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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

412
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...
412
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists

484
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,...
484
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists01:29

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

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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.
Phenothiazines, such as prochlorperazine...
690
Chemotherapy-Induced Nausea and Vomiting: Cannabinoids01:21

Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

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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.
Two synthetic agonists of THC,...
560
Pathophysiology of Vomiting01:22

Pathophysiology of Vomiting

2.2K
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...
2.2K
Gastritis III: Clinical Manifestations and Management01:23

Gastritis III: Clinical Manifestations and Management

918
The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
918

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Related Experiment Video

Updated: Dec 7, 2025

Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
05:56

Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting

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Nausea and Vomiting Not Related to Cancer Therapy: Intractable Problem or Clinical Challenge?

Rita J Wickham1

  • 1Rush University College of Nursing, Chicago, Illinois.

Journal of the Advanced Practitioner in Oncology
|September 25, 2020
PubMed
Summary
This summary is machine-generated.

Nausea and vomiting (N/V) in advanced cancer patients is complex. Effective management requires personalized, interprofessional collaboration focusing on symptom control and quality of life.

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Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity
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Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity

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Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity
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Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity

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Area of Science:

  • Palliative Care
  • Oncology
  • Symptom Management

Background:

  • Nausea and vomiting (N/V) in advanced cancer is often multicausal, posing unique management challenges.
  • Existing professional guidelines for palliative N/V management lack sufficient detail for clinical decision-making.
  • Oncology advanced practitioners (APs) require enhanced knowledge to manage these high-impact symptoms effectively.

Purpose of the Study:

  • To address the challenges in managing N/V in advanced cancer patients.
  • To provide detailed guidance for oncology advanced practitioners (APs) in N/V symptom management.
  • To optimize the care for N/V unrelated to cancer treatment.

Main Methods:

  • Comprehensive literature review of current and classic articles.
  • Focus on the physiologic basis of N/V in advanced disease and malignant bowel obstruction.
  • Integration of palliative care principles and clinical experience in symptom management.

Main Results:

  • Summary of the neuropharmacology of N/V in advanced cancer.
  • Detailed information on focused assessment strategies for N/V.
  • Inclusion of pharmacologic agents (antiemetics, neuromodulators, prokinetics) and non-drug adjunctive measures.

Conclusions:

  • Managing N/V in advanced cancer is crucial for quality of life, demanding persistence and interprofessional collaboration.
  • Personalized management strategies are essential for oncology APs and clinicians.
  • The perception of N/V as intractable can shift to viewing it as a manageable clinical challenge.