Nausea and vomiting are feared and frequently very distressing symptoms that have multiple triggers including drugs and poisons, motion, pregnancy, anxiety, vestibular disease, and gastrointestinal pathology.
Three primary pathophysiologic pathways are involved in the stimulation of the physiologic vomiting center in the medulla that directly mediates nausea and vomiting: vestibular fibers, afferent visceral fibers, and input from the chemoreceptor trigger zone.
Nausea and vomiting from visceral and chemoreceptor trigger zone stimulation is mediated through dopamine and serotonin whereas that from vestibular and central nervous system is caused through histamine and acetylcholine receptors. Treatment is directed at these receptors.
Antihistamines (cyclizine . . .
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