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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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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: 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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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: Cannabinoids01:21

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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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Related Experiment Video

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Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
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COVID-19, nausea, and vomiting.

Paul L R Andrews1, Weigang Cai2, John A Rudd3

  • 1Division of Biomedical Sciences, St George's University of London, London, UK.

Journal of Gastroenterology and Hepatology
|September 21, 2020
PubMed
Summary
This summary is machine-generated.

Nausea and vomiting are early symptoms of COVID-19, with nausea occurring in 10.5% of cases. Mechanisms involve SARS-CoV-2

Keywords:
ACE2COVID-19SARS-CoV-2angiotensin IIangiotensin converting enzyme 2dexamethasonediarrheaenteroendocrine cellsnauseavomiting

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Virology

Background:

  • Nausea and vomiting (NV) are often overlooked as early symptoms of COVID-19.
  • The incidence and underlying mechanisms of NV in COVID-19 require further investigation.

Purpose of the Study:

  • To determine the incidence of nausea and vomiting during SARS-CoV-2 infection.
  • To elucidate the potential gastrointestinal (GI) and central nervous system (CNS) mechanisms underlying NV in COVID-19.

Main Methods:

  • Literature review and analysis of existing data on NV incidence in COVID-19.
  • Exploration of proposed pathophysiological pathways involving SARS-CoV-2, ACE2 receptors, and the emetic pathways.

Main Results:

  • Nausea incidence is estimated at a median of 10.5%, comparable to diarrhea.
  • Variability in reporting may stem from poor definition, confusion with appetite loss, and combined reporting of nausea and/or vomiting (NV).

Conclusions:

  • Nausea should be recognized as a significant early symptom of COVID-19.
  • Potential mechanisms include SARS-CoV-2-induced mediators affecting vagal afferents and the area postrema (AP), and increased plasma angiotensin II.