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

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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...
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Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

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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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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Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the retrovirus to...
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Nausea and vomiting in HIV/AIDS.

Joyce K Anastasi1, Bernadette Capili

  • 1Division of Special Studies in Symptom Management, New York University, New York 10010, USA. ja2188@nyu.edu

Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates
|February 9, 2011
PubMed
Summary

Human Immunodeficiency Virus (HIV) is now a chronic illness, but treatments can cause nausea and vomiting. This article reviews managing these challenging symptoms to improve adherence and quality of life.

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Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Gastroenterology

Background:

  • Human Immunodeficiency Virus (HIV) infection is now a manageable chronic condition due to potent antiretroviral therapies.
  • Nausea and vomiting are common, distressing side effects of HIV medications.
  • These symptoms significantly impact patient adherence to treatment and overall quality of life.

Purpose of the Study:

  • To elucidate the mechanisms underlying nausea and vomiting in HIV-infected patients.
  • To outline current evaluation strategies for HIV-associated nausea and vomiting.
  • To present evidence-based management approaches for these symptoms.

Main Methods:

  • Literature review of antiretroviral agents and their gastrointestinal side effects.
  • Analysis of clinical guidelines for managing treatment-related nausea and vomiting.
  • Synthesis of information on supportive care for symptom management.

Main Results:

  • Specific antiretroviral drugs are frequently associated with nausea and vomiting.
  • Early identification and intervention are crucial for effective symptom management.
  • A multi-faceted approach including pharmacological and supportive measures is recommended.

Conclusions:

  • Effective management of nausea and vomiting is essential for long-term HIV therapy adherence.
  • Understanding the mechanisms and employing appropriate interventions can improve patient outcomes.
  • Further research into novel antiemetic strategies for HIV patients is warranted.