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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.
Phenothiazines, such as prochlorperazine...
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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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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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Bulimia Nervosa01:30

Bulimia Nervosa

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Bulimia nervosa is a complex and severe eating disorder characterized by a cyclical pattern of binge-and-purge eating pattern. It generally involves an episode of binge eating, followed by compensatory behaviors such as vomiting, excessive exercise, laxative use, or fasting, to prevent weight gain. Despite often maintaining a normal weight, individuals with bulimia are intensely preoccupied with their body image and harbor an overwhelming fear of gaining weight. This can contribute to the...
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Updated: Jun 25, 2025

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[Nausea and vomiting in pregnancy].

Philippe Deruelle1, Loïc Sentilhes2, Louise Ghesquière3

  • 1Service de gynécologieobstétrique, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, Montpellier, France.

La Revue Du Praticien
|May 30, 2024
PubMed
Summary

Nausea and vomiting in pregnancy (NVP) is common, but severe cases, hyperemesis gravidarum, can cause serious short-term and long-term health issues for mother and child. Management requires tailored interventions from lifestyle changes to hospitalization.

Keywords:
PregnancyVomiting

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Gastroenterology

Background:

  • Nausea and vomiting in pregnancy (NVP) affects a significant number of pregnant women.
  • Severe NVP, termed hyperemesis gravidarum (HG), represents a pathological condition with potential for serious health consequences.

Purpose of the Study:

  • To outline the spectrum of Nausea and Vomiting in Pregnancy (NVP), from mild cases to severe hyperemesis gravidarum (HG).
  • To detail the short-term and long-term complications associated with HG.
  • To discuss the diverse management strategies required for different severities of NVP.

Main Methods:

  • Review of existing literature on Nausea and Vomiting in Pregnancy (NVP) and hyperemesis gravidarum (HG).
  • Categorization of NVP severity and associated complications.
  • Description of treatment modalities, including lifestyle adjustments, non-pharmacological therapies, anti-emetics, and supportive care.

Main Results:

  • Mild NVP can be managed with lifestyle changes, dietary adjustments, ginger, acupuncture, or acupressure.
  • Moderate to severe hyperemesis gravidarum necessitates psychological support, anti-emetic medications, and potentially hospitalization with intravenous rehydration.
  • Complications range from hydro-electrolyte imbalances and growth retardation to long-term psychological effects like anxiety and PTSD.

Conclusions:

  • Effective management of Nausea and Vomiting in Pregnancy (NVP) requires individualized treatment plans based on symptom severity.
  • Hyperemesis gravidarum (HG) presents complex challenges due to potential complications and the difficulty in achieving complete symptom resolution.
  • Caregiver support is crucial in managing the complexities of hyperemesis gravidarum.