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Vomiting (AKA emesis)
protective mechanism in reponse to some trigger such as:
irritants
infection
distention
blockage
motion sickness
umpleasant sight or smell
Sympathetic responses to nausea
increased respiration
dilation of pupils
Parasympathetic responses to nausea
profuse salivation
pronounced motility of the esophagus, stomach and duodenum
relaxation of the esophageal sphincter
The process of vomiting
person takes a deep breath
pylorus closes
glottis closes so respiration stops
stomach is squeezed between the diaphragm and abdominal muscles, causing rapid emptying
Neurotransmitters involved in nausea and vomiting
H1 (histamine1) receptors
M1 (muscarinic1) receptors
D2 (dopamine2) receptors
serotonin (5-hydroxytryptamine3 5_ht3) receptors
NK1 (neurokinin1) receptors
CB1 (cannabinoid1) receptors
antagonists for all of these used for treatments
H1 receptor antagonists
antiemetic and antispasmodic activity by blocking H1 receptors
M1 (Muscarinic 1) receptor antagonists
work by correcting the imbalance of acetylcholine and norepinephrine that can occur in motion sickness
block signals to the brain that cause nausea and vomiting
D2 (Dopamine 2) receptor antagonists
not used as an antipsychotic therapy
block D2 receptors in the chemoreceptor trigger zone (CTZ)
effects are similar to both H1 and M1 receptor antagonists
5-HT3 (Serotonin) receptor antagonists
prevent nausea/vomiting due to cancer chemotherapy or surgery by blocking 5-HT3 receptors in CTZ
NK1 (Neurokinin1) receptor antagonists
used to prevent and treat acute and delayed nausea and vomiting associated with chemotherapy
CB1 (Cannabinoid1) receptor antagonists
antiemetic action of CB1 receptor agonists is due to stimulation of CB1 receptors in the vomiting center
Adjunct therapies used in combination with antiemetics
benzodiazepines (prevent nausea and vomiting associated with chemo)
glucocorticosteroids (augment antiemetic effect of %-HT3 receptor antagonist during chemo)
Benzquinamide
antagonizes both muscarinic and H1 receptors in CTZ to decrease vomiting center activity
Diphenidol
controls dizziness, nausea and vomiting associated with Meniere's disease, ear surgery and ear disorders
Trimethobenzamide
may inhibit CTZ where emetic impulses are sent to the vomiting center
Author
mhunger
ID
173375
Card Set
GI part 1.txt
Description
GI part 1, nausea and vomiting
Updated
9/25/2012, 10:30:32 PM
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