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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. Accessed June 6, 2012.

  • 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.

Table 1. Specific Etiologies of Nausea and Vomiting

  • Three consecutive phases of emesis:
    • Nausea
    • Retching
    • Vomiting
  • 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

Signs and Symptoms (Table 2)

  • Mild to severe distress
  • Queasiness
  • Discomfort
  • Weight loss
  • Abdominal pain

Table 2. Presentation of Nausea and Vomiting

Laboratory Tests

  • Simple nausea and vomiting: none
  • Complex nausea and vomiting
    • Serum electrolyte concentrations


  • Evaluation of upper and lower GI tract

  • Prevent or eliminate symptoms of nausea and vomiting.

  • Symptoms related to food or beverage consumption may ...

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