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Related Concept Videos

Drugs for Treatment of Diarrhea-Predominant IBS01:17

Drugs for Treatment of Diarrhea-Predominant IBS

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.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

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

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

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

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

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

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...
Chemotherapy-Induced Nausea and Vomiting: Cannabinoids01:21

Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

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,...
Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document any history...

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Updated: Jul 15, 2026

Cheek Injection Model for Simultaneous Measurement of Pain and Itch-related Behaviors
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Naltrexone for cholestatic itch: a systematic review.

Fay Louise Murray-Brown1

  • 1Palliative Medicine, Royal Gwent Hospital, Newport, UK faymurray-brown@nhs.net.

BMJ Supportive & Palliative Care
|March 11, 2021
PubMed
Summary

Oral naltrexone effectively relieves cholestatic itch, a symptom of liver disease. While generally safe, caution is advised for patients on opioid analgesics due to potential withdrawal reactions.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Pharmacology

Background:

  • Cholestatic itch is a distressing symptom of intrahepatic liver diseases and biliary obstruction.
  • Its pathophysiology is complex, with no definitive treatment currently established.
  • Naltrexone, an opioid receptor antagonist, targets the central opioidergic tone implicated in cholestatic pruritus.

Purpose of the Study:

  • To systematically review and evaluate the efficacy of oral naltrexone in managing cholestatic itch.

Main Methods:

  • A comprehensive search of electronic databases, grey literature, and clinical trial registries was conducted.
  • Relevant studies were retrieved, and their quality was assessed.
  • Thirteen papers, including randomized controlled trials and case reports, were included in the analysis.

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Nasolacrimal Lavage as a Treatment for Ocular Surface Toxic Soup Syndrome
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Main Results:

  • All included studies indicated that naltrexone is effective in alleviating pruritus.
  • Statistical analysis in five studies demonstrated a significant reduction in pruritus compared to baseline.
  • Adverse effects were reported in 37% of patients, primarily opioid withdrawal-type reactions.

Conclusions:

  • Oral naltrexone demonstrates efficacy in relieving cholestatic itch.
  • It should be considered for refractory pruritus, especially in end-stage liver disease patients.
  • Caution is recommended for patients concurrently using exogenous opioids for pain management.