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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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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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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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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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The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
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Can nausea and vomiting be treated with ginger extract?

A Giacosa1, P Morazzoni, E Bombardelli

  • 1Department of Gastroenterology, Policlinico di Monza, Monza, Italy. mariangela.rondanelli@unipv.it.

European Review for Medical and Pharmacological Sciences
|April 28, 2015
PubMed
Summary

Ginger (Zingiber officinale) may effectively prevent and treat nausea and vomiting. Further studies are needed, but ginger shows promise as a natural alternative to prokinetic drugs.

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Area of Science:

  • Pharmacology and Herbal Medicine
  • Gastroenterology

Background:

  • Ginger (Zingiber officinale) is a traditional spice with known effects on gastrointestinal motility.
  • Active compounds like gingerols and shogaols interact with cholinergic M and serotonergic 5-HT receptors.
  • Previous research on ginger's efficacy has yielded controversial results due to extract instability.

Purpose of the Study:

  • To review the evidence for ginger's efficacy in treating nausea and vomiting.
  • To focus on pregnancy-induced and chemotherapy-induced nausea and vomiting.
  • To explore ginger extract as a potential alternative to conventional prokinetic drugs.

Main Methods:

  • Systematic review of double-blind, placebo-controlled, randomized studies.
  • Analysis of ginger's mechanism of action on gastric emptying and contractions.
  • Focus on specific conditions like pregnancy and chemotherapy-related nausea.

Main Results:

  • A systematic review suggests ginger's potential efficacy in preventing and treating nausea and vomiting.
  • Ginger extracts accelerate gastric emptying and stimulate gastric antral contractions.
  • Controversial results in prior studies attributed to the chemical instability of gingerols.

Conclusions:

  • Ginger demonstrates potential therapeutic value for nausea and vomiting of various origins.
  • Ginger extracts may serve as a safer alternative to traditional prokinetic agents.
  • Additional controlled studies are necessary to confirm ginger's efficacy and optimal use.