Unusual reactions to 5‐HT3 receptor antagonists in a child with rhabdomyosarcoma
Bibliographic record
Abstract
Ondansetron and granisetron are 5‐HT 3 receptor antagonists commonly used for prevention of chemotherapy‐induced nausea and vomiting. Rare acute dystonic reactions to ondansetron have been reported previously. We report a case of abnormal facial movements associated with granisetron. A boy with prostatic rhabdomyosarcoma and lung and bone metastases developed abnormal facial movements while receiving ondansetron 4 mg po q8h (5 mg/m 2 /dose). These movements consisted of involuntary blinking of the eyes, pursing of the lips, forward thrusting of the jaw and protrusion of the tongue. After excluding other potential causes, the diagnosis of ondansetron‐induced movement disorder was made. These movements decreased when the dose of ondansetron was reduced and resolved with its discontinuation. On admission for a subsequent cycle of chemotherapy, the patient was treated with granisetron 480 µg iv q12h (20 µg/kg/dose). On day 3, the patient developed repeated forward thrusting of the jaw and simultaneous blinking of the eyes, which were self‐limiting and less severe than those associated with ondansetron use. As vomiting was effectively prevented, granisetron was continued until completion of therapy. Health professionals need to be aware of these possible, albeit rare, reactions to ondansetron and granisetron in paediatric oncology patients. Supported by Hospital for Sick Children Research Institute (CL, GK)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".