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Ondansetron does not reduce the shivering threshold in healthy volunteers
R Komatsu1, M Orhan-Sungur, J In
1Outcomes Research Institute, University of Louisville, KY, USA.
Background:
Ondansetron, a serotonin-3 receptor antagonist, reduces postoperative shivering. Drugs that reduce shivering usually impair central thermoregulatory control, and may thus be useful for preventing shivering during induction of therapeutic hypothermia. We determined, therefore, whether ondansetron reduces the major autonomic thermoregulatory response thresholds (triggering core temperatures) in humans.
Methods:
Control (placebo) and ondansetron infusions at the target plasma concentration of 250 ng ml(-1) were studied in healthy volunteers on two different days. Each day, skin and core temperatures were increased to provoke sweating; then reduced to elicit peripheral vasoconstriction and shivering. We determined the core-temperature sweating, vasoconstriction and shivering thresholds after compensating for changes in mean-skin temperature. Data were analysed using t-tests and presented as means (sds); P<0.05 was taken as significant.
Results:
Ondensetron plasma concentrations were 278 (57), 234 (55) and 243 (58) ng ml(-1) at the sweating, vasoconstriction and shivering thresholds, respectively; these corresponded to approximately 50 mg of ondansetron which is approximately 10 times the dose used for postoperative nausea and vomiting. Ondansetron did not change the sweating (control 37.4 (0.4) degrees C, ondansetron 37.6 (0.3) degrees C, P=0.16), vasoconstriction (37.0 (0.5) degrees C vs 37.1 (0.3) degrees C; P=0.70), or shivering threshold (36.3 (0.5) degrees C vs 36.3 (0.6) degrees C; P=0.76). No sedation was observed on either study day.
Conclusions:
/b>. Ondansetron appears to have little potential for facilitating induction of therapeutic hypothermia.
Insights
Ondansetron, used to prevent shivering, does not alter core body temperature thresholds for sweating, vasoconstriction, or shivering in humans. This suggests ondansetron has limited utility in facilitating therapeutic hypothermia induction.
Area of Science:
- Thermoregulation
- Pharmacology
- Clinical Medicine
Background:
- Ondansetron, a serotonin-3 receptor antagonist, is known to reduce postoperative shivering.
- Drugs that reduce shivering can impair thermoregulatory control, potentially aiding therapeutic hypothermia induction.
- This study investigated ondansetron's effect on human thermoregulatory response thresholds.
Purpose of the Study:
- To determine if ondansetron alters the core body temperature thresholds for major autonomic thermoregulatory responses in humans.
- To assess ondansetron's potential for facilitating therapeutic hypothermia.
Main Methods:
- Healthy volunteers received either ondansetron or placebo infusions.
- Skin and core temperatures were manipulated to elicit sweating, vasoconstriction, and shivering responses.
- Thermoregulatory thresholds were determined after adjusting for mean skin temperature changes.
Main Results:
- Ondansetron did not significantly alter the core temperature thresholds for sweating, vasoconstriction, or shivering.
- Observed thresholds were similar between ondansetron and placebo groups (P > 0.05 for all).
- No sedation was reported with ondansetron administration.
Conclusions:
- Ondansetron does not appear to affect the major autonomic thermoregulatory response thresholds in humans.
- The drug has minimal potential for facilitating the induction of therapeutic hypothermia.
- Further research may explore other applications of ondansetron in thermoregulation.
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