Amisulprida una nueva profilaxis contra las náuseas y vómitos postoperatorios: una revisión de la literatura / Amisulpride new prophylaxis against postoperative nausea and vomiting: a review of the literature

Introducción: las náuseas y vómitos postoperatorios (PONV) son una complicación postoperatoria común de la anestesia, por lo que la búsqueda de nuevas profilaxis efectivas ha aumentado durante los últimos años, en este contexto se perfila como una opción efectiva el amisulprida, antipsicótico que actúa bloqueando los receptores dopaminérgicos D2 y D3, en dosis bajas. Métodos: se realizó una búsqueda en bases de datos establecidas como: Pubmed, Embase, Google Scholar, Medline y la Cochrane central registed of controlled trials. Con las siguientes definiciones clave: "NV" or "postoperative nausea and vomiting" or "postoperative nausea" or "postoperative vomiting" and "Amisulpride" or "APD421", con el fin de cumplir el objetivo general de verificar la efectividad de amisulprida como medicamento profiláctico en manejo de PONV. Resultados: se evaluaron 3 estudios multicéntricos randomizados controlados, con alto grado de confiabilidad y buena calidad metodológica. Se evidencia que el amisulprida es un medicamento profiláctico efectivo contra PONV y con buen perfil de seguridad. Discusión/Conclusión: el amisulprida es un medicamento profiláctico eficaz para prevención de PONV, en dosis óptima de 5 mg, administrado durante el intraoperatorio de cirugías electivas en que se utilice anestesia general en pacientes de moderado a alto riesgo de PONV según escala de Apfel.

Introduction: postoperative nausea and vomiting (PONV) are common postoperative complications of anaesthesia, that is why the search for new effective prophylaxis has increased in recent years. Between the drugs that have been tested for this purpose, Amisulpride, an antipsychotic that blocks D2 and D3 dopaminergic receptors, seems to be an effective option when used in low doses. Methods: This search was done by using databases such as Pubmed, Embase, Google Scholar, Medline and the Cochrane central register of controlled. With the following keywords: "NV" or "postoperative nausea and vomiting" or "postoperative nausea" or "postoperative vomiting" and"Amisulpride" or "APD421", with the purpose of verifying the effectiveness of Amisulpride as prophylactic medication in PONV man-agement, which is our main objective. Results: 3 randomised, controlled, multicenter, with high reliability and good methodological quality studies were evaluated. Evidence suggests that Amisulpride is effective as a prophylactic medication against PONV, and it also has a good safety profile. Discussion/Conclusion: Amisulpride administered in an optimal dose of 5 mg during intraoperative elective surgeries that required general anaesthesia, showed to be effective in preventing PONV as a prophylactic drug in patients with moderate to high risk of PONV according to the Apfel scale.

Aripiprazole for drug-induced sexual dysfunction in schizophrenic males / 中华男科学杂志

Objective@#To investigate the clinical effects of aripiprazole on sexual dysfunction induced by amisulpride or risperidone in male patients with schizophrenia.@*METHODS@#This study included 75 male patients with drug-induced secondary sexual dysfunction after treated with amisulpride or risperidone for first-episode schizophrenia between October 2014 and October 2016. We substituted aripiprazole for amisulpride or risperidone, gradually increased the dose from 10 to 30 mg/d within 2 weeks, and maintained 30 mg/d from the 3rd week. At 4 and 8 weeks after medication, we evaluated the sexual function of the patients, measured the levels of serum prolactin (PRL) and testosterone (T), obtained the scores of the Positive and Negative Symptoms Scale (PANSS), recorded adverse reactions, and compared the parameters with those before aripiprazole administration.@*RESULTS@#Compared with pre-aripiprazole administration, the patients showed significant increases after 4 weeks of medication in the sexual function score (24.3 ± 2.1 vs 32.6 ± 3.6, P 0.05). In comparison with pre-aripiprazole administration, the PANSS score was significantly decreased at 4 weeks after medication (62.1 ± 4.9 vs 57.2 ± 5.5, P <0.05) and even lower at 8 weeks (51.2 ± 5.2) (P <0.05). The incidence rates of medication-related excitation, dizziness, insomnia, and loss of appetite were 6.7%, 5.3%, 4.0% and 1.3% respectively, and no other serious adverse reactions were observed.@*CONCLUSIONS@#Aripiprazole is effective for the treatment of drug-induced sexual dysfunction in schizophrenic men by continuously alleviating their positive and negative symptoms and meanwhile improving their sexual function and restoring their sexual hormone levels.