Ondansetron

Ondansetron(GR38032) is a serotonin 5-HT3 receptor antagonist used mainly as anantiemetic (to treat nausea and vomiting), often following chemotherapy.

Efficacy of ondansetron for the prevention of propofol injection pain: a meta-analysis.[Pubmed:28260943]

J Pain Res. 2017 Feb 21;10:445-450.

AIM: This review was performed to investigate the effect of Ondansetron on the prevention of propofol injection pain. METHODS: PubMed, Cochrane Library, and China National Knowledge Infrastructure (CNKI) were searched for randomized controlled trials (RCTs) of Ondansetron in preventing the pain on injection of propofol. Then, RevMan 5.2 was adopted to conduct a meta-analysis on propofol injection pain. RESULTS: Ten RCTs, totaling 782 patients, were included in this analysis. The meta-analysis showed that: 1) compared with the control group, the Ondansetron group was related to a decreasing incidence of propofol injection pain, and it was statistically significant (risk ratio [RR] = 0.41, 95% confidence interval [CI, 0.34, 0.49], P < 0.00001); 2) compared with the incidence of propofol injection pain in the lidocaine group, there was no difference and no statistical significance (RR = 1.28, 95% CI [0.85, 1.93], P = 0.25); 3) no statistically significant differences were found between the Ondansetron and magnesium sulfate groups in the incidence of propofol injection pain (RR = 1.20, 95% CI [0.87, 1.66], P = 0.27); and 4) the incidence of Ondansetron group igniting moderate pain (RR = 0.37, 95% CI [0.26, 0.52], P < 0.00001) and severe pain (RR = 0.27, 95% CI [0.17, 0.43] P < 0.00001) was less likely to occur during the injection of propofol compared with the control group, but there was no difference between the Ondansetron and control groups in the incidence of mild propofol injection pain (RR = 0.83, 95% CI [0.63, 1.10], P = 0.20). CONCLUSION: Ondansetron can effectively prevent propofol injection pain, and the effect is similar to that of magnesium sulfate and lidocaine.

Efficacy of Risperidone Augmentation with Ondansetron in the Treatment of Negative and Depressive Symptoms in Schizophrenia: A Randomized Clinical Trial.[Pubmed:28293046]

Iran J Med Sci. 2017 Jan;42(1):14-23.

BACKGROUND: Given the potential role of the 5-hydroxytryptamine-3 receptor in the pathogenesis of schizophrenia, this study was performed to determine whether Ondansetron plus risperidone could reduce the negative and depressive symptoms in patients with treatment-resistant schizophrenia. METHODS: In a double-blinded, placebo-controlled, randomized trial (IRCT registration # 201112125280N7), in 2012-2013 in Mashhad, Iran, 38 patients with treatment-resistant schizophrenia received risperidone either combined with a fixed dose (4-8 mg/d) of Ondansetron (n=18) or with a placebo (n=20) for 12 weeks. The patients were evaluated using the Positive and Negative Syndrome Scale (PANSS), Wechsler's Adult Intelligence Scale-Revised (WAIS-R), and Hamilton's Rating Scale for Depression (HRSD) at baseline and 12 weeks later. Changes in the inventories were used to evaluate the efficacy of the treatment. The t test, Chi-square test, and SPSS (version 16) were used to analyze the data. The statistical significance was set atP<0.05. RESULTS: Ondansetron plus risperidone was associated with a significantly larger improvement in the PANSS overall scale and subscales for negative symptoms and cognition than was risperidone plus placebo (P<0.001). The WAIS-R scale results indicated significant differences between the 2 groups before and after administrating the medicine and the placebo. The administration of Ondansetron significantly improved visual memory based on the subtests of the WAIS (P<0.05). Ondansetron had no positive effects on depressive symptoms (effect size=0.13). CONCLUSION: This study confirmed that Ondansetron, as an adjunct treatment, reduces negative symptoms in patients with schizophrenia and can be used as a potential adjunctive strategy particularly for negative symptoms and cognitive impairments. Trial Registration Number: IRCT201112125280N7.

A Comparative Evaluation of Ramosetron with Ondansetron for the Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Urological Procedures.[Pubmed:28298761]

Anesth Essays Res. 2017 Jan-Mar;11(1):78-83.

BACKGROUND: Postoperative nausea and vomiting (PONV) is a common problem causing distress to patients in the postoperative period. Younger age, gynecological surgeries, laparoscopic surgeries, female gender, volatile anesthetics, increased duration of anesthesia, and postoperative opioid use are associated with increased incidence of PONV. AIM: The present study was conducted to study the efficacy of ramosetron and its comparison with Ondansetron in the prevention of PONV in patients undergoing pyelolithotomy, pyeloplasty, and upper ureterolithotomy. METHODS: One hundred patients with physical status American Society of Anesthesiologists I and II, aged 20-60 years were enrolled in the study. Patients were randomly distributed to receive either injection ramosetron 0.3 mg intravenously (IV) or injection Ondansetron 6 mg IV just before extubation. RESULTS: There was no significant difference between the groups in age, gender, weight, duration of anesthesia, and duration of surgery. In the patients, who received ramosetron, it was observed that incidence of the episodes of nausea and vomiting increased with time after surgery. Each patient had an episode of nausea and an episode of vomiting during the 6-12 h interval. Similarly, two patients had episodes of nausea and two patients had episodes of vomiting at 18-24 h. This necessitated the increased need for rescue antiemetics with a total of four patients needing rescue antiemetics at 18-24 h. In patients receiving Ondansetron, the episodes of nausea were more in number when compared with the ramosetron group. Twelve patients complained of nausea and thirteen patients had episodes of vomiting with the needfor rescue antiemetic in 14 patients. Both genders had a comparable incidence of nausea and vomiting. CONCLUSION: A single dose of IV ramosetron (0.3 mg) is more effective when compared with a single dose IV Ondansetron (6 mg) in the prevention of PONV. We observed that the benefit was more in the later stages of the postoperative period (12-24 h).

The Effect of Ondansetron and Dexamethasone on Nausea and Vomiting under Spinal Anesthesia.[Pubmed:28289619]

World J Plast Surg. 2017 Jan;6(1):88-93.

BACKGROUND: During abdominal surgery under regional anesthesia, nausea may happen due to several contributing factors. This study compared the effects of Ondansetron and dexamethasone on nausea and vomiting under spinal anesthesia. METHODS: One hundred and twenty patients of 15 to 35 years old with ASA class I and II were enrolled. Before administering either Ondansetron or dexamethasone, blood pressure and heart rate of the patients were recorded. The patients received 70 mg of 5% lidocaine for spinal anesthesia. Patients who received 6 mg of Ondansetron were considered as group A, while group B received 8 mg of dexamethasone. The level of nausea and vomiting, blood pressure, heart rate and respiratory rate of each patient was measured at 1, 5, 10, 15 and 30 minutes after spinal anesthesia and during recovery (every 5 minutes). RESULTS: There was a significant difference between nausea and vomiting between the two groups after spinal anesthesia within the first and fifth minutes. There was no significant difference between nausea and vomiting between the two groups within 10, 15 and 30 minutes and during recovery at 5, 10, 15 and 30 minutes. CONCLUSION: Dexamethasone and Ondansetron were shown to equally reduce the incidence of nausea and vomiting under spinal anesthesia and can be recommended as a good choice for prevention of nausea and vomiting during surgeries.

Ondansetron(GR 38032; SN 307) is a serotonin 5-HT3 receptor antagonist used mainly as anantiemetic (to treat nausea and vomiting), often following chemotherapy.

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