14 de julho de 2019

What I learned by reading “Antiemetics in Acute Gastroenteritis in Children and Adolescents”.

Filed under: Saúde e bem-estar — Tags:, — Yure @ 14:32

“Antiemetics in Acute Gastroenteritis in Children and Adolescents” was written by Bruno Sanches, João Franco, Paulo Calhau and Ricardo M. Fernandes. Below, what I learned by reading this text.

  1. In developed countries, acute gastroenteritis is not a big problem, since it is treatable.
  2. This disease, however, causes vomiting, which prevents oral rehydration.
  3. There is no consensus on the use of antiemetics in the treatment of this problem because the side effects can make them not worth using.
  4. For example, if you use one of these older drugs, such as metoclopramide, you may have an extrapyramidal reaction, which is very unpleasant.
  5. If it is necessary that the patient stops vomiting so that he can rehydrate, a serotonin receptor antagonist is safer.
  6. If the patient can rehydrate orally, the need to take intravenous rehydration is lower.
  7. A meta-analysis done with seven studies examined data from 1020 subjects between five and twelve years who entered the emergency system with acute gastroenteritis.
  8. Of the studies analyzed, four compared the efficacy of a serotonin receptor antagonist with a placebo.
  9. Two other studies compared this serotonin receptor antagonist with metoclopramide, placebo, and dexamethasone.
  10. The last one compared a placebo and a dose of dimenhydrin.
  11. The group of those who took serotonin receptor antagonists had fewer subjects who ended up hospitalized, but some had to return to the doctor within three days.
  12. However, this group required less intravenous rehydration.
  13. Also in this group, most of them stopped vomiting within three days.
  14. Eight hours after taking the drug, the subject could drink water without vomiting, but he would need a new dose the next day.
  15. Those who took the medicine vomited less often than those who did not.
  16. However, it was observed that the subjects who took it also had diarrhea.
  17. For those taking dimenhydrin, the side effect observed was sedation (which occurred with a frequency of 21%).
  18. To summarize, taking a serotonin receptor antagonist may help stop vomiting, allowing the subject to rehydrate at home, but this does not guarantee that he will not have to return to the hospital later on.
  19. As the reviewed studies had high risks of bias and some important data was missing, the meta-analysis is not conclusive.
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