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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates these...
Pathophysiology of Vomiting01:22

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Vomiting is a complex physiological response to expel harmful or irritating substances from the body. It's a defensive mechanism triggered by stimuli like poisons, microbial toxins, cytotoxic drugs, and mechanical abdominal distension. The process is centrally coordinated by the vomiting (or emetic) center located in the medulla of the brainstem. This area, rich in muscarinic M1, histamine H1, neurokinin 1 (NK1), and serotonin 5-HT3 receptors, coordinates the act of vomiting through interaction...
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

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5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
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Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
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The inner ear assumes dual functionalities of auditory perception and equilibrium maintenance. The vestibule is the organ responsible for balance. This organ contains mechanoreceptors, specifically hair cells, endowed with stereocilia, which aid in deciphering information regarding the position and motion of our heads. Two intrinsic components, the utricle and saccule, help perceive head position, while the semicircular canals track head movement. Neurological messages initiated in the...

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Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
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Published on: June 21, 2024

Functional nausea and vomiting.

Kevin W Olden1, Pavan Chepyala

  • 1Department of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. kwolden@uams.edu

Nature Clinical Practice. Gastroenterology & Hepatology
|February 28, 2008
PubMed
Summary

Functional vomiting (FV), cyclic vomiting syndrome (CVS), and chronic idiopathic nausea (CIN) are rare but disabling. This review synthesizes current knowledge on their pathophysiology and management, highlighting the need for collaborative research due to low prevalence.

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Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
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Published on: August 4, 2023

Area of Science:

  • Gastroenterology
  • Neurology

Background:

  • Functional vomiting (FV), cyclic vomiting syndrome (CVS), and chronic idiopathic nausea (CIN) are rare but recognized as highly disabling conditions.
  • These disorders have historically been under-investigated, but recent interest in their pathophysiology and treatment has grown.

Purpose of the Study:

  • To present a literature-based review of the nomenclature, pathophysiology, clinical presentation, and management of CIN, CVS, and FV.
  • To consolidate current knowledge and treatment strategies for these challenging gastrointestinal disorders.

Main Methods:

  • Literature review synthesizing existing research on CIN, CVS, and FV.
  • Focus on pathophysiology, clinical presentation, and management strategies.

Main Results:

  • A comprehensive overview of the current understanding of CIN, CVS, and FV is provided.
  • The review highlights a significant lack of randomized controlled trials due to the low prevalence of these conditions.
  • Collaborative efforts among referral centers are crucial for advancing treatment strategies.

Conclusions:

  • Effective management of CIN, CVS, and FV relies on shared expertise from referral centers.
  • Further research, particularly collaborative trials, is needed to develop evidence-based treatment approaches.
  • This review consolidates current knowledge to guide the best possible treatment strategies for patients.