Drugs for the treatment of nausea and vomiting in adults in the emergency department setting.

Abstract:

BACKGROUND:Nausea and vomiting is a common and distressing presenting complaint in emergency departments (ED). The aetiology of nausea and vomiting in EDs is diverse and drugs are commonly prescribed. There is currently no consensus as to the optimum drug treatment of nausea and vomiting in the adult ED setting. OBJECTIVES:To provide evidence of the efficacy and safety of antiemetic medications in the management of nausea and vomiting in the adult ED setting. SEARCH METHODS:We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 8), MEDLINE (OvidSP) (January 1966 to August 2014), EMBASE (OvidSP) (January 1980 to August 2014) and ISI Web of Science (January 1955 to August 2014). We also searched relevant clinical trial registries and conference proceedings. SELECTION CRITERIA:We included randomized controlled trials (RCTs) of any drug in the treatment of nausea and vomiting in the treatment of adults in the ED. Study eligibility was not restricted by language or publication status. DATA COLLECTION AND ANALYSIS:Two review authors independently performed study selection, data extraction and assessment of risk of bias in included studies. We contacted authors of studies to obtain missing information if required. MAIN RESULTS:We included eight trials, involving 952 participants, of which 64% were women. Included trials were generally of adequate quality, with six trials at low risk of bias, and two trials at high risk of bias. Three trials with 518 participants compared five different drugs with placebo; all reported the primary outcome as mean change in visual analogue scale (VAS) (0 to 100) for nausea severity from baseline to 30 minutes. Trials did not routinely report other primary outcomes of the change in nausea VAS at 60 minutes or number of vomiting episodes. Differences in mean VAS change from baseline to 30 minutes between placebo and the drugs evaluated were: metoclopramide (three trials, 301 participants; mean difference (MD) -5.27, 95% confidence interval (CI) -11.33 to 0.80), ondansetron (two trials, 250 participants; MD -4.32, 95% CI -11.20 to 2.56), prochlorperazine (one trial, 50 participants; MD -1.80, 95% CI -14.40 to 10.80), promethazine (one trial, 82 participants; MD -8.47, 95% CI -19.79 to 2.85) and droperidol (one trial, 48 participants; MD -15.8, 95% CI -26.98 to -4.62). The only statistically significant change in baseline VAS to 30 minutes was for droperidol, in a single trial of 48 participants. No other drug was statistically significantly superior to placebo. Other included trials evaluated a drug compared to "active controls" (alternative antiemetic). There was no convincing evidence of superiority of any particular drug compared to active control. All trials included in this review reported adverse events, but they were variably reported precluding meaningful pooling of results. Adverse events were generally mild, there were no reported serious adverse events. Overall, the quality of the evidence was low, mainly because there were not enough data. AUTHORS' CONCLUSIONS:In an ED population, there is no definite evidence to support the superiority of any one drug over any other drug, or the superiority of any drug over placebo. Participants receiving placebo often reported clinically significant improvement in nausea, implying general supportive treatment such as intravenous fluids may be sufficient for the majority of people. If a drug is considered necessary, choice of drug may be dictated by other considerations such as a person's preference, adverse-effect profile and cost. The review was limited by the paucity of clinical trials in this setting. Future research should include the use of placebo and consider focusing on specific diagnostic groups and controlling for factors such as intravenous fluid administered.

authors

Furyk JS,Meek RA,Egerton-Warburton D

doi

10.1002/14651858.CD010106.pub2

subject

Has Abstract

pub_date

2015-09-28 00:00:00

pages

CD010106

issue

9

issn

1469-493X

pub_type

杂志文章,meta分析,评审
  • Audit and feedback: effects on professional practice and health care outcomes.

    abstract:BACKGROUND:Audit and feedback has been identified as having the potential to change the practice of health care professionals. OBJECTIVES:To assess the effects of audit and feedback on the practice of health professionals and patient outcomes. SEARCH STRATEGY:We searched MEDLINE up to June 1997, the Research and Deve...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000259

    authors: Thomson O'Brien MA,Oxman AD,Davis DA,Haynes RB,Freemantle N,Harvey EL

    更新日期:2000-01-01 00:00:00

  • Transient neurological symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics in adult surgical patients: a network meta-analysis.

    abstract:BACKGROUND:Spinal anaesthesia has been implicated as one of the possible causes of neurological complications following surgical procedures. This painful condition, occurring during the immediate postoperative period, is termed transient neurological symptoms (TNS) and is typically observed after the use of spinal lido...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD003006.pub4

    authors: Forget P,Borovac JA,Thackeray EM,Pace NL

    更新日期:2019-12-01 00:00:00

  • Antibiotics for treating osteomyelitis in people with sickle cell disease.

    abstract:BACKGROUND:Osteomyelitis (both acute and chronic) is one of the most common infectious complications in people with sickle cell disease. There is no standardized approach to antibiotic therapy and treatment is likely to vary from country to country. Thus, there is a need to identify the efficacy and safety of different...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007175.pub3

    authors: Martí-Carvajal AJ,Agreda-Pérez LH

    更新日期:2012-12-12 00:00:00

  • Fluticasone versus placebo for chronic asthma in adults and children.

    abstract:BACKGROUND:Inhaled fluticasone propionate (FP) is a relatively new inhaled corticosteroid for the treatment of asthma. OBJECTIVES:To assess efficacy and safety outcomes in studies that compared FP to placebo for treatment of chronic asthma. SEARCH STRATEGY:We searched the Cochrane Airways Group Specialised Register (...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003135.pub4

    authors: Adams NP,Bestall JC,Lasserson TJ,Jones P,Cates CJ

    更新日期:2008-10-08 00:00:00

  • Planned birth at or near term for improving health outcomes for pregnant women with gestational diabetes and their infants.

    abstract:BACKGROUND:Gestational diabetes is a type of diabetes that occurs during pregnancy. Women with gestational diabetes are more likely to experience adverse health outcomes such as pre-eclampsia or polyhydramnios (excess amniotic fluid). Their babies are also more likely to have health complications such as macrosomia (bi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD012910

    authors: Biesty LM,Egan AM,Dunne F,Dempsey E,Meskell P,Smith V,Ni Bhuinneain GM,Devane D

    更新日期:2018-01-05 00:00:00

  • Surgical management of functional bladder outlet obstruction in adults with neurogenic bladder dysfunction.

    abstract:BACKGROUND:The most common type of functional bladder outlet obstruction in patients with neurogenic bladder is detrusor-sphincter dyssynergia (DSD). The lack of co-ordination between the bladder and the external urethral sphincter muscle (EUS) in DSD can result in poor bladder emptying and high bladder pressures, whic...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004927.pub4

    authors: Utomo E,Groen J,Blok BF

    更新日期:2014-05-24 00:00:00

  • Laetrile treatment for cancer.

    abstract:BACKGROUND:Laetrile is an unconventional therapy which has been used illegally for decades by cancer patients who together with some alternative therapists claim its effectiveness as an anti-cancer treatment. It has been often referred to as amygdalin, although the two are not the same. OBJECTIVES:The aim of this revi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005476.pub2

    authors: Milazzo S,Ernst E,Lejeune S,Schmidt K

    更新日期:2006-04-19 00:00:00

  • Early enteral nutrition (within 48 hours) versus delayed enteral nutrition (after 48 hours) with or without supplemental parenteral nutrition in critically ill adults.

    abstract:BACKGROUND:Early enteral nutrition support (within 48 hours of admission or injury) is frequently recommended for the management of patients in intensive care units (ICU). Early enteral nutrition is recommended in many clinical practice guidelines, although there appears to be a lack of evidence for its use and benefit...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD012340.pub2

    authors: Fuentes Padilla P,Martínez G,Vernooij RW,Urrútia G,Roqué I Figuls M,Bonfill Cosp X

    更新日期:2019-10-31 00:00:00

  • Oral betamimetics for maintenance therapy after threatened preterm labour.

    abstract:BACKGROUND:Some women who have threatened to give birth prematurely, subsequently settle. They may then take oral tocolytic maintenance therapy to prevent preterm birth and to prolong gestation. OBJECTIVES:To assess the effects of oral betamimetic maintenance therapy after threatened preterm labour for preventing pret...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003927.pub3

    authors: Dodd JM,Crowther CA,Middleton P

    更新日期:2012-12-12 00:00:00

  • Aromatase inhibitors for subfertile women with polycystic ovary syndrome.

    abstract:BACKGROUND:Polycystic ovary syndrome (PCOS) is the most common cause of infrequent periods (oligomenorrhoea) and absence of periods (amenorrhoea). It affects about 4% to 8% of women worldwide and often leads to anovulatory subfertility. Aromatase inhibitors (AIs) are a novel class of drugs that were introduced for ovul...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010287.pub2

    authors: Franik S,Kremer JA,Nelen WL,Farquhar C

    更新日期:2014-02-24 00:00:00

  • Family therapy for anorexia nervosa.

    abstract:BACKGROUND:Anorexia Nervosa (AN) is characterised by distorted body image and deliberately maintained low body weight. The long term prognosis is often poor, with severe medical, developmental and psychosocial complications, high rates of relapse and mortality. Different variants of family therapy have been commonly us...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004780.pub2

    authors: Fisher CA,Hetrick SE,Rushford N

    更新日期:2010-04-14 00:00:00

  • Occupational safety and health enforcement tools for preventing occupational diseases and injuries.

    abstract:BACKGROUND:There is uncertainty as to whether and what extent occupational safety and health regulation and legislation enforcement activities, such as inspections, are effective and efficient to improve workers' health and safety. We use the term regulation to refer both to regulation and legislation. OBJECTIVES:To a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010183.pub2

    authors: Mischke C,Verbeek JH,Job J,Morata TC,Alvesalo-Kuusi A,Neuvonen K,Clarke S,Pedlow RI

    更新日期:2013-08-30 00:00:00

  • Extramedullary fixation implants for extracapsular hip fractures.

    abstract:BACKGROUND:Extramedullary fixation of hip fractures refers to the application of a plate and screws to the lateral side of the proximal femur. OBJECTIVES:To compare different types of extramedullary fixation implants for the surgical treatment of extracapsular hip fracture in adults. SEARCH STRATEGY:We searched the C...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000339

    authors: Parker MJ,Handoll HH,Chinoy MA

    更新日期:2001-01-01 00:00:00

  • Haloperidol versus placebo for schizophrenia.

    abstract:BACKGROUND:Haloperidol was developed in the late 1950s for use in the field of analgesia. Research subsequently demonstrated effects on hallucinations, delusions, aggressiveness, impulsiveness and states of excitement and led to the introduction of haloperidol as an antipsychotic. OBJECTIVES:To evaluate the clinical e...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003082

    authors: Joy CB,Adams CE,Lawrie SM

    更新日期:2001-01-01 00:00:00

  • Dance movement therapy for dementia.

    abstract:BACKGROUND:Dementia is a collective name for different degenerative brain syndromes which, according to Alzheimer's Disease International, affects approximately 35.6 million people worldwide. The latest NICE guideline for dementia highlights the value of diverse treatment options for the different stages and symptoms o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD011022.pub2

    authors: Karkou V,Meekums B

    更新日期:2017-02-03 00:00:00

  • Water-based exercise for adults with asthma.

    abstract:BACKGROUND:Asthma is a common condition characterised by airway inflammation and airway narrowing, which can result in intermittent symptoms of wheezing, coughing and chest tightness, possibly limiting activities of daily life. Water-based exercise is believed to offer benefits for people with asthma through pollen-fre...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD010456.pub2

    authors: Grande AJ,Silva V,Andriolo BN,Riera R,Parra SA,Peccin MS

    更新日期:2014-07-17 00:00:00

  • Hypertonic saline for peri-operative fluid management.

    abstract:BACKGROUND:Fluid excess may place patients undergoing surgery at risk for various complications. Hypertonic saline (HS) maintains intravascular volume with less intravenous fluid than isotonic salt (IS) solutions, but may increase serum sodium. OBJECTIVES:To determine the benefits and harms of HS versus IS solutions a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005576.pub2

    authors: McAlister V,Burns KE,Znajda T,Church B

    更新日期:2010-01-20 00:00:00

  • Intravenous immunoglobulin for preventing infection in preterm and/or low birth weight infants.

    abstract:BACKGROUND:Nosocomial infections continue to be a significant cause of morbidity and mortality among preterm and/or low birth weight (LBW) infants. Preterm infants are deficient in immunoglobulin G (IgG); therefore, administration of intravenous immunoglobulin (IVIG) may have the potential of preventing or altering the...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD000361.pub4

    authors: Ohlsson A,Lacy JB

    更新日期:2020-01-29 00:00:00

  • Gonadotrophin-releasing hormone analogues for pain associated with endometriosis.

    abstract:BACKGROUND:Endometriosis is a common gynaecological condition that frequently presents with the symptom of pain. The precise pathogenesis (mode of development) of endometriosis is unclear but it is evident that endometriosis arises by the dissemination of endometrium to ectopic sites and the subsequent establishment of...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000346

    authors: Prentice A,Deary AJ,Goldbeck-Wood S,Farquhar C,Smith SK

    更新日期:2000-01-01 00:00:00

  • Tailored interventions based on exhaled nitric oxide versus clinical symptoms for asthma in children and adults.

    abstract:BACKGROUND:The measurement of severity and control of asthma in both children and adults can be based on subjective or objective measures. It has been advocated that fractional exhaled nitric oxide (FeNO) can be used to monitor airway inflammation as it correlates with some markers of asthma. Interventions for asthma t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006340.pub3

    authors: Petsky HL,Cates CJ,Li A,Kynaston JA,Turner C,Chang AB

    更新日期:2009-10-07 00:00:00

  • Rutosides for treatment of post-thrombotic syndrome.

    abstract:BACKGROUND:Post-thrombotic syndrome (PTS) is a long-term complication of deep venous thrombosis (DVT) that is characterised by pain, swelling, and skin changes in the affected limb. One in three patients with DVT will develop post-thrombotic sequelae within five years. Rutosides are a group of compounds derived from ho...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005625.pub2

    authors: Morling JR,Yeoh SE,Kolbach DN

    更新日期:2013-04-30 00:00:00

  • Intravenous immunoglobulin for Guillain-Barré syndrome.

    abstract:BACKGROUND:Guillain-Barré syndrome is a potentially serious, acute, paralysing, probably autoimmune disease caused by inflammation of the peripheral nerves. Recovery has been shown to be speeded by plasma exchange which replaces the patient's own plasma with a plasma substitute. Intravenous immunoglobulin purified from...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002063

    authors: Hughes RA,Raphaël JC,Swan AV,van Doorn PA

    更新日期:2001-01-01 00:00:00

  • Patellar tendon versus hamstring tendon autograft for anterior cruciate ligament rupture in adults.

    abstract:BACKGROUND:Reconstruction of the anterior cruciate ligament (ACL) commonly involves patellar tendon (PT) or hamstring tendon(s) (HT) autografts. There is no consensus with respect to the choice between these two grafts in ACL surgery. OBJECTIVES:This review compared the outcomes of ACL reconstruction using PT versus H...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005960.pub2

    authors: Mohtadi NG,Chan DS,Dainty KN,Whelan DB

    更新日期:2011-09-07 00:00:00

  • Vitamin K for upper gastrointestinal bleeding in patients with liver diseases.

    abstract:BACKGROUND:Upper gastrointestinal bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis. Several treatments are used for upper gastrointestinal bleeding in patients with liver diseases. However, supplementary interventions are often used as well. One of them is vitamin ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004792.pub2

    authors: Martí-Carvajal AJ,Martí-Peña AJ

    更新日期:2005-07-20 00:00:00

  • Audio recordings of consultations with doctors for parents of critically sick babies.

    abstract:BACKGROUND:Family centred care is an important part of neonatal intensive care. Ensuring effective communication in the neonatal intensive care unit (NICU) is a challenge but is crucial to the implementation of family centred care. Providing parents in NICU with audiotape recordings of their conversations with neonatol...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004502.pub2

    authors: Koh TH,Budge D,Butow P,Renison B,Woodgate P

    更新日期:2005-01-25 00:00:00

  • Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke.

    abstract:BACKGROUND:Children's exposure to other people's tobacco smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children's exposure to ETS. Older children in child care or educational settings are also at risk of exposure to...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001746.pub4

    authors: Behbod B,Sharma M,Baxi R,Roseby R,Webster P

    更新日期:2018-01-31 00:00:00

  • Aerosolized prostacyclins for acute respiratory distress syndrome (ARDS).

    abstract:BACKGROUND:Acute respiratory distress syndrome (ARDS) is a critical condition that is associated with high mortality and morbidity. Aerosolized prostacyclin has been used to improve oxygenation despite the limited evidence available so far.This review was originally published in 2010 and updated in 2017. OBJECTIVES:To...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007733.pub3

    authors: Afshari A,Bastholm Bille A,Allingstrup M

    更新日期:2017-07-24 00:00:00

  • Motor control exercise for acute non-specific low back pain.

    abstract:BACKGROUND:Motor control exercise (MCE) is used by healthcare professionals worldwide as a common treatment for low back pain (LBP). However, the effectiveness of this intervention for acute LBP remains unclear. OBJECTIVES:To evaluate the effectiveness of MCE for patients with acute non-specific LBP. SEARCH METHODS:W...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD012085

    authors: Macedo LG,Saragiotto BT,Yamato TP,Costa LO,Menezes Costa LC,Ostelo RW,Maher CG

    更新日期:2016-02-10 00:00:00

  • Screening children in the first four years of life to undergo early treatment for otitis media with effusion.

    abstract:BACKGROUND:Otitis media with effusion (OME) is the most common cause of acquired hearing loss in childhood and has been associated with delayed language development and behavioural problems. This condition has a prevalence of about 20% at the age of two years, a time of rapid language development. It is most often asym...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004163

    authors: Butler CC,van der Linden MK,MacMillan H,van der Wouden JC

    更新日期:2003-01-01 00:00:00

  • Advance treatment directives for people with severe mental illness.

    abstract:BACKGROUND:An advance directive is a document specifying a person's preferences for treatment, should he or she lose capacity to make such decisions in the future. They have been used in end-of-life settings to direct care but should be well suited to the mental health setting. OBJECTIVES:To examine the effects of adv...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005963.pub2

    authors: Campbell LA,Kisely SR

    更新日期:2009-01-21 00:00:00