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Source: DiPiro CV and Ignoffo RJ.
Nausea and Vomiting. In: DiPiro, JT, Talbert RL, Yee GC, Matzke GR,
Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach.
8th ed. http://accesspharmacy.com/content.aspx?aid=7978503.
Accessed June 6, 2012.
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- Nausea: inclination to vomit; feeling in throat or epigastric
region alerting individual that vomiting imminent.
- Vomiting: ejection or expulsion of gastric contents through
mouth, often requiring forceful event.
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++
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- Three consecutive phases of emesis:
- Vomiting triggered by afferent impulses to vomiting center
from:
- Sensory centers
- Chemoreceptor
trigger zone (CTZ)
- Cerebral cortex
- Visceral afferents
- Pharynx
- Gastrointestinal (GI) tract
- Vomiting center sends efferent impulses to:
- Salivation
center
- Respiratory center
- Pharyngeal, GI, and abdominal muscles
- Neurotransmitter receptors in vomiting center, CTZ, and GI
tract
- Cholinergic
- Histaminic
- Dopaminergic
- Opiate
- Serotonin
- Neurokinin
- Benzodiazepine
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Signs and Symptoms
(Table 2)
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- Mild to severe distress
- Queasiness
- Discomfort
- Weight loss
- Abdominal pain
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- Simple nausea and vomiting: none
- Complex nausea and vomiting
- Serum electrolyte
concentrations
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- Evaluation of upper and lower GI tract
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- Prevent or eliminate symptoms of nausea and vomiting.
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- Symptoms related to food ...