Ondansetron chemical structure
Find information on thousands of medical conditions and prescription drugs.


Ondansetron is a serotonin 5-HT3 receptor antagonist used mainly to treat nausea and vomiting following chemotherapy. Its effects are thought to be on both peripheral and central nerves. One part is to reduce the activity of the vagus nerve, which is a nerve that activates the vomiting center in the medulla oblongata, the other is a blockage of serotonin receptors in the chemoreceptor trigger zone. It does not have much effect on vomiting due to motion sickness. This drug does not have any effect on dopamine receptors or muscarinic receptors. more...

Zoledronic acid

Ondansetron is broken down in the liver. It's elimination half-life is about 2-3 hours following i.v. administration in patients with normal liver and kidney functions. The drug is usually administered once, twice or three times daily, depending on the severity of nausea and/or vomiting. Following oral administration, it takes about 1.5-2 hours to reach maximum plasma concentrations. This drug is removed from the body by the liver and kidneys.

It is currently marketed by GlaxoSmithKline under the trade name Zofran; other manufacturers include Cipla Ltd (Emeset), Chemical Works of Gedeon Richter (Emetron), and Zentiva a.s. (Ondemet).

Clinical uses

  • Chemotherapy-induced nausea and vomiting
    • 5-HT3 receptor antagonists are the primary drugs used to treat and prevent chemotherapy-induced nausea and vomiting. Many times they are given intravenously about 30 minutes before beginning therapy.
  • Post-operative and post-radiation nausea and vomiting
  • Is a possible therapy for nausea and vomiting due to acute or chronic medical illness or acute gastroenteritis

Although highly effective, its high cost limits its use to controlling postoperative nausea and vomiting (PONV) and chemotherapy-induced nausea and vomiting (CINV). It is also used off-label to treat hyperemesis gravidarum in pregnant women, but there is no conclusive data available on its safety in pregnancy, especially during the first trimester.

Clinical effect of ondansetron (and other drugs from the same group) can be potentiated by combining it with dexamethasone.

Adverse effects

Ondansetron is a well-tolerated drug with few side effects. Headache, constipation, and dizziness are the most commonly reported side effects associated with its use. There have been no significant drug interactions reported with this drug's use. It is broken down by the liver's cytochrome P450 system and it has little effect on the metabolism of other drugs broken down by this system.

Read more at Wikipedia.org

[List your site here Free!]

Rapid recovery protocol reduces post-op downtime
From Cosmetic Surgery Times, 10/1/04 by Melissa Heltzel

New York -- It isn't difficult to understand what a patient likely wants from his or her facelift surgery. The patient wants to look great, without looking like they had surgery, and they want the results to last. But a patient also wants to return to normal life as soon as possible. At the crux of plastic surgery is the expectation of improved recovery time. David Rosenberg, M.D., P.L.L.C., has not only improved recovery time, but has done it without compromising the facelift's outcome.

Reducing the recovery time, he says, "opens the door to surgery to a whole array of patients who would otherwise not be able to take on cosmetic surgery."

He has assembled a protocol that effectively reduces the amount of swelling, bruising and discomfort from the surgery. He hopes this will encourage people whose career, familial or social obligations might otherwise keep them from considering facelift surgery.

The preoperative period, he says, is a rigorous preparation in relaxation and education for the patient. He took his cue from more than 200 articles in anesthesia and dental journals that make a direct correlation between a patient's pre-surgical anxiety level and the degree of pain and ability to recover afterward. "If you can minimize anxiety before surgery, then I know the patients are going to require less pain medication and have less discomfort afterwards," he says.

The first building block to alleviating patient anxiety is education. Dr. Rosenberg engages patients in a 45-minute initial, forthright education session that serves both to set reasonable expectations and to put their minds at ease. He explains to patients why they can expect minimal discomfort, and that he doesn't employ the use of drains.

"Patients, I have found, find drains coming out of their skin to be extremely anxiety-producing," Dr. Rosenberg says. "By reassuring them that it's nothing like that, their blood pressure drops."

He sets up a supplement regimen for the two weeks preceding surgery that aims to keep the bruising and swelling to a minimum. He has the patient stop taking any supplements that thin the blood--such as aspirin, Vitamin E, green tea and St. John's Wort, as well as omega-3 fatty acids and fish oils. He replaces these supplements with those that aid in healing for a five-day regimen prior to surgery. It includes bromelain (500 mg, three times a day) and Arnica montana, as well as a prescription for vitamin K (Mephyton, 5 mg). He also issues a prescription for Valium (Roche Pharmaceuticals, Nutley, N.I.) to further minimize anxiety.

On the day of surgery, an anesthesiologist starts an intravenous combination of propofol and midazolam; Dr. Rosenberg follows that up by administering a long-lasting local anesthetic of lidocaine (1 percent) with epinephrine (1:100,000) equally with marcaine (0.25 percent) with epinephrine (1:200,000). The anesthesiologist administers Decadron (Merck, Rahway, N.J.) and Zofran (GlaxoSmithKline, Research Triangle Park, N.C.), both to limit any lingering potential for nausea. The local anesthetic typically lasts through the night, barring the need for morphine or other narcotics in the recovery room, and in fact, Dr. Rosenberg finds that this combination prevents the need for anything stronger than a Tylenol (1,000 mg) later that evening.

"Hiding the scar is a must," Dr. Rosenberg explains. Thus, he says he uses posttragal incision. "This is very meticulous and takes a few extra minutes," he says. "But when the stitches come out at seven days, you don't see a scar in front of the ear."

He then performs a deep plane facelift with minor modifications--a technique that he's found to leave less bruising and swelling than a subcutaneous or a submusclar aponeurotic system(SMAS) lift. In modifying the traditional deep plane lift, he says, "I leave the fascia and a small amount of fat on the zygomaticus major muscle. I find this approach reduces the swelling in the cheeks."

In almost every case, when dealing with the patient's neck, he performs liposuction on the neck and has found that a 2.0 mm cannulae is the least traumatic to the area, yet carries out the necessary fat removal. He then performs a submentoplasty, taking care to remain superficial to the fascia of the platysma muscle to minimize muscle injury and subsequent skin bruising. If there is noticeable capillary bleeding, he uses Tisseel (Baxter Healthcare, Deerfield, Ill.) at the time of closure, and the sealant seems to assuage further bruising and swelling. Once he completes elevation of the surgical flaps and hemostasis is achieved, then closure can begin. He separately secures the platysma muscle with running sutures to the underlying fascia, which causes less swelling in front of the ear. At last, a conforming dressing is applied to the face, putting moderate pressure on the area in front of the ear, the mastoid, the temple region and the submentum.

Following surgery, the patient is placed in the recovery area, and a cool compress is applied to reduce swelling. Dr. Rosenberg emphasizes the lack of need for opiates for the pain, thereby preventing nausea and vomiting. This saves the patient much distress and keeps unwanted pressure off the fresh sutures. After two to three hours, Dr. Rosenberg finds it greatly reduces the patient's anxiety to get out of the recovery room and into a hotel nearby the facility, accompanied by a registered nurse. The nurse will then make sure the patient is drinking fluids, and later gives the patient Tylenol (1,000 mg) every four hours and Valium (5 mg) every eight hours.

The next morning, 15 to 20 hours after the surgery, Dr. Rosenberg personally visits the patient to remove the dressing and clean the incisions. He starts the patient on a Medrol (Pharmacia Corp., Peapack, N.J.) dose pack to improve comfort and reduce swelling.

To improve the sense of well-being, the patient is encouraged to shower (with assistance) after 24 hours. Dr. Rosenberg then calls the patient every morning for the next four days to check in and answer any questions. Between days five and ser en after surgery, the patient returns to his office for the removal of sutures and a consultation with a licensed aesthetician. The patient is educated in the application of LycoGel, a silica-based concealer, which can be used several days after surgery. Because, "despite the gentlest of techniques, there will always be some bruising," Dr. Rosenberg says.

In days five to seven following the surgery, Dr. Rosenberg encourages the patient to go out to lunch or dinner with friends, noting that re-entering society is key to a speedier recovery.

Some patients may be slightly behind on that curve, but nearly all are out and about, or back to work, by the tenth day following surgery.

The success of the rapid recovery facelift depends heavily on patient interaction, Dr. Rosenberg says.

"One of the greatest tools for marketing a practice is spending time with your patients to let them know you care about them. You set aside a lot of time for them because that's what people undergoing aesthetic surgery deserve," he adds.

COPYRIGHT 2004 Advanstar Communications, Inc.
COPYRIGHT 2004 Gale Group

Return to Zofran
Home Contact Resources Exchange Links ebay