Bromopride, metoclopramide, or ondansetron for the treatment of vomiting in the pediatric emergency department: a randomized controlled trial
Objective: To compare the effectiveness of a single intramuscular dose of bromopride, metoclopramide, or ondansetron for treating vomiting. Methods: Randomized controlled trial including children 1–12 years of age presenting with acute vomiting at the pediatric emergency department. Outcomes: number...
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| Format: | Article |
| Language: | Portuguese |
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Brazilian Society of Pediatrics
2018-01-01
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| Series: | Jornal de Pediatria (Versão em Português) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2255553617300915 |
| _version_ | 1797984410499284992 |
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| author | Matias Epifanio Janete de L. Portela Jefferson P. Piva Cristina H. Targa Ferreira Edgar E. Sarria Rita Mattiello |
| author_facet | Matias Epifanio Janete de L. Portela Jefferson P. Piva Cristina H. Targa Ferreira Edgar E. Sarria Rita Mattiello |
| author_sort | Matias Epifanio |
| collection | DOAJ |
| description | Objective: To compare the effectiveness of a single intramuscular dose of bromopride, metoclopramide, or ondansetron for treating vomiting.
Methods: Randomized controlled trial including children 1–12 years of age presenting with acute vomiting at the pediatric emergency department. Outcomes: number of children that stopped vomiting at one, six, and 24 h following treatment; episodes of diarrhea; acceptance of oral liquids; intravenous rehydration; return to hospital and side effects.
Results: There were 175 children who completed the study. Within the first hour after treatment, all drugs were equally effective, with ondansetron preventing vomiting in 100%, bromopride in 96.6%, and metoclopramide in 94.8% of children (p = 0.288). Within six hours, ondansetron was successful in preventing vomiting in 98.3% of children, compared to bromopride and metoclopramide, which were successful in 91.5% and 84.4% of patients, respectively (p = 0.023). Within 24 h, ondansetron was superior to both other agents, as it remained efficacious in reducing vomiting in 96.6% of children, as opposed to 67.8% and 67.2% with bromopride and metoclopramide, respectively (p = 0.001). The ondansetron group showed better acceptance of oral liquids (p = 0.05) when compared to the bromopride and metoclopramide. The ondansetron group did not show any side effects in 75.9% of cases, compared to 54.2% and 53.5% in the bromopride and metoclopramide groups, respectively. Somnolence was the most common side effect.
Conclusions: A single dose of ondansetron is superior to bromopride and metoclopramide in preventing vomiting six hours and 24 h following treatment. Oral fluid intake after receiving medication was statistically better with Ondansetronwhile also having less side effects compared to the other two agents. |
| first_indexed | 2024-04-11T07:01:07Z |
| format | Article |
| id | doaj.art-66f2b65e2f364466ac202692f65d70e0 |
| institution | Directory Open Access Journal |
| issn | 2255-5536 |
| language | Portuguese |
| last_indexed | 2024-04-11T07:01:07Z |
| publishDate | 2018-01-01 |
| publisher | Brazilian Society of Pediatrics |
| record_format | Article |
| series | Jornal de Pediatria (Versão em Português) |
| spelling | doaj.art-66f2b65e2f364466ac202692f65d70e02022-12-22T04:38:39ZporBrazilian Society of PediatricsJornal de Pediatria (Versão em Português)2255-55362018-01-01941626810.1016/j.jpedp.2017.08.009Bromopride, metoclopramide, or ondansetron for the treatment of vomiting in the pediatric emergency department: a randomized controlled trialMatias Epifanio0Janete de L. Portela1Jefferson P. Piva2Cristina H. Targa Ferreira3Edgar E. Sarria4Rita Mattiello5Pontifícia Universidade Católica do Rio Grande do Sul (PUC‐RS), Escola de Medicina, Porto Alegre, RS, BrasilUniversidade Federal de Santa Maria (UFSM), Hospital Universitário de Santa Maria, Santa Maria, RS, BrasilUniversidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Porto Alegre, RS, BrasilUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, BrasilUniversidade de Santa Cruz (Unisc), Faculdade de Medicina, Departamento de Biologia e Farmácia, Santa Cruz do Sul, RS, BrasilPontifícia Universidade Católica do Rio Grande do Sul (PUC‐RS), Escola de Medicina, Porto Alegre, RS, BrasilObjective: To compare the effectiveness of a single intramuscular dose of bromopride, metoclopramide, or ondansetron for treating vomiting. Methods: Randomized controlled trial including children 1–12 years of age presenting with acute vomiting at the pediatric emergency department. Outcomes: number of children that stopped vomiting at one, six, and 24 h following treatment; episodes of diarrhea; acceptance of oral liquids; intravenous rehydration; return to hospital and side effects. Results: There were 175 children who completed the study. Within the first hour after treatment, all drugs were equally effective, with ondansetron preventing vomiting in 100%, bromopride in 96.6%, and metoclopramide in 94.8% of children (p = 0.288). Within six hours, ondansetron was successful in preventing vomiting in 98.3% of children, compared to bromopride and metoclopramide, which were successful in 91.5% and 84.4% of patients, respectively (p = 0.023). Within 24 h, ondansetron was superior to both other agents, as it remained efficacious in reducing vomiting in 96.6% of children, as opposed to 67.8% and 67.2% with bromopride and metoclopramide, respectively (p = 0.001). The ondansetron group showed better acceptance of oral liquids (p = 0.05) when compared to the bromopride and metoclopramide. The ondansetron group did not show any side effects in 75.9% of cases, compared to 54.2% and 53.5% in the bromopride and metoclopramide groups, respectively. Somnolence was the most common side effect. Conclusions: A single dose of ondansetron is superior to bromopride and metoclopramide in preventing vomiting six hours and 24 h following treatment. Oral fluid intake after receiving medication was statistically better with Ondansetronwhile also having less side effects compared to the other two agents.http://www.sciencedirect.com/science/article/pii/S2255553617300915Clinical trialAntiemeticsVomiting |
| spellingShingle | Matias Epifanio Janete de L. Portela Jefferson P. Piva Cristina H. Targa Ferreira Edgar E. Sarria Rita Mattiello Bromopride, metoclopramide, or ondansetron for the treatment of vomiting in the pediatric emergency department: a randomized controlled trial Jornal de Pediatria (Versão em Português) Clinical trial Antiemetics Vomiting |
| title | Bromopride, metoclopramide, or ondansetron for the treatment of vomiting in the pediatric emergency department: a randomized controlled trial |
| title_full | Bromopride, metoclopramide, or ondansetron for the treatment of vomiting in the pediatric emergency department: a randomized controlled trial |
| title_fullStr | Bromopride, metoclopramide, or ondansetron for the treatment of vomiting in the pediatric emergency department: a randomized controlled trial |
| title_full_unstemmed | Bromopride, metoclopramide, or ondansetron for the treatment of vomiting in the pediatric emergency department: a randomized controlled trial |
| title_short | Bromopride, metoclopramide, or ondansetron for the treatment of vomiting in the pediatric emergency department: a randomized controlled trial |
| title_sort | bromopride metoclopramide or ondansetron for the treatment of vomiting in the pediatric emergency department a randomized controlled trial |
| topic | Clinical trial Antiemetics Vomiting |
| url | http://www.sciencedirect.com/science/article/pii/S2255553617300915 |
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