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Drug Class Review: HMG-CoA Reductase Inhibitors (Statins) and Fixed-dose Combination Products Containing a Statin: Final Report Update 5 [Internet]

In the United States, coronary heart disease and cardiovascular disease account for nearly 40% of all deaths each year. Coronary heart disease continues to be the leading cause of mortality and a significant cause of morbidity among North Americans. In 2006, coronary heart disease claimed 607 000 lives, translating into about 1 out of every 5 deaths in the United States. High levels of cholesterol, or hypercholesterolemia, are an important risk factor for coronary heart disease. The 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase inhibitors, also known as statins, are the most effective class of drugs for lowering serum low-density lipoprotein cholesterol concentrations. They are first-line agents for patients who require drug therapy to reduce serum low-density lipoprotein cholesterol concentrations. The purpose of this review is to compare the benefits and harms of different statins in adults and children with hypercholesterolemia.

Drug Class Reviews - Oregon Health & Science University.

Version: November 2009
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Levomepromazine for the treatment of nausea and vomiting in people with advanced disease

This is an update of the review published in 2013. Nausea (feeling sick) and vomiting (being sick) are common and unpleasant symptoms that are often experienced by people with advanced disease. There are several different drug therapies which are available to treat these symptoms, known as antiemetics. Levomepromazine was originally used to treat schizophrenia but is also used to control nausea and vomiting. It can be given as a tablet or as an injection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Long-term Use of Ondansetron, Dolasetron and Granisetron for the Prevention of Nausea and Vomiting: A Review of the Clinical Effectiveness and Safety [Internet]

The purpose of this review is to provide evidence on the comparative clinical effectiveness and safety of the long-term use (> 5 days) of serotonin receptor antagonists (5-HT3RAs) for the prevention of nausea and vomiting.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: April 23, 2014
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Droperidol for the treatment of nausea and vomiting (sickness) in people with advanced disease

Nausea (a feeling of sickness) and vomiting are common and distressing symptoms for people with advanced cancer and other life‐threatening illnesses. Several medications to control these symptoms are available. Droperidol is one example, which has been used to try to prevent or treat nausea and vomiting for people having surgery or chemotherapy. In our search updated in November 2013 we found no randomised studies of droperidol for the treatment of nausea or vomiting for people receiving palliative care or suffering from an incurable progressive medical condition. Several studies reported on the use of droperidol for the prevention of nausea and vomiting associated with chemotherapy. Further studies are needed to find out which medications are most suitable to treat nausea and vomiting in palliative care.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Netupitant / palonosetron (Akynzeo) for chemotherapy-related nausea and vomiting: Overview

The fixed-dose combination of the drugs netupitant and palonosetron (trade name: Akynzeo) has been approved in Germany since May 2015 for use in adults who are receiving chemotherapy for the treatment of cancer. The combination netupitant / palonosetron is used to prevent nausea and vomiting.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 10, 2016

Haloperidol for the treatment of nausea and vomiting in palliative care patients

Haloperidol is often used to help control nausea (feeling sick) or vomiting (being sick), both of which are common problems for patients with serious life‐threatening illnesses. Haloperidol can be given by mouth or by injection. There has been some research looking at how this drug works in nausea and vomiting caused by surgery and when trying to prevent nausea and vomiting caused by anti‐cancer treatments.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Wrist PC6 acupuncture point stimulation to prevent nausea and vomiting after surgery

Does a review of the evidence support the use of wrist PC6 acupuncture point stimulation (PC6 acupoint) as effective in reducing nausea and vomiting after surgery (PONV), compared to sham (dummy acupoint stimulation) or antiemetics (drugs that relieve nausea and vomiting) in people undergoing surgery? This review updates the evidence published in 2009, and is current to December 2014.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Medicines in the treatment of emergency department nausea and vomiting

We reviewed the effects of medicines in the treatment of nausea and vomiting in adults in the emergency department.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Cannabis‐based medicine for nausea and vomiting in people treated with chemotherapy for cancer

As many as three‐quarters of people who receive chemotherapy experience nausea (feeling sick) and vomiting (being sick), which many find distressing. While conventional anti‐sickness medicines are effective, they do not work for everyone, all of the time. Therapeutic drugs based on the active ingredient of cannabis, known as THC (delta‐9‐tetrahydrocannabinol), have been approved for use as anti‐sickness medicines in some countries.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Nausea and Vomiting (PDQ®): Health Professional Version

Expert-reviewed information summary about nausea and vomiting as complications of cancer or its treatment. Approaches to the management of nausea and vomiting are discussed.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: January 4, 2016

Antiemetics For Adults Experiencing Opioid-Induced Nausea: A Review of Clinical and Cost-Effectiveness, Benefits and Harms, and Guidelines [Internet]

The purpose of this report is to retrieve and review existing evidence comparing the efficacy of different antiemetics for treatment of opioid-induced nausea. This report also aims to retrieve and review the evidence regarding the clinical effectiveness, benefits and harms, cost-effectiveness and evidence-based guidelines regarding the use of dimenhydrinate and ondansetron for adult patients experiencing opioid-induced nausea.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: April 9, 2014
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Nabilone for Non-chemotherapy Associated Nausea and Weight Loss due to Medical Conditions: A Review of the Clinical Effectiveness and Guidelines [Internet]

Cannabis has been used medically for its antiemetic, sedative, and analgesic effects and for its ability to stimulate appetite. The major psychoactive ingredient of cannabis is delta-9-tetrahydrocannabinol (THC). Nabilone is a synthetic cannabinoid analog of THC and is approved for use in Canada for the treatment of severe nausea and vomiting associated with chemotherapy in adults over the age of 18 years. For its approved indication, nabilone (1 mg to 2 mg) is used short-term, administered the night before and one to three hours prior to chemotherapy and can be continued up to 24 hours following chemotherapy. A systematic review of randomized controlled trials (RCTs) found that 70% of patients undergoing chemotherapy who received cannabinoids had complete control of nausea compared to 57% of placebo patients (RR 1.21; 95% CI 1.03 to 1.42). As well, 66% of patients had complete control of vomiting with cannabinoids compared to 36% of patients treated with placebo (RR 1.84; 95% CI 1.42 to 2.38).

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: September 12, 2014
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Aspirin with or without an antiemetic for acute migraine headaches in adults

This is an updated version of the original Cochrane review published in Issue 4, 2010 (Kirthi 2010); no new studies were found. A single oral dose of 1000 mg of aspirin reduced pain from moderate or severe to none by two hours in approximately 1 in 4 people (24%) taking aspirin, compared with about 1 in 10 (11%) taking placebo. Pain was reduced from moderate or severe to no worse than mild pain by two hours in roughly 1 in 2 people (52%) taking aspirin compared with approximately 1 in 3 (32%) taking placebo. Of those who experienced effective headache relief at two hours, more had that relief sustained over 24 hours with aspirin than with placebo. Addition of 10 mg of the antiemetic metoclopramide substantially increased relief of nausea and vomiting compared with aspirin alone, but made little difference to pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

[Ondansetron: a meta-analysis on its efficacy to prevent postoperative nausea and vomiting after craniotomy in adults and children]

OBJECTIVE: To justify the use of ondansetron as a preventive treatment for postoperative nausea and vomiting (PONV) of adults and children in neurosurgery.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Acupressure for nausea and vomiting in cancer patients receiving chemotherapy

Practitioners working with patients undergoing chemotherapy regularly encourage them to use acupressure in the form of Sea Bands for the relief of treatment-related nausea and vomiting. This mini-review sets out to uncover and examine the evidence base for this recommendation. A mini systematic review was carried out to identify randomized controlled trials comparing the use of acupressure plus usual care with usual care alone. The population was adult patients receiving cancer chemotherapy. The outcome was nausea or vomiting duration or intensity. Searches on Medline, Embase, AMED, the Cochrane Library, Cancerlit and Cinahl identified two randomized controlled trials involving 482 patients with compared acupressure to no intervention control. The results suggest that acupressure may decrease nausea among patients undergoing chemotherapy but further work is required before conclusively advising patients on the efficacy of acupressure in preventing and treating chemotherapy-induced nausea.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Diarrhoea and Vomiting Caused by Gastroenteritis: Diagnosis, Assessment and Management in Children Younger than 5 Years

When young children suddenly experience the onset of diarrhoea, with or without vomiting, infective gastroenteritis is by far the most common explanation. A range of enteric viruses, bacteria and protozoal pathogens may be responsible. Viral infections account for most cases in the developed world. Gastroenteritis is very common, with many infants and young children experiencing more than one episode in a year.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: April 2009

A systematic review and meta-analysis of intravenous palonosetron in the prevention of chemotherapy-induced nausea and vomiting in adults

OBJECTIVES: We performed a systematic review and meta-analysis to compare treatment effectiveness and adverse effects in cancer patients receiving chemotherapy with palonosetron to prevent chemotherapy-induced nausea and vomiting (CINV).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Routine abdominal drainage versus no drainage for patients undergoing uncomplicated laparoscopic cholecystectomy

The liver produces bile which has many functions, including elimination of waste processed by the liver and digestion of fat. The bile is temporarily stored in the gallbladder (an organ situated underneath the liver) before it reaches the small bowel. Concretions in the gallbladder are called gallstones. Gallstones are present in about 5% to 25% of the adult western population. Between 2% and 4% become symptomatic in a year. The symptoms include pain related to the gallbladder (biliary colic), inflammation of the gallbladder (cholecystitis), obstruction to the flow of bile from the liver and gallbladder into the small bowel resulting in jaundice (yellowish discolourisation of the body usually most prominently noticed in the white of the eye, which turns yellow), bile infection (cholangitis), and inflammation of the pancreas, an organ which secretes digestive juices and harbours the insulin secreting cells which maintain blood sugar level (pancreatitis). Removal of the gallbladder (cholecystectomy) is currently considered the best treatment option for patients with symptomatic gallstones. This is generally performed by key‐hole surgery (laparoscopic cholecystectomy). Drain is a tube that is left inside the tummy to allow drainage of fluids to outside the tummy. Some surgeons have routinely drained after laparoscopic cholecystectomy because of the fear of collection of bile or blood requiring re‐operation. As the name indicates, the drain may drain out these collections to the exterior, thereby avoiding open surgery. However, routine use of drains may necessitate the patient to stay overnight or require drain removal after discharge both of which increase resource utilisation in this era of day surgery (where patients are admitted and discharged on the same day of surgery). The review authors set out to determine whether it is preferable to use routine drainage after laparoscopic cholecystectomy. A systematic search of medical literature was performed in order to identify studies which provided information on the above question. The authors obtained information from randomised trials only since such types of trials provide the best information if conducted well. Two authors independently identified the trials and collected the information.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Effect of intraoperative high inspired oxygen fraction on surgical site infection, postoperative nausea and vomiting, and pulmonary function: systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Intraoperative high inspired oxygen fraction (FIO2) is thought to reduce the incidence of surgical site infection (SSI) and postoperative nausea and vomiting, and to promote postoperative atelectasis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Screening for Depression in Adults and Older Adults in Primary Care: An Updated Systematic Review [Internet]

Depression causes significant suffering and is commonly seen in primary care. Because primary care providers sometimes fail to identify patients as depressed, systematic screening programs in primary care may be of use in improving outcomes in depressed patients. Depression screening is predicated on the notion that identification will allow effective treatments to be delivered and that the benefits of treatment will outweigh the harms. Treatment efficacy of antidepressants and psychotherapy in general adult populations was established in a previous United States Preventive Services Task Force (USPSFT) review on depression screening, but treatment in older adults was not examined specifically. Additionally, harms of screening and treatment were not previously examined in detail.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: December 2009
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