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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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In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
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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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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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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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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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Updated: Mar 21, 2026

Author Spotlight: Alleviating Nausea and Vomiting in Pregnancy with Safe and Effective Auricular Acupuncture
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Interventions for treating hyperemesis gravidarum.

Rupsa C Boelig1, Samantha J Barton, Gabriele Saccone

  • 1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, 833 Chestnut Street, Level 1, Philadelphia, Pennsylvania, USA, PA 19107.

The Cochrane Database of Systematic Reviews
|May 12, 2016
PubMed
Summary
This summary is machine-generated.

This review found limited high-quality evidence for interventions treating hyperemesis gravidarum (HG), a severe pregnancy condition. More research is needed to guide effective management of nausea and vomiting in pregnancy (NVP).

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Area of Science:

  • Obstetrics and Gynecology
  • Clinical Pharmacology
  • Evidence-Based Medicine

Background:

  • Hyperemesis gravidarum (HG) is a severe pregnancy complication affecting 0.3-1.0% of pregnancies, often requiring hospitalization.
  • Existing reviews focus on general nausea and vomiting in pregnancy (NVP), not specifically HG.

Purpose of the Study:

  • To evaluate the effectiveness and safety of all interventions for hyperemesis gravidarum (HG) up to 20 weeks' gestation.

Main Methods:

  • Searched Cochrane registers for randomized controlled trials (RCTs) of HG interventions.
  • Included 25 trials (2052 women), assessing various treatments like acupuncture, IV fluids, and pharmaceuticals.
  • Evaluated study quality and extracted data, noting low to very low-quality evidence for most outcomes.

Main Results:

  • Limited evidence supports specific interventions for HG, with many comparisons based on single, small studies.
  • Acupuncture showed no clear benefit over placebo for most outcomes.
  • Vitamin B6 slightly increased hospital stay; metoclopramide and ondansetron showed no clear difference in efficacy but metoclopramide had more side effects.
  • Corticosteroids decreased readmission rates but had insufficient evidence for other outcomes.

Conclusions:

  • There is a lack of high-quality evidence to support any single intervention for hyperemesis gravidarum (HG).
  • Consistent definitions, validated outcome measures, and larger placebo-controlled trials are crucial for future research.
  • The economic impact of HG and interventions requires further investigation.