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Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

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...

Hyperosmolar Hyperglycemic State

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Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists

Chemotherapy-Induced Nausea and Vomiting: 5-HT₃ Receptor Antagonists

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,...

Pathophysiology of Vomiting

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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: Dopamine Receptor Antagonists

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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Related Experiment Video

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Preclinical Model of Prenatal Delta-9-Tetrahydrocannabinol Exposure to Assess Its Impact on Neurodevelopmental Outcomes

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Published on: February 28, 2025

Cannabinoid hyperemesis syndrome.

Jonathan A Galli¹, Ronald Andari Sawaya, Frank K Friedenberg

¹Temple University Hospital, Philadelphia, PA 19140, USA.

Current Drug Abuse Reviews

|December 14, 2011

Summary

This summary is machine-generated.

Cannabinoid Hyperemesis Syndrome (CHS) is a condition linked to chronic cannabis use, causing cyclical vomiting and relief from hot bathing. Its exact cause and treatment require further research.

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Published on: August 1, 2025

Area of Science:

Gastroenterology
Toxicology
Cannabinoid Science

Background:

Cannabinoid Hyperemesis Syndrome (CHS) is increasingly recognized alongside rising cannabis abuse rates.
CHS is characterized by chronic cannabis use, cyclical nausea, vomiting, and compulsive hot bathing.
The underlying mechanism of CHS remains unknown, despite cannabis's known anti-emetic properties.

Purpose of the Study:

To review the clinical presentation, pathophysiology, and management of Cannabinoid Hyperemesis Syndrome.
To highlight the paradoxical effects of cannabinoids on the gastrointestinal tract and central nervous system.
To differentiate CHS from similar conditions like Cyclic Vomiting Syndrome.

Main Methods:

Literature review of existing studies on Cannabinoid Hyperemesis Syndrome.
Analysis of the clinical phases of CHS: prodromal, hyperemetic, and recovery.
Discussion of the differential diagnosis and potential confusion with Cyclic Vomiting Syndrome.

Main Results:

Cannabis, specifically THC, CBD, and CBG, exhibits complex and opposing effects on emesis.
The hyperemetic phase of CHS typically resolves within 48 hours with supportive care.
Frequent hot bathing provides temporary relief from symptoms, indicating a learned behavioral component.

Conclusions:

CHS diagnosis is often delayed due to a broad differential diagnosis for nausea and vomiting.
Further investigation into the epidemiology, pathophysiology, and natural history of CHS is essential.
Understanding cannabinoid interactions is crucial for managing CHS.