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Showing papers on "Granisetron published in 1990"


Journal ArticleDOI
TL;DR: The results show that the 5‐HT3 receptor antagonists used exerted different effects on the reflex responses to duodenal distension, but reduced the responses to distension with a bell‐shaped dose‐response relationship.
Abstract: 1. Distension of the duodenum in anaesthetized rats, by rapid application of intraluminal pressures (10-75 cmH2O), evoked falls in diastolic blood pressure and intragastric pressure. 2. The distension-induced responses were blocked by pretreatment with morphine (20 mg kg-1, s.c.), an action reversible by injection of naloxone (5 mg kg-1, i.v.). 3. Bilateral cervical vagotomy reduced the distension-evoked fall in intragastric pressure but had no effect on the corresponding fall in blood pressure. 4. Granisetron or ICS 205-930 (1-1000 micrograms kg-1, i.v.) had no effects on duodenal intraluminal pressure, but reduced the responses to distension with a bell-shaped dose-response relationship. Ondansetron (1-1000 micrograms kg-1, i.v.) did not reduce the reflex responses. 5. These results show that the 5-HT3 receptor antagonists used exerted different effects on the reflex responses to duodenal distension.

91 citations


Journal ArticleDOI
TL;DR: Autoradiography results provide strong circumstantial evidence that 5-hydroxytryptamine3 receptors are located on vagal afferent terminals in the ferret brainstem.

79 citations


Journal Article
TL;DR: Granisetron is a novel specific 5-HT3 receptor antagonist whose effects have been evaluated in an extensive programme of volunteer studies and exhibited essentially linear kinetics over the dose range studied (30-300 micrograms/kg).

76 citations





Journal ArticleDOI
TL;DR: A phase I/II trial of the 5-HT3 antagonist granisetron in 24 chemotherapy-naïve patients who were receiving any combination of doxorubicin and/or cisplatin shows promise as a well-tolerated and effective antiemetic.
Abstract: A new class of antiemetic agents, the 5-hydroxytryptamine (5-HT3) antagonists, have been shown to possess potent antiemetic properties in the ferret model. We conducted a phase I/II trial of the 5-HT3 antagonist BRL43694 (granisetron) in 24 chemotherapy-naive patients who were receiving any combination of doxorubicin and/or cisplatin. The first 12 patients received 40 micrograms/kg and the second 12 received 80 micrograms/kg of granisetron intravenously before beginning chemotherapy. Nausea was assessed by a patient-completed visual analogue scale and episodes of retching recorded by the patient and an independent observer. Fifty-two percent of the 22 evaluable patients had no retching or vomiting and 32% had no nausea during the first 24 hours after chemotherapy. Pharmacokinetic measurements were performed. The disposition of granisetron was best described using a two-compartment model. The area under the plasma concentration curve (AUC) was 277 +/- 226 ng.h/mL and 359 +/- 282 ng.h/mL at 40 and 80 microg...

56 citations


Journal Article
TL;DR: As a single intervention agent, granisetron achieved control or improvement of existing symptoms in the remaining members of the placebo group.

54 citations


Journal Article
TL;DR: There was no relationship between the total dose and the number and severity of specific adverse events, and no differences in efficacy or safety between the two doses of granisetron were established.

50 citations


Journal Article
TL;DR: It was concluded that granisetron is a selective and potent anti-emetic worthy of clinical investigation.

43 citations



Journal Article
TL;DR: Early trials show granisetron to be a very effective anti-emetic and suggest useful advantages over the regimens currently considered to be standard therapy for prophylaxis and treatment of cytostatic drug-induced emesis.

Journal Article
TL;DR: Granisetron was well tolerated throughout the dose range of the study (40-240 micrograms/kg) and the commonest adverse event was headache, seen in 13-16% of patients.

Journal Article
TL;DR: The efficacy and safety of granisetron, a novel anti-emetic, were compared with those of high-dose metoclopramide plus dexamethasone in 234 patients undergoing treatment with high- doses of cisplatin.

Journal Article
TL;DR: Dose-finding studies have confirmed the wide therapeutic margin with four-fold increases in dose producing comparable results and granisetron produces a greater degree of control than the anti-emetic combinations of metoclopramide/dexamethasone or dexamethAsone/chlorpromazine.

Journal Article
TL;DR: The data suggest that the emetic response to p.o. zacopride is mediated in part by 5-hydroxytryptamine receptors residing on either enteric neurons or vagal afferents, however, the underlying pharmacology of the response may also include activation of cholinergic and dopaminergic pathways.
Abstract: Three antiemetic compounds (zacopride, batanopride, granisetron [BRL43694]) were evaluated for the production of gastrointestinal side effects in the conscious ferret after i.v. or p.o. administration. Zacopride evoked multiple emetic and defecatory responses at clinically relevant doses (0.003-0.3 mg/kg) and in a dose-dependent manner. The oral route was the more potent one for eliciting emesis (ED50 0.033 mg/kg). At 0.3 mg/kg p.o., zacopride reliably evoked an 80 to 100% incidence of emesis and a 40 to 80% incidence of defecation. In contrast, batanopride and BRL43694 i.v. evoked a small (10%) incidence of these side effects, but only at 0.1 to 10 mg/kg doses. When given p.o. (0.00003-10 mg/kg), these latter compounds never evoked emesis and significantly reduced (P less than .05) the incidence of defecation below that of vehicle. Responses to zacopride (0.3 mg/kg p.o.) were challenged by i.p. pretreatment with the 5-hydroxytryptamine receptor agonist 2-methyl serotonin, the 5-hydroxytryptamine receptor antagonist BRL43694, the quaternary atropine derivative glycopyrrolate, the dopamine receptor antagonist domperidone or selective abdominal vagotomies. All compounds and either bilateral or dorsal vagotomy significantly reduced the incidence of emesis, but did not abolish it. Latency to first emesis was delayed by BRL43694, domperidone or dorsal vagotomy. The data suggest that the emetic response to p.o. zacopride is mediated in part by 5-hydroxytryptamine receptors residing on either enteric neurons or vagal afferents. However, the underlying pharmacology of the response may also include activation of cholinergic and dopaminergic pathways.

Journal ArticleDOI
TL;DR: The results suggest that the anti-emetic effect of 5-HT3 receptor antagonists in cisplatin-induced vomiting is mediated peripherally rather than centrally, and does not act centrally on either the brainstem neuronal network known as the "vomiting center" or related neuronal structures.
Abstract: Cancer therapy with cytotoxic drugs such as cisplatin or cyclophosphamide is usually associated with violent crisis of vomiting. Recently, it was shown that 5-HT 3 receptor antagonists block cisplatin-induced vomiting but the mechanisms and their sites of action remain unknown. We tested the hypothesis that these agents act on structures within the central nervous system by evaluating the effectiveness of vagal stimulation in eliciting fictive vomiting in decerebrate, paralyzed and ventilated cats before and after administration of such agents. Fictive vomiting was defined as a series of large bursts of synchronous activity in the phrenic and abdominal (expiratory) nerves (retching) followed by a burst in which the abdominal activity was prolonged (expulsion). The latency and number of these co-activations were measured before and after intravenous administration of three 5-HT 3 receptor antagonists (GR 38032F (Ondansetron), Zacopride, and BRL 43694A (Granisetron)). All compounds, administered at doses of 1 and 2 mg/kg failed to block vomiting behaviour in 100% and 68% of trials, respectively. Nor did their administration affect the latency and number of co-activations. We conclude that intravenous administration of 5-HT 3 receptor antagonists do not act centrally on either the brainstem neuronal network known as the “vomiting center” or related neuronal structures. Our results suggest that the anti-emetic effect of 5-HT 3 receptor antagonists in cisplatin-induced vomiting is mediated peripherally rather than centrally.

Journal Article
TL;DR: Patients with cancer were randomized in single-blind fashion to receive either granisetron or a conventional anti-emetic combination of chlorpromazine and dexamethasone as prophylactic agents against the nausea and vomiting induced by a number of designated cytostatic drugs.

Journal ArticleDOI
TL;DR: The idea that emesis could be controlled by 5-HTs receptor antagonists was seen as an exciting step towards identifying an effective antiemetic which does not cause the extrapyramidal side-effects seen with metoclopramide.

Journal ArticleDOI
TL;DR: In healthy volunteers granisetron was well tolerated, with constipation as the only consistent complaint, and there was a prolonged pharmacodynamic effect as measured by the degree of the inhibition of the axon-reflex flare.

Journal ArticleDOI
TL;DR: A single dose of intravenous granisetron protected the majority of patients from nausea and vomiting, and was more effective than 40 μg/kg with no more side effects.
Abstract: Fifty six patients, with histologically confirmed cancer, who received highly emetogenic chemotherapy, were entered on a randomized double blind, low versus high dose, study of granisetron, a 5HT3 receptor antagonist. A single dose of intravenous granisetron protected the majority of patients from nausea and vomiting, 160 μg/kg was more effective than 40 μg/kg with no more side effects. Additional doses of granisetron conferred added benefit to patients who experienced breakthrough symptoms. Granisetron at a dose range of 40–240 μg/kg over a 24 hour period was well tolerated with the only side effect being mild headache.

Journal ArticleDOI
TL;DR: The common side effect of chemotherapy, nausea and vomiting, often results in what is known as “anticipatory vomiting” before further courses of treatment or in some patients refusing to submit to further therapy, even though it is potentially curative.


Journal ArticleDOI
TL;DR: The efficacy of oral follow-up doses of granisetron in prolonging the blockade of 5-HT3 receptor is being defined, and the benefit of the addition of dexamethasone to granisetic prophylactic dose on the first day of treatment is also being explored.