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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,...

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...

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.
Phenothiazines, such as prochlorperazine...

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.
Two synthetic agonists of THC,...

Pathophysiology of Vomiting

Pathophysiology of Vomiting

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...

Continuing Care

Continuing Care

Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...

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Updated: May 5, 2026

Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting

Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting

Published on: June 21, 2024

Nausea and vomiting in palliative care.

Brendan Kelly¹, Kate Ward

¹Trinity Hospice, London.

Nursing Times

|December 6, 2013

Summary

Nausea and vomiting in advanced illness significantly impact quality of life. Palliative care interventions and thorough assessments, including understanding neurotransmitters, can effectively manage these debilitating symptoms.

Area of Science:

Palliative Care
Symptom Management
Oncology

Background:

Nausea and vomiting are common, debilitating symptoms in advanced disease, affecting both malignant and non-malignant conditions.
These symptoms severely reduce the quality of life for patients and their families.
Effective management is crucial for improving end-of-life care experiences.

Purpose of the Study:

To discuss systematic assessment for identifying causes of nausea and vomiting in advanced illness.
To explore non-pharmacological and pharmacological interventions for symptom management.
To explain the pathophysiology of nausea, including neurotransmitters, to guide prescribing.

Main Methods:

Systematic patient assessment to identify potential causes of nausea and vomiting.

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Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting

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Review of simple, non-pharmacological measures for symptom relief.

Explanation of the neurochemical pathways involved in nausea.

Guidance on appropriate pharmacotherapy based on pathophysiology.

Main Results:

Palliative care interventions significantly improve nausea and vomiting.
Non-pharmacological measures can be effective initial management strategies.
Understanding neurotransmitter roles aids in targeted prescribing.

Conclusions:

Comprehensive assessment and tailored interventions, prioritizing simple measures, are key to managing nausea and vomiting in advanced disease.
Palliative care plays a vital role in enhancing patient quality of life.
Knowledge of nausea pathophysiology informs effective treatment strategies.