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Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

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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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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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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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CNS stimulants, such as cocaine, amphetamines, and cannabinoids, have varying structures and mechanisms of action that lead to different therapeutic effects and side effects. Cocaine, with its molecular formula C17H21NO4, is a tropane alkaloid and a tertiary amino compound. It has two chemical forms: the hydrochloride salt and the "freebase." The former is in powder form, while the latter involves removing the hydrochloride salt to create a form that can be smoked. Cocaine exerts its effects by...

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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...

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Related Experiment Video

Updated: May 26, 2026

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

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

Published on: February 28, 2025

Cannabinoid hyperemesis.

Kim Wild¹, Hugh Wilson

¹Department of Anaesthetics, Norfolk and Norwich University Hospital, Norwich, UK. kim.wild@doctors.org.uk

Emergency Medicine Journal : EMJ

|December 22, 2011

Summary

This summary is machine-generated.

Cannabinoid hyperemesis syndrome (CHS) is a condition causing severe nausea and vomiting in chronic cannabis users. Abstinence from cannabis is key to symptom resolution, though relapses are common.

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Oromucosal as an Alternative Method for Administration of Cannabis Products in Rodents

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

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Oromucosal as an Alternative Method for Administration of Cannabis Products in Rodents

Oromucosal as an Alternative Method for Administration of Cannabis Products in Rodents

Published on: August 22, 2025

Area of Science:

Gastroenterology
Toxicology
Psychiatry

Background:

Cannabis use disorder is prevalent, with potential gastrointestinal complications.
Cannabinoid hyperemesis syndrome (CHS) is an increasingly recognized condition in chronic, heavy cannabis users.

Observation:

A 21-year-old woman with a 7-year history of heavy cannabis use presented with acute, severe vomiting, nausea, and anorexia.
Biochemistry revealed metabolic derangement (hypokalemia, metabolic alkalosis); urine toxicology was positive for cannabinoids.
All other investigations, including CT head, were normal, supporting a diagnosis of CHS.

Findings:

The patient's symptoms resolved with intravenous fluids, antiemetics, and cannabis abstinence.
Recurrent CHS episodes were directly linked to subsequent cannabis use, each resolving with abstinence.
The patient is pursuing cognitive behavioral therapy for sustained abstinence.

Implications:

CHS is a diagnosis of exclusion, requiring a high index of suspicion in patients with unexplained cyclic vomiting and a history of cannabis use.
Cannabis cessation is the primary treatment for CHS, though relapse is a significant challenge.
Multidisciplinary approaches, including behavioral therapy, may be necessary for long-term management and to prevent recurrent episodes.