Antiemetic activity of ondansetron in acute gastroenteritis.
BACKGROUND
The mechanism of nausea and vomiting associated with gastroenteritis is unknown. The role of 5-HT3 receptors in emesis associated with gastroenteritis was investigated in paediatric patients.


METHODS
A randomized, double-blind, placebo-controlled, parallel-group study was conducted in three groups of 12 patients each, receiving either a single i.v. dose of ondansetron (0.3 mg/kg), metoclopramide (0.3 mg/kg) or placebo (sterile saline). Food was restricted and oral rehydration was administered for 4 h.


RESULTS
During 0-24 h, the number of emetic episodes experienced was significantly greater (P = 0.048) with placebo (mean = 5) than ondansetron (mean = 2) and the proportion of patients experiencing no emesis was significantly greater (P = 0.039) with ondansetron (58%) than placebo (17%). A numerical difference, in favour of ondansetron, was observed between ondansetron and metoclopramide groups for both of the above parameters. Fewer treatment failures were observed with ondansetron (17%) than placebo (33%) and metoclopramide (42 %). More diarrheal episodes were observed in the groups receiving anti-emetic treatment. All three treatments were well tolerated.


CONCLUSIONS
Ondansetron, a 5HT3 receptor antagonist, was significantly superior to placebo in preventing emesis associated with acute gastroenteritis, in paediatric patients. Therefore, serotonin, acting through 5HT3 receptors, may play a role in this form of emesis.
Cubeddu
L X
LX
Department of Pharmacology, School of Pharmacy, Central University of Venezuela, Caracas.
Trujillo
L M
LM
Talmaciu
I
I
Gonzalez
V
V
Guariguata
J
J
Seijas
J
J
Miller
I A
IA
Paska
W
W
D000208:Acute Disease; D000932:Antiemetics / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000139:chemically induced; D005260:Female; D005440:Fluid Therapy; D005759:Gastroenteritis / Q000150:complications / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008787:Metoclopramide / Q000009:adverse effects / Q000627:therapeutic use; D017294:Ondansetron / Q000009:adverse effects / Q000627:therapeutic use*; D014839:Vomiting / Q000188:drug therapy* / Q000209:etiology
D000932:Antiemetics; D017294:Ondansetron; D008787:Metoclopramide