Nausea and vomiting
Wesley C. Finegan, Angela McGurk, Wilma O’Donnell, Jan Pederson, Elizabeth Rogerson in Care of the Cancer Patient, 2018
This chapter describes the medical conditions of nausea and vomiting. Nausea is the unpleasant feeling of needing to vomit, and may be accompanied by symptoms such as feeling sweaty and clammy, and the patient may have no desire to do anything except lie quiet and still. Vomiting is the forceful expulsion of the gastric contents through the mouth. Nausea is under the physiological control of the vomiting centre in the medulla. Oral medication may be adequate to control nausea, but the rectal or subcutaneous route may be better for persistent nausea. The patient's nausea may be caused by more than one stimulus activating more than one site in the brain. Corticosteroids are not anti-emetics as such, but sometimes have a non-specific action in reducing nausea and vomiting and, of course, have a role in reducing raised intracranial pressure or reducing the size of an enlarging liver pressing on the stomach.
Nausea and Vomiting
Susie Wilkinson in Palliative Care Nursing, 2018
The palliative-care nurse has a pivotal role as a team member in the alleviation of nausea and vomiting and associated symptoms. The nurse's role in the management of nausea and vomiting requires excellent assessment skills and contemporary knowledge of physiology, current pharmacology, and appropriate non-pharmacological interventions. The causes of nausea and vomiting can be divided into four categories: chemical; visceral; central nervous system; and vestibular dysfunction. The systematic documentation of the symptoms of nausea and vomiting is the foundation for the adjustment of antiemetic drugs and other therapy to allow optimal control of these distressing symptoms. Measures to reduce nausea and vomiting include planning and presenting meals in accordance with the likes of the person. Percutaneous gastrostomy might be appropriate for persistent nausea and vomiting related to bowel obstruction. Careful analysis of the causes of nausea and vomiting combined with appropriately applied therapeutic intervention can usually improve these symptoms to an acceptable level for the patient.
Nausea and vomiting
Heather Campbell in Nursing & Health Survival Guide: Palliative Care, 2014
This chapter deals with the management of nausea and vomiting which depends on the cause. Some gastrointestinal causes are Squashed stomach, Intestinal obstruction, Constipation, Gastritis, Delayed gastric emptying, Enlarged liver. Vomiting occurs when the vomiting reflex in the brain is stimulated by sensory messages from various parts of the brain and gastrointestinal tract. It in turn stimulates the vagus nerve and other cranial nerves to the stomach and upper gastrointestinal tract to cause vomiting to occur. The importance of understanding the pathways and the neurotransmitters involved is important because:The sensory pathways to the vomiting centre have different neurotransmitter receptor sites Different antiemetics block different neurotransmitter receptors which in turn inhibit the sensory signals to the vomiting centre. Other antiemetics are Levomepromazine, Ondansetron, Octreotide, Hyoscine butylbromide. General principles to manage nausea and vomiting are Treat the cause, The antiemetic chosen depends on the cause. May need to be given via a parenteral route. Some antiemetics should not be given together.
Effect of low dose ketamine versus dexamethasone on intraoperative nausea and vomiting during cesarean section under spinal anesthesia
Published in Egyptian Journal of Anaesthesia, 2015
Ahmed Hassanein, Eissa Mahmoud
ObjectivesThe purpose of our study was to evaluate the prophylactic use of low dose ketamine and comparing it to dexamethasone for reducing intraoperative nausea and vomiting (IONV) during cesarean section under spinal anesthesia. MethodsThe study was performed in 135 full term parturient women of ASA I & II (American Society of Anesthesiology Grade I & II), aged between 20 and 40 years with uncomplicated pregnancies. The group I (n = 45) received 0.4 mg/kg ketamine, group II (n = 45) received 8 mg dexamethasone while control group III (n = 45) received 5 ml normal saline, slowly IV immediately after spinal anesthesia and before surgical incision. The number of episodes of nausea and vomiting was recorded, as well as any other adverse effects. ResultsThe results of this study showed that the rate of nausea and vomiting was lower in patients who received 0.4 mg/kg ketamine and 8 mg dexamethasone than in the placebo group with significant reduction in hypotensive episodes in ketamine group (P = 0.02). ConclusionLow dose ketamine is effective as dexamethasone in prevention of IONV during cesarean section under spinal anesthesia.
The safety of rolapitant for the treatment of nausea and vomiting associated with chemotherapy
Published in Expert Opinion on Drug Safety, 2019
Introduction: Chemotherapy-induced nausea and vomiting is a significant clinical issue that affects patients' quality of life as well as treatment decisions. Significant improvements in the control of chemotherapy-induced nausea and vomiting have occurred in the past 15 years with the introduction of new antiemetic agents 5-HT3, receptor antagonists, neurokinin-1 receptor antagonists, and olanzapine. Oral (aprepitant, 2003; netupitant, 2014; rolapitant, 2015) neurokinin-1 receptor antagonists have been developed along with intravenous formulations (fosaprepitant, NEPA, rolapitant, HTX-019) for the prevention of chemotherapy-induced nausea and vomiting. Areas covered: This review presents a description of the safety and efficacy of rolapitant along with a comparison to the other oral and intravenous formulations of the neurokinin-1 receptor antagonists. Expert opinion: Oral rolapitant has been demonstrated in clinical trials to be safe and effective in controlling chemotherapy-induced nausea and vomiting in patients receiving moderately and highly emetogenic chemotherapy. Rolapitant has a longer half-life (180 h) than other commercially available NK-1 receptor antagonists and does not induce or inhibit CYP34A, unlike the other NK-1 receptor antagonists. Future studies may determine if these may be important clinical issues.
Nausea and Vomiting in Late Pregnancy
Published in Health Care for Women International, 2005
Nausea and vomiting in late pregnancy is a little-studied phenomenon. In this study of 116 midwestern women, 32% of the women had nausea and vomiting after 20 weeks gestation. The purpose of this study was to examine demographic, anthropometric, maternal health factors, and pregnancy outcomes in women who had late nausea and vomiting in pregnancy (NVP) and those that did not. Women who experienced late NVP had significantly higher parity, were older, gained less weight in pregnancy, and slept fewer hours per night than women who did not experience late NVP. By being aware of prenatal factors that may affect nausea and vomiting in late pregnancy, health care providers will be better able to maximize the quality of life for these women.
Related Knowledge Centers
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