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  • Image not available.Nausea and/or vomiting is often a part of the symptom complex for a variety of GI, cardiovascular, infectious, neurologic, metabolic, or psychogenic processes.
  • Image not available. Nausea or vomiting is caused by a variety of medications or other noxious agents.
  • Image not available. The overall goal of treatment should be to prevent or eliminate nausea and vomiting regardless of etiology.
  • Image not available. Treatment options for nausea and vomiting include drug and nondrug modalities such as relaxation, biofeedback, and self-hypnosis.
  • Image not available. The primary goal with chemotherapy-induced nausea and vomiting (CINV) is to prevent nausea and/or vomiting. Optimal control of acute nausea and vomiting positively impacts the incidence and control of delayed and anticipatory nausea and vomiting.
  • Image not available. The emetic risk of the chemotherapeutic regimen is the primary factor to consider when selecting prophylactic antiemetics for CINV.
  • Image not available. Patients at high risk of vomiting should receive prophylactic antiemetics for postoperative nausea and vomiting.
  • Image not available. Patients undergoing radiation therapy to the upper abdomen or receiving total or hemibody irradiation should receive prophylactic antiemetics for radiation-induced nausea and vomiting.

On completion of the chapter, the reader will be able to:

  1. Construct a list of etiologies associated with the occurrence of nausea and vomiting.

  2. Explain the pathophysiologic mechanisms involved in the act of vomiting.

  3. Recommend appropriate nonpharmacologic management options for patients undergoing chemotherapy.

  4. Differentiate between the therapy of simple and complex nausea and vomiting.

  5. Select the most appropriate agent for treatment of simple nausea and vomiting in the elderly.

  6. List three risk factors associated with chemotherapy-induced nausea and vomiting (CINV).

  7. Select a prophylactic antiemetic based on the emetic risk of a specific chemotherapy agent.

  8. Recommend a treatment regimen for prophylaxis of delayed CINV in a patient receiving cisplatin-based chemotherapy.

  9. List three risk factors for the development of postoperative nausea and vomiting (PONV).

  10. Contrast the prophylactic and treatment doses of serotonin receptor antagonists used for PONV.

  11. Recommend a drug and dose for a patient undergoing total-body irradiation.

  12. Recommend a drug for prophylaxis of motion sickness.

  13. Discuss options for treatment of nausea and vomiting in a pregnant woman.

  14. Discuss the role of drugs in the treatment of pediatric gastroenteritis.

  15. List two objective parameters to determine if a patient is benefiting or having toxicity from his/her drug therapy of nausea and vomiting.

Nausea and vomiting are common complaints from individuals of all ages. Management can be quite simple or detailed and complex, essentially innocuous or associated with therapy-induced adverse reactions. This chapter provides an overview of nausea and vomiting, two multifaceted problems.

Nausea is defined as the inclination to vomit or as a feeling in the throat or epigastric region alerting an individual that vomiting is imminent. Vomiting is defined as the ejection or expulsion of gastric contents through the mouth and is often a forceful event. Either condition may occur transiently with no other associated signs or symptoms; however, these conditions also may be only part of a more complex clinical presentation.

Image not available.Nausea and vomiting may be associated with a variety ...

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