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Related Concept Videos

Pathophysiology of Vomiting01:22

Pathophysiology of Vomiting

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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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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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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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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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Acute Pharyngitis01:30

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Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
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Acute intractable vomiting: Do I belong somewhere else?

Sucharita Anand1, Anmol Singh Rai1, Rohit Chhirolya1

  • 1Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences , Raebareli Road, Lucknow, 226 014, India.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|August 9, 2018
PubMed
Summary
This summary is machine-generated.

Neuromyelitis optica spectrum disorder (NMOSD) can rarely cause isolated intractable vomiting, often initially misdiagnosed in gastroenterology. Early diagnosis of NMOSD is crucial for effective treatment and preventing severe neurological deficits.

Keywords:
Acute intractable vomitingAnti-aquaporin-4 antibodyNeuromyelitis opticaNeuromyelitis optica spectrum disorderOptic neuritis

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Area of Science:

  • Neurology
  • Gastroenterology

Background:

  • Acute intractable vomiting is a common gastroenterological complaint with diverse etiologies.
  • Differential diagnoses include pancreatitis, intestinal obstruction, myocardial infarction, and stroke.
  • Most causes present with additional characteristic symptoms.

Observation:

  • Neuromyelitis optica spectrum disorder (NMOSD) is a rare cause of isolated acute intractable vomiting.
  • Three cases of NMOSD presenting primarily with vomiting are detailed.
  • Patients were initially managed in a gastroenterology setting.

Findings:

  • Isolated intractable vomiting can be the sole initial presentation of NMOSD.
  • Prompt diagnosis of NMOSD is possible even with gastrointestinal symptoms.
  • Timely NMOSD diagnosis can prevent severe neurological sequelae.

Implications:

  • Highlights the importance of considering NMOSD in unexplained intractable vomiting.
  • Suggests a need for increased neurologist-gastroenterologist collaboration.
  • Emphasizes the potential for early intervention in NMOSD to improve patient outcomes.