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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...
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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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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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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...
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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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Updated: Apr 13, 2026

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Cannabinoid hyperemesis syndrome.

Lynn Heise1

  • 1Marquette University College of Nursing, Milwaukee, Wisconsin.

Advanced Emergency Nursing Journal
|May 2, 2015
PubMed
Summary
This summary is machine-generated.

Legalization of marijuana may increase long-term users. Cannabinoid hyperemesis syndrome, characterized by severe nausea and vomiting, is best treated with marijuana abstinence.

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Area of Science:

  • Medical Science
  • Clinical Medicine
  • Gastroenterology

Background:

  • The increasing legalization of marijuana use is associated with a rise in chronic, long-term users.
  • Cannabinoid Hyperemesis Syndrome (CHS) presents a diagnostic challenge in emergency departments.
  • Understanding CHS is crucial for healthcare providers managing patients with unexplained gastrointestinal distress.

Observation:

  • A previous Australian study identified 19 chronic marijuana users presenting with recurrent vomiting and abdominal pain.
  • Patients with CHS often experience severe nausea and vomiting unresponsive to standard antiemetic treatments.
  • Abdominal pain in CHS may not be alleviated by narcotics and can paradoxically worsen.

Findings:

  • Cannabinoid Hyperemesis Syndrome is a condition linked to chronic marijuana abuse.
  • Standard antiemetic therapies and narcotic analgesics are largely ineffective for CHS symptoms.
  • Complete abstinence from marijuana is the most effective treatment for Cannabinoid Hyperemesis Syndrome.

Implications:

  • Advanced practice nurses should consider CHS in the differential diagnosis for patients with recurrent nausea, vomiting, and abdominal pain.
  • Increased awareness and knowledge of CHS among healthcare professionals are essential for accurate diagnosis and effective patient management.
  • Recognizing CHS is critical for preventing prolonged emergency department visits and inappropriate treatments.