Pharmacology of Nausea and Vomiting

The area in the brain responsible for coordinating nausea and vomiting.

An unpleasant feeling of discomfort that often precedes vomiting. It can occur without actual retching or vomiting.

The process of forcibly expelling stomach contents through the mouth.

The area in the brain that receives signals from the gut and other parts of the body and can trigger nausea and vomiting.

Vomiting that's caused by the administration of chemotherapy drugs.

A condition where nausea and vomiting occur due to motion, like on a boat or in a car.

Medications that are specifically used to prevent or treat nausea and vomiting.

The process where stomach muscle contractions are weakened or stopped, which can contribute to nausea.

Nausea and vomiting can be serious symptoms that can lead to other problems. They can be signs of a serious underlying health issue.

Also called the area postrema, this region in the medulla oblongata is sensitive to toxins and plays a key role in triggering vomiting.

These medications are specifically designed to prevent or treat nausea and vomiting. Examples include Promethazine, Ondansetron, and Metoclopramide.

This specialized type of anti-emetic drug targets the serotonin 5HT3 receptor, which is involved in nausea and vomiting pathways.

This type of anti-emetic works by blocking the histamine H1 receptor, which is involved in nausea and vomiting pathways.

This drug, used for emesis, is a dopamine D2 receptor agonist. It stimulates the vomiting center and can lead to vomiting.

The reflex mechanism that expels stomach contents through the mouth.

A key neurotransmitter implicated in vomiting, released from enterochromaffin cells in the intestinal mucosa.

The brain center responsible for coordinating the physical act of vomiting. It receives input from various sources, including the CTZ and vagal afferents.

A region in the brainstem that is sensitive to emetic stimuli and plays a crucial role in triggering vomiting. It's located outside the blood-brain barrier.

A common symptom associated with vomiting that arises from the proximity of the vomiting and salivary centers in the medulla. It can be copious and often precedes or accompanies retching.

A drug often used as an emetic agent and treatment for ED (erectile dysfunction). It is a dopamine receptor agonist, hence its effect on the CTZ.

Opioid analgesics are known to activate the CTZ, contributing to the nausea and vomiting often associated with these medications.

General anaesthetics (e.g., Isofluorane) are commonly associated with nausea and vomiting during recovery, as they trigger activity in the CTZ.

Cardiac glycosides such as digoxin, used for heart conditions, can trigger vomiting due to their ability to stimulate the CTZ.

Certain chemotherapeutic agents used to treat cancer are notorious for causing nausea and vomiting due to activation of the CTZ.

These drugs block muscarinic receptors, which are involved in the nervous system. They're mainly used for motion sickness.

Scopolamine is a common example, and it has mild sedative effects. However, it's not very effective for nausea caused by the chemoreceptor trigger zone (CTZ).

These medications block the release of histamine and acetylcholine, both involved in nausea.

A common example is chlorpromazine, which can be given rectally when people are already vomiting.

These medications are used primarily for CINV (chemotherapy-induced nausea and vomiting) and PONV (post-operative nausea and vomiting).

Metoclopramide and domperidone are examples. They are structurally similar and work through the same mechanism. Domperidone has fewer side effects than metoclopramide.

They block serotonin receptors, which are involved in nausea and vomiting.

Ondansetron, tropisetron, and granisetron are commonly used for nausea and vomiting related to chemotherapy and surgery.

These medications block the effects of substance P, a neurotransmitter involved in delayed-phase nausea after chemotherapy.

Rolapitant is a long-acting NK1 antagonist, meaning it stays in the body for a longer time, offering a longer-lasting effect.

Antihistamines like promethazine, cinnarizine, and cyclizine work by targeting H1 receptors in the central nervous system (CNS) to reduce nausea and vomiting.

Antimuscarinics like hyoscine primarily target the vestibular apparatus (balance system) by blocking acetylcholine receptors, leading to reduced motion sickness.

Cannabinoids, like nabilone, are thought to act mainly on CB1 receptors in the gastrointestinal tract to suppress nausea and vomiting.

Dopamine antagonists work by blocking dopamine D2 receptors found in the chemoreceptor trigger zone (CTZ) and other parts of the gastrointestinal tract, thereby decreasing nausea and vomiting.

Dexamethasone is a glucocorticoid that works by suppressing the release of inflammatory mediators that trigger nausea and vomiting, likely via multiple mechanisms in the gastrointestinal tract.

Ondansetron, granisteron, and palonosetron, commonly known as 5-HT3 antagonists, prevent nausea and vomiting by blocking serotonin receptors (5-HT3) in the chemoreceptor trigger zone (CTZ) and the gastrointestinal tract.