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Vomiting (the expulsion of gastric contents) is usually preceded by retching, but retching and vomiting can occur separately [6] and involve different sets of muscles. [7] During a retch, thoracic pressure is decreased and abdominal pressure is increased , which may serve to position gastric contents and overcome esophageal resistance. [ 6 ]
The development of selective 5-HT 3 receptor antagonists was a dramatic improvement in the treatment of nausea and vomiting. [30] Ondansetron, granisetron, dolasetron and palonosetron are currently approved in the United States, and form the cornerstone of therapy for the control of acute emesis with chemotherapy agents with moderate to high ...
The two general types of alternative pressure therapy are sham acupressure and the use of the P6 point. A 2015 study found no significant difference between the use of either therapy in the treatment or prevention of PONV. In a review of 59 studies, both therapies significantly affected the nausea aspect, but had no significant effect on vomiting.
The vomiting center of the brain refers to the groups of loosely organized neurons in the medulla that include the CTZ within the area postrema and the nucleus tractus solitarii. [2] One of the ways the chemoreceptor trigger zone implements its effects on the vomiting center is by activation of the opioid mu receptors and delta receptors. [6]
Nausea and vomiting associated with migraine headaches respond best to dopamine antagonists such as metoclopramide, prochlorperazine, and chlorpromazine. [22] In cases of gastroenteritis, serotonin antagonists such as ondansetron were found to suppress nausea and vomiting, as well as reduce the need for IV fluid resuscitation. [ 22 ]
The newest 5-HT 3 inhibitor, palonosetron (Aloxi), also prevents delayed nausea and vomiting, which can occur during the 2–5 days after treatment. Since some patients have trouble swallowing pills, these drugs are often available by injection , as orally disintegrating tablets , or as transdermal patches .
The Rome criteria are achieved and finally issued through a consensual process, using the Delphi method (or Delphi technique). The Rome Foundation process is an international effort to create scientific data to help in the diagnosis and treatment of functional gastrointestinal disorders, also known as disorders of gut-brain interaction. [22]
Drug reaction (vomiting may occur as an acute somatic response to): [citation needed] Alcohol, which can be partially oxidized into acetaldehyde that causes the symptoms of hangover, including nausea, vomiting, shortness of breath, and fast heart rate. [22] Opioids; Selective serotonin reuptake inhibitors; Many chemotherapy drugs