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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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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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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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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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Updated: Nov 11, 2025

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[Update nausea and vomiting amongst the elderly].

Rolf Schaefer1

  • 1Facharzt für Innere Medizin, Geriatrie, Palliativmedizin, internistische Intensivmedizin.

Deutsche Medizinische Wochenschrift (1946)
|March 29, 2021
PubMed
Summary
This summary is machine-generated.

Nausea affects up to two-thirds of elderly individuals, stemming from various causes, not just aging. Treatment should prioritize addressing the root cause over symptom relief for effective management in older adults.

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Area of Science:

  • Geriatrics
  • Gastroenterology
  • Internal Medicine

Background:

  • Nausea is a common symptom in the elderly, affecting approximately 2nd to 3rd individuals.
  • It is crucial to distinguish nausea as a symptom rather than an independent disease.
  • The aging process of the gastrointestinal tract alone does not induce nausea.

Purpose of the Study:

  • To explore the multifaceted causes of nausea in the elderly population.
  • To emphasize the importance of accurate diagnosis and individualized treatment strategies.
  • To highlight the limitations of current therapeutic options for nausea in older adults.

Main Methods:

  • Diagnosis relies on comprehensive medical history and physical examination.
  • Further diagnostic procedures are tailored to individual patient needs.
  • No established official diagnostic guidelines currently exist.

Main Results:

  • Nausea in the elderly has diverse origins, including cerebral and gastrointestinal factors.
  • Physiological aging of the gastrointestinal tract is not a direct cause of nausea.
  • Effective diagnosis requires a personalized approach due to the lack of standardized guidelines.

Conclusions:

  • Treatment should primarily focus on addressing the underlying cause of nausea, such as an existing disease or polypharmacy.
  • Symptomatic treatment should be a secondary consideration.
  • Many medications commonly used for nausea are unsuitable for the elderly population, necessitating careful drug selection.