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Related Concept Videos

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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Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists01:29

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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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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...
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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...
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Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
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Cyclic vomiting syndrome: treatment options.

Reza A Hejazi1, Richard W McCallum

  • 1Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA, reza.abbaszdehhejazi@ttuhsc.edu.

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|May 28, 2014
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Cyclic vomiting syndrome (CVS) treatment in adults shows significant response to high-dose tricyclic antidepressants. Addressing trigger factors and coexisting conditions is crucial for managing this recognized disorder.

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Area of Science:

  • Gastroenterology
  • Neurology
  • Pharmacology

Background:

  • Cyclic vomiting syndrome (CVS) is a debilitating disorder marked by severe, recurrent nausea and vomiting episodes.
  • Symptom-free intervals separate acute attacks, posing diagnostic and therapeutic challenges.

Purpose of the Study:

  • To review current treatments for adult cyclic vomiting syndrome.
  • To identify research gaps and unanswered questions in CVS management.

Main Methods:

  • A comprehensive PubMed search was performed using keywords: "cyclic vomiting syndrome," "nausea," "vomiting," "treatment," "trigger factors," and "tricyclic antidepressants."
  • Findings were synthesized with authors' clinical expertise and research.

Main Results:

  • High-dose tricyclic antidepressants demonstrate impressive and sustained efficacy in treating adult CVS.
  • Poor responders (approx. 13%) often present with identifiable profiles including psychological disorders, marijuana use, uncontrolled migraines, or chronic narcotic use.

Conclusions:

  • Cyclic vomiting syndrome is an increasingly recognized condition in adults.
  • Tricyclic antidepressants are the primary pharmacotherapy for symptom control in CVS.
  • Identifying and managing trigger factors is integral to effective CVS treatment.