Center, Universitätsmedizin Marburg-Campus Fulda; Berliner Krebsgesellschaft e. V., Berlin; Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam.
Background: Nausea and vomiting are common and distressing side effects of tumor therapy. Despite prophylaxis, 40-50% of patients suffer from nausea, and 20-30% from vomiting. Antiemetic prophylaxis and treatment are therefore of great importance for improving patients' quality of life and preventing sequelae such as tumor cachexia.
Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA.
Background: Histamine type-1 (H1) receptor antagonists such as diphenhydramine are frequently used for treatment of pruritus in dogs, yet therapeutic efficacy for allergic disorders is reported to be highly variable. Dimenhydrinate is a salt of diphenhydramine and 8-chlorotheophylline, and has been reported to produce superior oral absorption of diphenhydramine.
Hypothesis/objective: To determine the pharmacokinetic and pharmacodynamic properties of diphenhydramine in dogs after intravenous (1 mg/kg) and oral (5 mg/kg) administration, and when given orally as dimenhydrinate at a dose of 10 mg/kg (≈5 mg/kg diphenhydramine).
