Presentation
We relate a patient who presents with hypokalemia of unknown etiology, with evidence suggesting a possible relationship to ondansetron. We also present a proposed mechanism for this phenomenon. [ncbi.nlm.nih.gov]
Entire Body System
- Shivering
RESULTS: Treatment with ondansetron was associated with decreased odds of postanesthesia shivering symptoms compared to the control group. There was also a significant decrease in shivering score with time after anesthesia. [ncbi.nlm.nih.gov]
Postanaesthic shivering. Epidemiology, pathophysiology and approaches to prevention and management. Drugs. 2001 ; 61(15): 2193 – 2205. Google Scholar | Medline | ISI 2. Alfonsi, P. Postanaesthic shivering. [doi.org]
One way for a drug to reduce shivering would be to lower the shivering threshold, so that the lower temperatures seen during recovery from anesthesia would no longer trigger shivering. [nature.com]
- Intravenous Administration
RESULTS: 49 studies are included with a total of 53 drugs. 15 drugs were found compatible administered with ondansetron in a clinical routine concentration range in intravenous administration. [ncbi.nlm.nih.gov]
administration Drug: Ondansetron 4 mg intravenous dose administered over 2 minutes through a peripheral intravenous catheter Active Comparator: Metoclopramide Metoclopramide 10 mg intravenous administration Drug: Metoclopramide 10 mg intravenous dose [clinicaltrials.gov]
- Underweight
[…] included psychiatric and neurological conditions (anxiety, depression, migraine, or other headache) and other chronic conditions (diabetes, hypertension, renal disease, Crohn disease, irritable bowel syndrome, ulcerative colitis, overweight or obesity, underweight [jamanetwork.com]
Gastrointestinal
- Abdominal Pain
Abdominal pain score is measured using the patient diaries daily from baseline and week 12 2. [isrctn.com]
Patient 1 was a 53-year-old man with severe abdominal pain who received ondansetron before laboratory results were available. [academic.oup.com]
[…] reports) GI: constipation, diarrhea, abdominal pain, dry mouth GU: urinary retention Respiratory: bronchospasm Skin: rash Other: pain at injection site, shivering, anaphylaxis Interactions Drug-drug. [medical-dictionary.thefreedictionary.com]
Ref ] Very common (10% or more): Diarrhea (up to 16%), constipation (up to 11%) Common (1% to 10%): Xerostomia, nausea, vomiting, localized anal/rectal burning sensation Uncommon (0.1% to 1%): Throat disorder Frequency not reported : Gastric symptoms, abdominal [drugs.com]
Other less frequent side effects included headache (2 ondansetron, 2 placebo), rectal bleeding (2 ondansetron, 2 placebo, none of which were found to be due to ischaemic colitis), backache (1 ondansetron, 1 placebo) and abdominal pain (2 ondansetron, [gut.bmj.com]
- Dyspepsia
The comparative study of the effectiveness of cimetidine, ranitidine, famotidine, and omeprazole in treatment of children with dyspepsia. ISRN Pediatr. 2011;2011:219287. 20. [paediatricaindonesiana.org]
It should be noted that dyspepsia is a common comorbidity with IBS and earlier studies suggest benefit to heartburn and postprandial pain. 9 Therefore some of the global benefit may have been from improvement in dyspepsia, though we did not assess this [gut.bmj.com]
Functional dyspepsia score is measured using the short-form Leeds dyspepsia questionnaire (SF-LDQ) at baseline and week 12 1.6. IBS severity is measured using the IBS Symptom Severity Scale (IBS-SSS) questionnaire at baseline and week 12 1.7. [isrctn.com]
- Abdominal Distension
[…] pain; abdominal distension or rebound tenderness." [bmcpediatr.biomedcentral.com]
Cardiovascular
- Heart Disease
which can result in a potentially fatal abnormal heart rhythm, specifically, torsades de pointes. [openanesthesia.org]
You are more at risk for this type of abnormal heart rhythm and its complications if you: are female are older than 65 years of age have a family history of sudden cardiac death have a history of heart disease or abnormal heart rhythms have a slow heart [chealth.canoe.com]
Liver, Gall & Pancreas
- Jaundice
Call your doctor at once if you have: severe constipation, stomach pain, or bloating; headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats; fast or pounding heartbeats; jaundice (yellowing of the skin or eyes); blurred [uofmhealth.org]
Call your doctor at once if you have: severe constipation, stomach pain, or bloating ; headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats; fast or pounding heartbeats; jaundice (yellowing of the skin or eyes); blurred [emedicinehealth.com]
Skin
- Skin Rash
Fernando and Broadfoot [17] and Pretti Goyal et al. [5] reported a reaction that consisted of marked hypotension without skin rash or bronchospasm, as was the case in our 3 patients. [oatext.com]
rash, hives, or itching sweating total body jerking unusual tiredness or weakness Incidence not known Agitation blistering, peeling, or loosening of the skin blurred vision chills diarrhea dizziness, faintness, or lightheadedness when getting up suddenly [mayoclinic.org]
rash, skin lumps or hives These are all serious side effects. [nps.org.au]
rash Other: pain at injection site, shivering, anaphylaxis Interactions Drug-drug. [medical-dictionary.thefreedictionary.com]
[…] which may cause difficulty in swallowing or breathing; Skin rash, skin lumps or hives. [myvmc.com]
Eyes
- Blurred Vision
Transient visual disturbances, blurred vision, and transient blindness occurred predominantly during rapid IV administration. Many of the cases of blindness resolved from within a few minutes to approximately 28 hours. [drugs.com]
Talk to your doctor about using ondansetron safely.This drug may make you dizzy or drowsy or cause blurred vision. [medicinenet.com]
If experienced, patients should consult their doctors immediately: blurred vision or vision loss rash hives itching swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs hoarseness difficulty breathing or swallowing shortness [livescience.com]
[…] puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue seizures skin rash, hives, or itching sweating total body jerking unusual tiredness or weakness Incidence not known Agitation blistering, peeling, or loosening of the skin blurred [mayoclinic.org]
If you experience any of the following symptoms, call your doctor immediately or seek emergency medical treatment: blurred vision or vision loss rash hives itching swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs hoarseness [nlm.nih.gov]
- Transient Blindness
Adverse Reactions: Diarrhea, headache, fever, constipation, fatigue, transient blindness; serotonin syndrome (discontinue if occurs); rare: angina, bronchospasm, anaphylaxis, seizures, ECG changes (including QT prolongation). [empr.com]
Cases of transient blindness, predominantly during intravenous administration, have been reported. Use in pregnancy. FDA Category B. Not likely to cause harm when used as short-term therapy (See Introduction in Section III). [accessmedicine.mhmedical.com]
Transient visual disturbances, blurred vision, and transient blindness occurred predominantly during rapid IV administration. Many of the cases of blindness resolved from within a few minutes to approximately 28 hours. [drugs.com]
Neurologic
- Insomnia
Ondansetron for opiate withdrawal may also help with insomnia since drowsiness is a major side effect. While ondansetron for opiate withdrawal can be helpful, it’s not a cure-all for addiction. [therecoveryvillage.com]
SelfHacked Elimination Diet course – a video course that will help you figure out which diet works best for you Selfhacked Inflammation course – a video course on inflammation and how to bring it down Biohacking insomnia – an ebook on how to get great [selfhacked.com]
Workup
Undergone standardised workup to exclude the following alternative diagnoses 5.1. Microscopic colitis (colonoscopy or flexible sigmoidoscopy) 5.2. [isrctn.com]
Treatment
[…] over repeated cycles of treatment with cisplatin. [pharmaceutical-journal.com]
CONCLUSIONS: A single dose of ondansetron is superior to bromopride and metoclopramide in preventing vomiting six hours and 24h following treatment. [ncbi.nlm.nih.gov]
This study will consist of at least 6 weeks of retrospectively documented SRI treatment (prior to screening), 6 weeks of prospective SRI treatment after screening (run-in) but prior to randomization, and 12 weeks of double-blind treatment with study drug [clinicaltrials.gov]
Prognosis
OUTCOME AND PROGNOSIS Short-term outcomes Nausea and vomiting of pregnancy — Although the maternal course can be long and tedious [ 96 ], nausea and vomiting is typically not associated with adverse pregnancy outcomes. [web.archive.org]
Etiology
We relate a patient who presents with hypokalemia of unknown etiology, with evidence suggesting a possible relationship to ondansetron. We also present a proposed mechanism for this phenomenon. [ncbi.nlm.nih.gov]
In a negative control analysis, we assessed the risk of malformations in women who filled their first ondansetron prescription in gestational months 5 to 8, which is after the etiologically relevant window. [jamanetwork.com]
Epidemiology
Epidemiology, pathophysiology and approaches to prevention and management. Drugs. 2001 ; 61(15): 2193 – 2205. Google Scholar | Medline | ISI 2. Alfonsi, P. Postanaesthic shivering. [doi.org]
Coding of drug information in the National Birth Defects Prevention Study used the Slone Drug Dictionary under license from the Slone Epidemiology Center of Boston University. Financial Disclosure Dr. [journals.lww.com]
A study from the Slone Epidemiology Center at Boston University, in collaboration with the Centers for Disease Control and Prevention (CDC), found that taking ondansetron during early pregnancy did not appear to increase the chance of having a baby with [cdc.gov]
Author information 1 Department of Epidemiology, Graduate School of Public Health, the Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, Magee Womens Hospital of the University of Pittsburgh Medical Center, the Department [ncbi.nlm.nih.gov]
Pathophysiology
Epidemiology, pathophysiology and approaches to prevention and management. Drugs. 2001 ; 61(15): 2193 – 2205. Google Scholar | Medline | ISI 2. Alfonsi, P. Postanaesthic shivering. [doi.org]
To present a case of asystole during spinal anesthesia that responded to atropine and ondansetron and to discuss the possible pathophysiology with special emphasis on the Bezold-Jarisch reflex and the role of 5-HT3 receptors in mediating bradycardia and [ncbi.nlm.nih.gov]
Postanaesthetic shivering: epidemiology, pathophysiology, and approaches to prevention and management. Drugs 2001; 61 :2193–205. 3. Marashi SM, Soltani-Omid S, Soltani Mohammadi S, Aghajani Y, Movafegh A. [nature.com]
Prevention
However, palonosetron was more efficacious than ondansetron in the prevention of vomiting after laparoscopic surgery. [ncbi.nlm.nih.gov]
The group concluded from this study that ondansetron 8mg and granisetron 3mg combined with dexamethasone in this schedule showed similar efficacy and tolerability in the prevention of cisplatin-induced emesis. 4 The use of oral dexamethasone for the prevention [pharmaceutical-journal.com]