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Nausea and vomiting secondary prevention

2021-01-21T03:21:13Z

Tayebah Chaudhry: /* Secondary prevention */

__NOTOC__
{{Nausea and vomiting}}
==Overview==
==Secondary prevention==
* eating light, [[bland]] foods (such as crackers or plain bread)
* avoiding [[fatty]] and spicy food and eating [[protein]] meals <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* eating and drinking slowly
* eating small frequent meals <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* consuming [[peppermint tea]] or [[aromatherapy]] with [[peppermint oil]] <ref name="pmid29850445">{{cite journal |vauthors=Joulaeerad N, Ozgoli G, Hajimehdipoor H, Ghasemi E, Salehimoghaddam F |title=Effect of Aromatherapy with Peppermint Oil on the Severity of Nausea and Vomiting in Pregnancy: A Single-blind, Randomized, Placebo-controlled trial |journal=J Reprod Infertil |volume=19 |issue=1 |pages=32–38 |date=2018 |pmid=29850445 |pmc=5960050 |doi= |url=}}</ref>
* avoiding [[physical]] activity after eating
* avoiding brushing [[teeth]] after eating
* keeping [[hydrated]]
* discontinuing any [[oral]] [[medication]] that can irritate the [[stomach]]
* [[acupressure]] and [[acupuncture]] <ref name="pmid26348534">{{cite journal |vauthors=Matthews A, Haas DM, O'Mathúna DP, Dowswell T |title=Interventions for nausea and vomiting in early pregnancy |journal=Cochrane Database Syst Rev |volume= |issue=9 |pages=CD007575 |date=September 2015 |pmid=26348534 |pmc=7196889 |doi=10.1002/14651858.CD007575.pub4 |url=}}</ref> <ref name="pmid31517844">{{cite journal |vauthors=Hu J, Shen Y, Zhang G, He J, Sun M, Zhang H, Hua B, Zheng H |title=Effect of acupoint therapies on chemotherapy-induced nausea and vomiting: A systematic review protocol |journal=Medicine (Baltimore) |volume=98 |issue=37 |pages=e17109 |date=September 2019 |pmid=31517844 |pmc=6750289 |doi=10.1097/MD.0000000000017109 |url=}}</ref>
* [[Transcutaneous electrical nerve stimulation]] ([[TENS]]) with a wrist band is used to prevent nausea and vomiting postoperatively. <ref name="pmid32913634">{{cite journal |vauthors=Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H |title=Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review |journal=F1000Res |volume=9 |issue= |pages= |date=2020 |pmid=32913634 |pmc=7429924 |doi=10.12688/f1000research.21832.1 |url=}}</ref>
* using specific drugs for specific conditions to prevent nausea and vomiting. Eg, [[neurokinin]]-1 [[receptor]] [[antagonists]] ([[Aprepitant]]), [[5-HT3]] [[antagonists]] ([[Ondansetron]]) and [[corticosteroid]] ([[dexamethasone]]) to prevent [[chemotherapy]] induced nausea and vomiting <ref name="pmid31194593">{{cite journal |vauthors=Karthaus M, Schiel X, Ruhlmann CH, Celio L |title=Neurokinin-1 receptor antagonists: review of their role for the prevention of chemotherapy-induced nausea and vomiting in adults |journal=Expert Rev Clin Pharmacol |volume=12 |issue=7 |pages=661–680 |date=July 2019 |pmid=31194593 |doi=10.1080/17512433.2019.1621162 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting primary prevention

2021-01-21T03:16:52Z

Tayebah Chaudhry: /* Primary prevention */

__NOTOC__
{{Nausea and vomiting}}
Please help WikiDoc by adding content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.
==overview==
==Primary prevention==
Nausea can be prevented by:
* eating [[frequent small meals]] instead of three large meals <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* eating slowly
* consuming foods that are easy to [[digest]] <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* consuming food that is cold or at room temperature since smell of warm or hot food can cause [[nausea]]
* avoid triggers like unpleasant [[odor]] and [[sight]]
* resting after eating keeping the head elevated
* drinking fluids between meals instead of during meals
Vomiting (after feeling nauseated) can be prevented by:
* keeping [[hydrated]] by consuming small amounts of clear, sweet liquids such as Ginger ale, Gatorade and fruit juices that are not too [[acidic]]
* eating sweetened icy treats like popsicles <ref name="pmid28403420">{{cite journal |vauthors=Johns DE, Gerling V, Pasker-de Jong PC |title=Ice pops in the recovery room: effects on postoperative nausea and vomiting |journal=Br J Anaesth |volume=118 |issue=4 |pages=637–638 |date=April 2017 |pmid=28403420 |doi=10.1093/bja/aex063 |url=}}</ref>
* avoid activity and rest in sitting or [[propped-up]] lying position
* [[ginger]] is shown to be useful in prevention of nausea and vomiting <ref name="pmid23638927">{{cite journal |vauthors=Palatty PL, Haniadka R, Valder B, Arora R, Baliga MS |title=Ginger in the prevention of nausea and vomiting: a review |journal=Crit Rev Food Sci Nutr |volume=53 |issue=7 |pages=659–69 |date=2013 |pmid=23638927 |doi=10.1080/10408398.2011.553751 |url=}}</ref>
* specific [[drugs]] can be used to prevent certain cases of nausea and vomiting, for example, [[transdermal]] patch of [[anticholinergic]] agent [[Scopolamine]] for [[prophylaxis]] of [[motion sickness]].

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting surgery

2021-01-21T03:13:20Z

Tayebah Chaudhry: /* Surgery */

__NOTOC__
Please help WikiDoc by adding content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.

{{Nausea and vomiting}}
==Overview==
==Surgery==
* [[Gastric electrical stimulation]] ([[GES]]) is a surgical procedure to [[implant]] an electronic device into the [[abdomen]], with wires ([[electrodes]]) that are attached to the [[stomach]] wall. It may not improve stomach emptying but may improve [[nausea]] and [[vomiting]] in most cases. <ref name="pmid23358845">{{cite journal |vauthors=Keller DS, Parkman HP, Boucek DO, Sankineni A, Meilahn JE, Gaughan JP, Harbison S |title=Surgical outcomes after gastric electric stimulator placement for refractory gastroparesis |journal=J Gastrointest Surg |volume=17 |issue=4 |pages=620–6 |date=April 2013 |pmid=23358845 |doi=10.1007/s11605-013-2147-z |url=}}</ref> <ref name="pmid23433238">{{cite journal |vauthors=Lu PL, Teich S, Di Lorenzo C, Lorenzo CD, Skaggs B, Alhajj M, Mousa HM |title=Improvement of quality of life and symptoms after gastric electrical stimulation in children with functional dyspepsia |journal=Neurogastroenterol Motil |volume=25 |issue=7 |pages=567–e456 |date=July 2013 |pmid=23433238 |doi=10.1111/nmo.12104 |url=}}</ref>
* Other surgical procedures depend on the underlying cause of [[nausea]] and [[vomiting]].

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting medical therapy

2021-01-21T03:11:51Z

Tayebah Chaudhry: /* Medical Therapy */

__NOTOC__
{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}
==Overview==
Mainstay of treatment of [[nausea]] and [[vomiting]] is correcting any [[electrolyte imbalance]], [[dehydration]], [[malnutrition]], and suppression of [[symptoms]] while evaluating and treating the underlying cause. [[Dietary]] recommendations include a low-[[fat]], low-[[fiber]] diet with frequent small meals if able to tolerate [[oral]] intake. Liquid diet is recommended in case solid diet is not well tolerated. Medical therapy involves two groups of [[drugs]] i.e., [[antiemetics]] and [[prokinetics]]. Antiemetics suppress nausea and vomiting and typically act [[centrally]]. Prokinetics modulate [[gastrointestinal]] [[motility]].

== Medical Therapy ==
* Mainstay of treatment of [[nausea]] and [[vomiting]] is correcting any [[electrolyte imbalance]], [[dehydration]], [[malnutrition]], and [[suppression]] of [[symptoms]] while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* [[Dietary]] recommendations include a low-[[fat]], low-[[fiber]] diet with frequent small meals if able to tolerate [[oral]] intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of [[drugs]] i.e., [[antiemetics]] and [[prokinetics]]. Antiemetics suppress nausea and vomiting and typically act [[centrally]]. Prokinetics modulate [[gastrointestinal]] [[motility]].
===Antiemetics===
* [[Benzodiazepines]] are used for [[anticipatory]] [[nausea]] and [[postoperative]] [[nausea]] and [[vomiting]]. Eg., [[Lorazepam]] 0.5-2mg oral, SL ([[sublingual]]) or IM ([[intramuscular]]), [[Alprazolam]] 0.25-1mg [[oral]] or IV ([[intravenous]]). <ref name="pmid8123420">{{cite journal |vauthors=Di Florio T, Goucke R |title=Reduction of dopamine release and postoperative emesis by benzodiazepines |journal=Br J Anaesth |volume=71 |issue=2 |pages=325 |date=August 1993 |pmid=8123420 |doi=10.1093/bja/71.2.325 |url=}}</ref>
*[[Serotonin]] [[5-HT3]] [[antagonists]] are used in postoperative, post-[[radiation]] and [[chemotherapy]] induced nausea and vomiting. Eg., [[Ondansetron]] 4-8mg oral or IV, [[Granisetron]] 1-2 mg every 4-8 hours or 0.075mg-0.25mg every 24 hours oral or IV. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
*[[Antihistamines]] are used in [[motion sickness]] and [[labrythitis]]. Eg., [[Meclizine]] 25-50mg every 24 hours oral, [[Diphenhydramine]], [[Cyclizine]], [[Hydroxazine]] 25-50mg every 6-8 hours, 25–75 mg every 8 hours, 25–50 mg every 4–6 hours, 25–100 mg every 6–8 hours oral, IM or IV. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref> <ref name="pmid15023018">{{cite journal |vauthors=Flake ZA, Scalley RD, Bailey AG |title=Practical selection of antiemetics |journal=Am Fam Physician |volume=69 |issue=5 |pages=1169–74 |date=March 2004 |pmid=15023018 |doi= |url=}}</ref>
*[[Anticholinergic]] agents are used in [[motion sickness]]. Eg., [[Scopolamine]] 0.3–0.6 mg every 24 hours SL, IV, IM or [[transdermal]]. <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref> <ref name="pmid9205824">{{cite journal |vauthors=Golding JF, Stott JR |title=Comparison of the effects of a selective muscarinic receptor antagonist and hyoscine (scopolamine) on motion sickness, skin conductance and heart rate |journal=Br J Clin Pharmacol |volume=43 |issue=6 |pages=633–7 |date=June 1997 |pmid=9205824 |pmc=2042789 |doi=10.1046/j.1365-2125.1997.00606.x |url=}}</ref>
*[[Phenothiazines]] are [[antidopaminergics]] which are effective for [[migraine]], [[motion sickness]], [[vertigo]], postoperative and chemotherapy induced nausea and vomiting. Eg., [[Prochlorperazine]], [[Promethazine]], [[Chlorpromazine]], [[Perphenazine]] 5–10 mg every 6–8 hours, 12.5 –25 mg every 4–6 hours, 10–25 mg every 4–6 hours, 4–8 mg every 8–12 hours Oral, IV or IM. <ref name="pmid16934536">{{cite journal |vauthors=Sanger GJ, Andrews PL |title=Treatment of nausea and vomiting: gaps in our knowledge |journal=Auton Neurosci |volume=129 |issue=1-2 |pages=3–16 |date=October 2006 |pmid=16934536 |doi=10.1016/j.autneu.2006.07.009 |url=}}</ref> <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref>
*[[Droperidol]] is a [[Butyrophenone]] and a [[restricted drug]] used for postoperative and [[chemotherapy]] induced nausea and vomiting, 0.625–1.25 mg every 24hours IM or IV <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref>
* [[Cannabinoids]] are used for [[chemotherapy]] induced nausea and vomiting. Eg., [[Dronabinol]], [[Nabilone]] 2.5–10 mg every 6–8 hours, 1–2 mg every 8–12 hours oral. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid375088">{{cite journal |vauthors=Herman TS, Einhorn LH, Jones SE, Nagy C, Chester AB, Dean JC, Furnas B, Williams SD, Leigh SA, Dorr RT, Moon TE |title=Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy |journal=N Engl J Med |volume=300 |issue=23 |pages=1295–7 |date=June 1979 |pmid=375088 |doi=10.1056/NEJM197906073002302 |url=}}</ref>
* [[Corticosteroids]] are used for [[acute]] or [[delayed]] chemotherapy induced or postoperative nausea and vomiting. Eg., [[Dexamethasone]] 4–8 mg every 4–6 hours Oral, IM or IV. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid15190136">{{cite journal |vauthors=Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N |title=A factorial trial of six interventions for the prevention of postoperative nausea and vomiting |journal=N Engl J Med |volume=350 |issue=24 |pages=2441–51 |date=June 2004 |pmid=15190136 |pmc=1307533 |doi=10.1056/NEJMoa032196 |url=}}</ref>
* [[NK-1]] [[Receptor]] [[Antagonist]] is used in acute as well as delayed chemotherapy-induced nausea and vomiting. It has also been used in gastroparesis-associated nausea and vomiting. Eg., [[Aprepitant]] 80–125 mg every 24 hours oral. <ref name="pmid18208572">{{cite journal |vauthors=Madsen JL, Fuglsang S |title=A randomized, placebo-controlled, crossover, double-blind trial of the NK1 receptor antagonist aprepitant on gastrointestinal motor function in healthy humans |journal=Aliment Pharmacol Ther |volume=27 |issue=7 |pages=609–15 |date=April 2008 |pmid=18208572 |doi=10.1111/j.1365-2036.2008.03618.x |url=}}</ref> <ref name="pmid19719336">{{cite journal |vauthors=Curran MP, Robinson DM |title=Aprepitant: a review of its use in the prevention of nausea and vomiting |journal=Drugs |volume=69 |issue=13 |pages=1853–78 |date=2009 |pmid=19719336 |doi=10.2165/11203680-000000000-00000 |url=}}</ref> <ref name="pmid19444262">{{cite journal |vauthors=Chong K, Dhatariya K |title=A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant |journal=Nat Rev Endocrinol |volume=5 |issue=5 |pages=285–8 |date=May 2009 |pmid=19444262 |doi=10.1038/nrendo.2009.50 |url=}}</ref>

===Prokinetics===
*[[Prokinetic]] agents are used for only prokinetic activity (eg, [[Erythromycin]]) or both prokinetic and [[antiemetic]] activity (eg, [[Benzamides]] like [[Metoclopramide]] and [[Domperidone]] are shown to be efficacious in chemotherapy induced vomiting and [[gastroparesis]]). [[Metoclopramide]] 10–20 mg every 6–8 hours Oral, IM or IV, [[Domperidone]] 10mg every 8–24 hours oral, [[Erythromycin]] 250–500mg every 8 hours oral or IV. <ref name="pmid23201066">{{cite journal |vauthors=Javid FA, Bulmer DC, Broad J, Aziz Q, Dukes GE, Sanger GJ |title=Anti-emetic and emetic effects of erythromycin in Suncus murinus: role of vagal nerve activation, gastric motility stimulation and motilin receptors |journal=Eur J Pharmacol |volume=699 |issue=1-3 |pages=48–54 |date=January 2013 |pmid=23201066 |doi=10.1016/j.ejphar.2012.11.035 |url=}}</ref> <ref name="pmid1612359">{{cite journal |vauthors=Tack J, Janssens J, Vantrappen G, Peeters T, Annese V, Depoortere I, Muls E, Bouillon R |title=Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis |journal=Gastroenterology |volume=103 |issue=1 |pages=72–9 |date=July 1992 |pmid=1612359 |doi=10.1016/0016-5085(92)91097-n |url=}}</ref>

===Miscellaneous therapy===
* [[Novel]] and [[non-traditional]] therapies for nausea and vomiting include [[Tricyclic antidepressants]] ([[TCAs]]), [[Gabapentin]] and [[Olanzapine]]. [[Gabapentin]] is shown effective in life-threatening [[refractory]] [[emesis]] following [[posterior fossa]] [[surgery]]. TCAs ([[Amitriptyline]], [[Nortriptyline]], [[Doxepin]], [[Desipramine]], [[Imipramine]]) 10–100 mg/day oral, [[Gabapentin]] 300–900 mg three times daily oral, [[Olanzapine]] 5–10 mg/day oral. <ref name="pmid9753257">{{cite journal |vauthors=Prakash C, Lustman PJ, Freedland KE, Clouse RE |title=Tricyclic antidepressants for functional nausea and vomiting: clinical outcome in 37 patients |journal=Dig Dis Sci |volume=43 |issue=9 |pages=1951–6 |date=September 1998 |pmid=9753257 |doi=10.1023/a:1018878324327 |url=}}</ref> <ref name="pmid24668130">{{cite journal |vauthors=Guttuso T |title=Gabapentin's anti-nausea and anti-emetic effects: a review |journal=Exp Brain Res |volume=232 |issue=8 |pages=2535–9 |date=August 2014 |pmid=24668130 |doi=10.1007/s00221-014-3905-1 |url=}}</ref> <ref name="pmid15796394">{{cite journal |vauthors=Guttuso T, Vitticore P, Holloway RG |title=Responsiveness of life-threatening refractory emesis to gabapentin-scopolamine therapy following posterior fossa surgery. Case report |journal=J Neurosurg |volume=102 |issue=3 |pages=547–9 |date=March 2005 |pmid=15796394 |doi=10.3171/jns.2005.102.3.0547 |url=}}</ref> <ref name="pmid15700131">{{cite journal |vauthors=Navari RM, Einhorn LH, Passik SD, Loehrer PJ, Johnson C, Mayer ML, McClean J, Vinson J, Pletcher W |title=A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: a Hoosier Oncology Group study |journal=Support Care Cancer |volume=13 |issue=7 |pages=529–34 |date=July 2005 |pmid=15700131 |doi=10.1007/s00520-004-0755-6 |url=}}</ref> <ref name="pmid15493359">{{cite journal |vauthors=Passik SD, Navari RM, Jung SH, Nagy C, Vinson J, Kirsh KL, Loehrer P |title=A phase I trial of olanzapine (Zyprexa) for the prevention of delayed emesis in cancer patients: a Hoosier Oncology Group study |journal=Cancer Invest |volume=22 |issue=3 |pages=383–8 |date=2004 |pmid=15493359 |doi=10.1081/cnv-200029066 |url=}}</ref>
* [[Ginger]] has some [[efficacy]] to reduce postoperative [[nausea]] and [[vomiting]], [[morning sickness]] and [[motion sickness]]. <ref name="pmid10793599">{{cite journal |vauthors=Ernst E, Pittler MH |title=Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials |journal=Br J Anaesth |volume=84 |issue=3 |pages=367–71 |date=March 2000 |pmid=10793599 |doi=10.1093/oxfordjournals.bja.a013442 |url=}}</ref> <ref name="pmid12233808">{{cite journal |vauthors=Keating A, Chez RA |title=Ginger syrup as an antiemetic in early pregnancy |journal=Altern Ther Health Med |volume=8 |issue=5 |pages=89–91 |date=2002 |pmid=12233808 |doi= |url=}}</ref>
* [[Gastric electric stimulation]]([[GES]]) is a surgical procedure used in [[refractory]] [[gastroparesis]]. <ref name="pmid19719511">{{cite journal |vauthors=McCallum RW, Dusing RW, Sarosiek I, Cocjin J, Forster J, Lin Z |title=Mechanisms of symptomatic improvement after gastric electrical stimulation in gastroparetic patients |journal=Neurogastroenterol Motil |volume=22 |issue=2 |pages=161–7, e50–1 |date=February 2010 |pmid=19719511 |doi=10.1111/j.1365-2982.2009.01389.x |url=}}</ref>
* [[Transcutaneous electrical nerve stimulation]] ([[TENS]]) with a wrist band is used to control symptoms postoperatively. <ref name="pmid32913634">{{cite journal |vauthors=Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H |title=Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review |journal=F1000Res |volume=9 |issue= |pages= |date=2020 |pmid=32913634 |pmc=7429924 |doi=10.12688/f1000research.21832.1 |url=}}</ref>
* Alternative approaches include [[hypnosis]], [[acupressure]] and [[acupuncture]]. <ref name="pmid10971166">{{cite journal |vauthors=Marchioro G, Azzarello G, Viviani F, Barbato F, Pavanetto M, Rosetti F, Pappagallo GL, Vinante O |title=Hypnosis in the treatment of anticipatory nausea and vomiting in patients receiving cancer chemotherapy |journal=Oncology |volume=59 |issue=2 |pages=100–4 |date=August 2000 |pmid=10971166 |doi=10.1159/000012144 |url=}}</ref> <ref name="pmid19370583">{{cite journal |vauthors=Lee A, Fan LT |title=Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD003281 |date=April 2009 |pmid=19370583 |pmc=3113464 |doi=10.1002/14651858.CD003281.pub3 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs overview]]

Nausea and vomiting medical therapy

2021-01-21T02:57:44Z

Tayebah Chaudhry: /* Overview */

__NOTOC__
{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}
==Overview==
Mainstay of treatment of [[nausea]] and [[vomiting]] is correcting any [[electrolyte imbalance]], [[dehydration]], [[malnutrition]], and suppression of [[symptoms]] while evaluating and treating the underlying cause. [[Dietary]] recommendations include a low-[[fat]], low-[[fiber]] diet with frequent small meals if able to tolerate [[oral]] intake. Liquid diet is recommended in case solid diet is not well tolerated. Medical therapy involves two groups of [[drugs]] i.e., [[antiemetics]] and [[prokinetics]]. Antiemetics suppress nausea and vomiting and typically act [[centrally]]. Prokinetics modulate [[gastrointestinal]] [[motility]].

== Medical Therapy ==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.
===Antiemetics===
* Benzodiazepines are used for anticipatory nausea and postoperative nausea and vomiting. Eg., Lorazepam 0.5-2mg oral, SL (sublingual) or IM (intramuscular), Alprazolam 0.25-1mg oral or IV (intravenous). <ref name="pmid8123420">{{cite journal |vauthors=Di Florio T, Goucke R |title=Reduction of dopamine release and postoperative emesis by benzodiazepines |journal=Br J Anaesth |volume=71 |issue=2 |pages=325 |date=August 1993 |pmid=8123420 |doi=10.1093/bja/71.2.325 |url=}}</ref>
*Serotonin 5-HT3 antagonists are used in postoperative, post-radiation and chemotherapy induced nausea and vomiting. Eg., Ondansetron 4-8mg oral or IV, Granisetron 1-2 mg every 4-8 hours or 0.075mg-0.25mg every 24 hours oral or IV. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
*Antihistamines are used in motion sickness and labrythitis. Eg., Meclizine 25-50mg every 24 hours oral, Diphenhydramine, Cyclizine, Hydroxazine 25-50mg every 6-8 hours, 25–75 mg every 8 hours, 25–50 mg every 4–6 hours, 25–100 mg every 6–8 hours oral, IM or IV. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref> <ref name="pmid15023018">{{cite journal |vauthors=Flake ZA, Scalley RD, Bailey AG |title=Practical selection of antiemetics |journal=Am Fam Physician |volume=69 |issue=5 |pages=1169–74 |date=March 2004 |pmid=15023018 |doi= |url=}}</ref>
*Anticholenergic agents are used in motion sickness. Eg., Scopolamine 0.3–0.6 mg every 24 hours SL, IV, IM or transdermal. <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref> <ref name="pmid9205824">{{cite journal |vauthors=Golding JF, Stott JR |title=Comparison of the effects of a selective muscarinic receptor antagonist and hyoscine (scopolamine) on motion sickness, skin conductance and heart rate |journal=Br J Clin Pharmacol |volume=43 |issue=6 |pages=633–7 |date=June 1997 |pmid=9205824 |pmc=2042789 |doi=10.1046/j.1365-2125.1997.00606.x |url=}}</ref>
*Phenothiazines are antidopaminergics which are effective for migraine, motion sickness, vertigo, postoperative and chemotherapy induced nausea nd vomiting. Eg., Prochlorperazine, Promethazine, Chlorpromazine, Perphenazine 5–10 mg every 6–8 hours, 12.5 –25 mg every 4–6 hours, 10–25 mg every 4–6 hours, 4–8 mg every 8–12 hours Oral, IV or IM. <ref name="pmid16934536">{{cite journal |vauthors=Sanger GJ, Andrews PL |title=Treatment of nausea and vomiting: gaps in our knowledge |journal=Auton Neurosci |volume=129 |issue=1-2 |pages=3–16 |date=October 2006 |pmid=16934536 |doi=10.1016/j.autneu.2006.07.009 |url=}}</ref> <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref>
*Droperidol is a Butyrophenone and a restricted drug used for postoperative and chemotherapy induced nausea and vomiting, 0.625–1.25 mg every 24hours IM or IV <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref>
* Cannabinoids are used for chemotherapy induced nausea and vomiting. Eg., Dronabinol, Nabilone 2.5–10 mg every 6–8 hours, 1–2 mg every 8–12 hours oral. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid375088">{{cite journal |vauthors=Herman TS, Einhorn LH, Jones SE, Nagy C, Chester AB, Dean JC, Furnas B, Williams SD, Leigh SA, Dorr RT, Moon TE |title=Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy |journal=N Engl J Med |volume=300 |issue=23 |pages=1295–7 |date=June 1979 |pmid=375088 |doi=10.1056/NEJM197906073002302 |url=}}</ref>
* Corticosteroids are used for acute or delayed chemotherapy induced or postoperative nausea and vomiting. Eg., Dexamethasone 4–8 mg every 4–6 hours Oral, IM or IV. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid15190136">{{cite journal |vauthors=Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N |title=A factorial trial of six interventions for the prevention of postoperative nausea and vomiting |journal=N Engl J Med |volume=350 |issue=24 |pages=2441–51 |date=June 2004 |pmid=15190136 |pmc=1307533 |doi=10.1056/NEJMoa032196 |url=}}</ref>
* NK-1 Receptor Antagonist is used in acute as well as delayed chemotherapy-induced nausea and vomiting. It has also been used in gastroparesis-associated nausea and vomiting. Eg., Aprepitant 80–125 mg every 24 hours oral. <ref name="pmid18208572">{{cite journal |vauthors=Madsen JL, Fuglsang S |title=A randomized, placebo-controlled, crossover, double-blind trial of the NK1 receptor antagonist aprepitant on gastrointestinal motor function in healthy humans |journal=Aliment Pharmacol Ther |volume=27 |issue=7 |pages=609–15 |date=April 2008 |pmid=18208572 |doi=10.1111/j.1365-2036.2008.03618.x |url=}}</ref> <ref name="pmid19719336">{{cite journal |vauthors=Curran MP, Robinson DM |title=Aprepitant: a review of its use in the prevention of nausea and vomiting |journal=Drugs |volume=69 |issue=13 |pages=1853–78 |date=2009 |pmid=19719336 |doi=10.2165/11203680-000000000-00000 |url=}}</ref> <ref name="pmid19444262">{{cite journal |vauthors=Chong K, Dhatariya K |title=A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant |journal=Nat Rev Endocrinol |volume=5 |issue=5 |pages=285–8 |date=May 2009 |pmid=19444262 |doi=10.1038/nrendo.2009.50 |url=}}</ref>

===Prokinetics===
*Prokinetic agents are used for only prokinetic activity (eg, Erythromycin) or both prokinetic and antiemetic activity (eg, Benzamides like Metoclopramide and Domperidone are shown to be efficacious in chemotherapy induced vomiting and gastroparesis). Metoclopramide 10–20 mg every 6–8 hours Oral, IM or IV, Domperidone 10mg every 8–24 hours oral, Erythromycin 250–500mg every 8 hours oral or IV. <ref name="pmid23201066">{{cite journal |vauthors=Javid FA, Bulmer DC, Broad J, Aziz Q, Dukes GE, Sanger GJ |title=Anti-emetic and emetic effects of erythromycin in Suncus murinus: role of vagal nerve activation, gastric motility stimulation and motilin receptors |journal=Eur J Pharmacol |volume=699 |issue=1-3 |pages=48–54 |date=January 2013 |pmid=23201066 |doi=10.1016/j.ejphar.2012.11.035 |url=}}</ref> <ref name="pmid1612359">{{cite journal |vauthors=Tack J, Janssens J, Vantrappen G, Peeters T, Annese V, Depoortere I, Muls E, Bouillon R |title=Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis |journal=Gastroenterology |volume=103 |issue=1 |pages=72–9 |date=July 1992 |pmid=1612359 |doi=10.1016/0016-5085(92)91097-n |url=}}</ref>

===Miscellaneous therapy===
* Novel and non-traditional therapies for nausea and vomiting include Tricyclic antidepressants (TCAs), Gabapentin and Olanzapine. Gabapentin is shown effective in life-threatening refractory emesis following posterior fossa surgery. TCAs (Amitriptyline, Nortriptyline, Doxepin, Desipramine, Imipramine) 10–100 mg/day oral, Gabapentin 300–900 mg three times daily oral, Olanzapine 5–10 mg/day oral. <ref name="pmid9753257">{{cite journal |vauthors=Prakash C, Lustman PJ, Freedland KE, Clouse RE |title=Tricyclic antidepressants for functional nausea and vomiting: clinical outcome in 37 patients |journal=Dig Dis Sci |volume=43 |issue=9 |pages=1951–6 |date=September 1998 |pmid=9753257 |doi=10.1023/a:1018878324327 |url=}}</ref> <ref name="pmid24668130">{{cite journal |vauthors=Guttuso T |title=Gabapentin's anti-nausea and anti-emetic effects: a review |journal=Exp Brain Res |volume=232 |issue=8 |pages=2535–9 |date=August 2014 |pmid=24668130 |doi=10.1007/s00221-014-3905-1 |url=}}</ref> <ref name="pmid15796394">{{cite journal |vauthors=Guttuso T, Vitticore P, Holloway RG |title=Responsiveness of life-threatening refractory emesis to gabapentin-scopolamine therapy following posterior fossa surgery. Case report |journal=J Neurosurg |volume=102 |issue=3 |pages=547–9 |date=March 2005 |pmid=15796394 |doi=10.3171/jns.2005.102.3.0547 |url=}}</ref> <ref name="pmid15700131">{{cite journal |vauthors=Navari RM, Einhorn LH, Passik SD, Loehrer PJ, Johnson C, Mayer ML, McClean J, Vinson J, Pletcher W |title=A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: a Hoosier Oncology Group study |journal=Support Care Cancer |volume=13 |issue=7 |pages=529–34 |date=July 2005 |pmid=15700131 |doi=10.1007/s00520-004-0755-6 |url=}}</ref> <ref name="pmid15493359">{{cite journal |vauthors=Passik SD, Navari RM, Jung SH, Nagy C, Vinson J, Kirsh KL, Loehrer P |title=A phase I trial of olanzapine (Zyprexa) for the prevention of delayed emesis in cancer patients: a Hoosier Oncology Group study |journal=Cancer Invest |volume=22 |issue=3 |pages=383–8 |date=2004 |pmid=15493359 |doi=10.1081/cnv-200029066 |url=}}</ref>
* Ginger has some efficacy to reduce postoperative nausea and vomiting, morning sickness and motion sickness. <ref name="pmid10793599">{{cite journal |vauthors=Ernst E, Pittler MH |title=Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials |journal=Br J Anaesth |volume=84 |issue=3 |pages=367–71 |date=March 2000 |pmid=10793599 |doi=10.1093/oxfordjournals.bja.a013442 |url=}}</ref> <ref name="pmid12233808">{{cite journal |vauthors=Keating A, Chez RA |title=Ginger syrup as an antiemetic in early pregnancy |journal=Altern Ther Health Med |volume=8 |issue=5 |pages=89–91 |date=2002 |pmid=12233808 |doi= |url=}}</ref>
* Gastric electric stimulation(GES) is a surgical procedure used in refractory gastroparesis. <ref name="pmid19719511">{{cite journal |vauthors=McCallum RW, Dusing RW, Sarosiek I, Cocjin J, Forster J, Lin Z |title=Mechanisms of symptomatic improvement after gastric electrical stimulation in gastroparetic patients |journal=Neurogastroenterol Motil |volume=22 |issue=2 |pages=161–7, e50–1 |date=February 2010 |pmid=19719511 |doi=10.1111/j.1365-2982.2009.01389.x |url=}}</ref>
* Transcutaneous electrical nerve stimulation (TENS) with a wrist band is used to control symptoms postoperatively. <ref name="pmid32913634">{{cite journal |vauthors=Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H |title=Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review |journal=F1000Res |volume=9 |issue= |pages= |date=2020 |pmid=32913634 |pmc=7429924 |doi=10.12688/f1000research.21832.1 |url=}}</ref>
* Alternative approaches include hypnosis, acupressure and acupuncture. <ref name="pmid10971166">{{cite journal |vauthors=Marchioro G, Azzarello G, Viviani F, Barbato F, Pavanetto M, Rosetti F, Pappagallo GL, Vinante O |title=Hypnosis in the treatment of anticipatory nausea and vomiting in patients receiving cancer chemotherapy |journal=Oncology |volume=59 |issue=2 |pages=100–4 |date=August 2000 |pmid=10971166 |doi=10.1159/000012144 |url=}}</ref> <ref name="pmid19370583">{{cite journal |vauthors=Lee A, Fan LT |title=Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD003281 |date=April 2009 |pmid=19370583 |pmc=3113464 |doi=10.1002/14651858.CD003281.pub3 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs overview]]

Nausea and vomiting other diagnostic studies

2021-01-21T02:55:08Z

Tayebah Chaudhry: /* Other Diagnostic Studies */

__NOTOC__
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{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}}
==Overview==
== Other Diagnostic Studies ==
* [[Endoscopy]]
* [[Colonoscopy]]
* [[GI]] [[motility]] testing
*[[Psychological]] evaluation

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting ultrasound

2021-01-21T02:53:59Z

Tayebah Chaudhry: /* Echocariography or Ultrasound */

__NOTOC__
{{Nausea and vomiting}}
==Overview==
==Echocariography or Ultrasound==
[[Abdominal]] [[ultrasound]] is useful in [[GI]] causes.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting MRI

2021-01-21T02:53:12Z

Tayebah Chaudhry: /* MRI */

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{{Nausea and vomiting}}
==Overview==
==MRI==
[[MRI]] to rule out [[brain]] [[lesions]]

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting x ray

2021-01-21T02:52:42Z

Tayebah Chaudhry: /* X-ray */

__NOTOC__

{{Nausea and vomiting}}
==Overview==
==X-ray==
[[Xray]]s of [[abdomen]] and [[brain]] including plain xrays or [[barium]] xrays of [[GI tract]].

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]
[[Category:Needs overview]]

Nausea and vomiting CT

2021-01-21T02:50:56Z

Tayebah Chaudhry: /* CT */

__NOTOC__
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{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}}
==Overview==
==CT==
* Abdominal [[CT scan]] (with [[oral]] and [[IV]] [[contrast]])
* [[Head]] [[CT scan]]

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting x ray

2021-01-21T02:50:12Z

Tayebah Chaudhry: /* X-ray */

__NOTOC__

{{Nausea and vomiting}}
==Overview==
==X-ray==
[[Xray]]s of [[GI tract]], [[abdomen]] or [[brain]] including plain xrays or [[barium]] xrays.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]
[[Category:Needs overview]]

Nausea and vomiting electrocardiogram

2021-01-21T02:49:10Z

Tayebah Chaudhry: /* Electrocardiogram */

__NOTOC__

{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}}
==Overview==

==Electrocardiogram==
[[ECG]] is done to rule out an inferior [[MI]] or [[arrhythmia]].

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting laboratory findings

2021-01-21T02:48:26Z

Tayebah Chaudhry: /* Laboratory Findings */

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{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}}
==Overview==
== Laboratory Findings ==
Following lab tests should be performed to to establish [[etiology]]. Findings on these tests depend on the underlying cause. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* [[Complete blood count]] ([[CBC]])
* [[Electrolytes]]
* [[Liver function tests]] ([[LFTs]])
* [[Amylase]]
* [[Lipase]]
* [[Calcium]]
* [[Magnesium]]
* [[Salicylate]] level
* [[Hepatitis]] [[serology]]
* [[Cerebrospinal fluid]] ([[CSF]]) analysis
* [[Toxicology]] screen
* [[Pregnancy test]] where applicable

=== Electrolyte and Biomarker Studies ===
* [[Electrolytes]]
* [[Biomarkers]] to rule out [[tumors]]

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]
[[Category:Needs overview]]

Nausea and vomiting physical examination

2021-01-21T02:46:19Z

Tayebah Chaudhry: /* Physical Examination */

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{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}}
==Overview==
== Physical Examination ==
Exam should include:
*general exam including any [[signs]] of [[dehydration]] and [[skin]] changes
*[[head]] and [[neck]] exam
*[[ENT]] exam
*[[eye]] exam
*[[abdominal]] exam
*[[neurological]] exam
*[[teeth]] exam

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting history and symptoms

2021-01-21T02:43:36Z

Tayebah Chaudhry: /* Symptoms */

__NOTOC__
{{Nausea and vomiting}}
Please help WikiDoc by adding more content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.

{{CMG}}
==Overview==

==History and symptoms==
===History===
* [[Onset]] ([[acute]] [[onset]] likely in [[drugs]], [[toxins]] and [[infections]]), duration and frequency
* Long standing history (points to [[chronic]] illness)
* Timing of [[nausea]] and [[vomiting]] after eating (may indicate site of [[obstruction]] in [[gut]])
* Associated [[symptoms]] ([[abdominal pain]], [[fever]], [[diarrhea]], or [[headache]])
* Content and color of [[vomitus]]
* Presence of any [[blood]] or [[coffee ground]] content in the [[vomitus]]
* [[Projectile vomiting]] (indicating increased [[intracranial pressure]])
* History of weight loss
* History of recent travel
* History of medication intake
* Symptoms in [[close contacts]] or people eating at the same place as the patient
* History of [[pregnancy]]

===Symptoms===
*[[discomfort]] in [[chest]], [[abdomen]] or [[throat]]
*[[cold sweats]]
*[[headache]]
*[[sleepiness]]
*[[yawning]]
*loss of [[appetite]]
*increased [[salivation]]
*[[tiredness]]
*[[fever]]
*[[diarrhea]]
*[[indigestion]]
*inability to walk
*[[weight loss]]
*[[dizziness]]
*[[vertigo]]
*[[anxiety]], [[depression]] or [[eating problems]]

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting history and symptoms

2021-01-21T02:41:50Z

Tayebah Chaudhry: /* History */

__NOTOC__
{{Nausea and vomiting}}
Please help WikiDoc by adding more content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.

{{CMG}}
==Overview==

==History and symptoms==
===History===
* [[Onset]] ([[acute]] [[onset]] likely in [[drugs]], [[toxins]] and [[infections]]), duration and frequency
* Long standing history (points to [[chronic]] illness)
* Timing of [[nausea]] and [[vomiting]] after eating (may indicate site of [[obstruction]] in [[gut]])
* Associated [[symptoms]] ([[abdominal pain]], [[fever]], [[diarrhea]], or [[headache]])
* Content and color of [[vomitus]]
* Presence of any [[blood]] or [[coffee ground]] content in the [[vomitus]]
* [[Projectile vomiting]] (indicating increased [[intracranial pressure]])
* History of weight loss
* History of recent travel
* History of medication intake
* Symptoms in [[close contacts]] or people eating at the same place as the patient
* History of [[pregnancy]]

===Symptoms===
*discomfort in chest, abdomen or throat
*cold sweats
*headache
*sleepiness
*yawning
*loss of appetite
*increased salivation
*tiredness
*fever
*diarrhea
*indigestion
*inability to walk
*weight loss
*dizziness
*vertigo
*anxiety, depression or eating problems

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting natural history, complications and prognosis

2021-01-21T02:39:04Z

Tayebah Chaudhry: /* Prognosis */

__NOTOC__

{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}}
==Overview==
==Natural history, complications and prognosis==
===Natural history===
* Nausea starts as an urge of [[vomiting]]. There is a diffuse sensation of unease and [[discomfort]] (often described as feeling sick or queasy feeling). Discomfort in [[chest]], upper [[abdomen]] or back of [[throat]] might be present. It is often accompanied by excessive [[salivation]]. If vomiting follows, there is [[involuntary]] expulsion of [[stomach]] contents through mouth and sometimes nose. If nausea and vomiting are left untreated, the general feeing of distress can progress to life threatening complications.

===Complications===
*[[aspiration]] of [[gastric]] content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>
*[[dehydration]] <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*[[electrolyte imbalance]] leading to [[metabolic alkalosis]] (increased blood [[pH]]), showing [[hypokalemia]] and [[hypochloremia]] <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref> <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[cachexia]] due to loss of intake of food <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*[[antepartum]] [[hemorrhage]] of indeterminate origin in early pregnancy <ref name="pmid2599251">{{cite journal |vauthors=Chin RK |title=Antenatal complications and perinatal outcome in patients with nausea and vomiting-complicated pregnancy |journal=Eur J Obstet Gynecol Reprod Biol |volume=33 |issue=3 |pages=215–9 |date=December 1989 |pmid=2599251 |doi=10.1016/0028-2243(89)90132-9 |url=}}</ref>
*[[callus]] formation and [[abrasions]] on [[skin]] of hands in case of self induced [[vomiting]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*pressure on [[ear]], [[nose]] and [[eyes]] sometimes leading to [[subconjunctival]] [[hemorrhage]] and [[nose bleed]]s due to prolonged [[retching]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[dental]] [[erosion]], [[discoloration]] and [[sensitivity]] of teeth, [[gum]] disease due to [[acidic]] [[gastric]] content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*cracking of corners of [[lips]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* [[mucositis]] of [[hard palate]] and [[throat]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[hoarseness]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[salivary gland]] enlargement and [[parotid]] gland [[hypertrophy]] in [[bulimic]]s <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

*[[GERD]] in case of frequent [[vomiting]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[Mallory-Weiss tear]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* [[Boerhaauve's syndrome]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*elevated [[amylase]] level in case of repeated vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

* [[Cardiovascular]] symptoms including [[hypotention]], [[sinus tachycardia]], [[arrythmias]] and [[orthostasis]] in [[bulimic]] patients <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

===Prognosis===
[[Prognosis]] for [[nausea]] and [[vomiting]] depends on the [[underlying cause]].

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]
[[Category:Needs overview]]

Nausea and vomiting natural history, complications and prognosis

2021-01-21T02:38:26Z

Tayebah Chaudhry: /* Complications */

__NOTOC__

{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}}
==Overview==
==Natural history, complications and prognosis==
===Natural history===
* Nausea starts as an urge of [[vomiting]]. There is a diffuse sensation of unease and [[discomfort]] (often described as feeling sick or queasy feeling). Discomfort in [[chest]], upper [[abdomen]] or back of [[throat]] might be present. It is often accompanied by excessive [[salivation]]. If vomiting follows, there is [[involuntary]] expulsion of [[stomach]] contents through mouth and sometimes nose. If nausea and vomiting are left untreated, the general feeing of distress can progress to life threatening complications.

===Complications===
*[[aspiration]] of [[gastric]] content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>
*[[dehydration]] <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*[[electrolyte imbalance]] leading to [[metabolic alkalosis]] (increased blood [[pH]]), showing [[hypokalemia]] and [[hypochloremia]] <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref> <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[cachexia]] due to loss of intake of food <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*[[antepartum]] [[hemorrhage]] of indeterminate origin in early pregnancy <ref name="pmid2599251">{{cite journal |vauthors=Chin RK |title=Antenatal complications and perinatal outcome in patients with nausea and vomiting-complicated pregnancy |journal=Eur J Obstet Gynecol Reprod Biol |volume=33 |issue=3 |pages=215–9 |date=December 1989 |pmid=2599251 |doi=10.1016/0028-2243(89)90132-9 |url=}}</ref>
*[[callus]] formation and [[abrasions]] on [[skin]] of hands in case of self induced [[vomiting]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*pressure on [[ear]], [[nose]] and [[eyes]] sometimes leading to [[subconjunctival]] [[hemorrhage]] and [[nose bleed]]s due to prolonged [[retching]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[dental]] [[erosion]], [[discoloration]] and [[sensitivity]] of teeth, [[gum]] disease due to [[acidic]] [[gastric]] content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*cracking of corners of [[lips]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* [[mucositis]] of [[hard palate]] and [[throat]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[hoarseness]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[salivary gland]] enlargement and [[parotid]] gland [[hypertrophy]] in [[bulimic]]s <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

*[[GERD]] in case of frequent [[vomiting]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[Mallory-Weiss tear]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* [[Boerhaauve's syndrome]] <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*elevated [[amylase]] level in case of repeated vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

* [[Cardiovascular]] symptoms including [[hypotention]], [[sinus tachycardia]], [[arrythmias]] and [[orthostasis]] in [[bulimic]] patients <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

===Prognosis===
Prognosis for nausea and vomiting depends on the underlying cause.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]
[[Category:Needs overview]]

Nausea and vomiting natural history, complications and prognosis

2021-01-21T02:32:53Z

Tayebah Chaudhry: /* Natural history */

__NOTOC__

{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}}
==Overview==
==Natural history, complications and prognosis==
===Natural history===
* Nausea starts as an urge of [[vomiting]]. There is a diffuse sensation of unease and [[discomfort]] (often described as feeling sick or queasy feeling). Discomfort in [[chest]], upper [[abdomen]] or back of [[throat]] might be present. It is often accompanied by excessive [[salivation]]. If vomiting follows, there is [[involuntary]] expulsion of [[stomach]] contents through mouth and sometimes nose. If nausea and vomiting are left untreated, the general feeing of distress can progress to life threatening complications.

===Complications===
*aspiration of gastric content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>
*dehydration <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*electrolyte imbalance leading to [[metabolic alkalosis]] (increased blood [[pH]]), showing [[hypokalemia]] and [[hypochloremia]] <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref> <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[cachexia]] due to loss of intake of food <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*antepartum hemorrhage of indeterminate origin in early pregnancy <ref name="pmid2599251">{{cite journal |vauthors=Chin RK |title=Antenatal complications and perinatal outcome in patients with nausea and vomiting-complicated pregnancy |journal=Eur J Obstet Gynecol Reprod Biol |volume=33 |issue=3 |pages=215–9 |date=December 1989 |pmid=2599251 |doi=10.1016/0028-2243(89)90132-9 |url=}}</ref>
*[[callus]] formation and [[abrasions]] on skin of hands in case of self induced vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*pressure on ear, nose and eyes sometimes leading to [[subconjunctival]] [[hemorrhage]] and nose bleeds due to prolonged retching <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*dental [[erosion]], discoloration and sensitivity of teeth, gum disease due to acidic gastric content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*cracking of corners of lips <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* mucositis of hard palate and throat <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*hoarseness <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*salivary gland enlargement and parotid gland hypertrophy in bulimics <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

*GERD in case of frequent vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*Mallory-Weiss tear <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* Boerhaauve's syndrome <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*elevated amylase level in case of repeated vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

* Cardiovascular symptoms including hypotention, sinus tachycardia, arrythmias and orthostasis in bulimic patients <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*

===Prognosis===
Prognosis for nausea and vomiting depends on the underlying cause.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]
[[Category:Needs overview]]

Nausea and vomiting risk factors

2021-01-21T02:30:50Z

Tayebah Chaudhry: /* Risk factors */

__NOTOC__
{{Nausea and vomiting}}
==Overview==
==Risk factors==
*Risk factors for [[nausea]] and [[vomiting]] vary with underlying cause.

*Well established [[risk factors]] for [[postoperative]] nausea and vomiting include: <ref name="pmid16717343">{{cite journal |vauthors=Gan TJ |title=Risk factors for postoperative nausea and vomiting |journal=Anesth Analg |volume=102 |issue=6 |pages=1884–98 |date=June 2006 |pmid=16717343 |doi=10.1213/01.ANE.0000219597.16143.4D |url=}}</ref>
** female gender post [[puberty]]
** nonsmoking status
** history of postoperative nausea and vomiting
** history of [[motion sickness]]
** childhood after [[infancy]] and younger adulthood
** increasing duration of surgery
** use of volatile [[anesthetics]], [[nitrous oxide]], large-dose [[neostigmine]], or [[intraoperative]] or [[postoperative]] [[opioids]]
* Possible risk factors for postoperative nausea and vomiting include: <ref name="pmid16717343">{{cite journal |vauthors=Gan TJ |title=Risk factors for postoperative nausea and vomiting |journal=Anesth Analg |volume=102 |issue=6 |pages=1884–98 |date=June 2006 |pmid=16717343 |doi=10.1213/01.ANE.0000219597.16143.4D |url=}}</ref>
** history of [[migraine]]
** history of postoperative nausea and vomiting or [[motion sickness]] in a child's parent or sibling
** intense preoperative [[anxiety]]
** certain ethnicities or surgery types
** decreased [[perioperative]] fluids
** [[crystalloid]] versus [[colloid]] administration
** increasing duration of [[anesthesia]]
** general versus regional [[anesthesia]] or [[sedation]]
** balanced versus total IV anesthesia
** use of longer-acting versus shorter-acting [[opioids]]

* Risk factors for nausea and vomiting in [[pregnancy]] include: <ref name="pmid16879499">{{cite journal |vauthors=Louik C, Hernandez-Diaz S, Werler MM, Mitchell AA |title=Nausea and vomiting in pregnancy: maternal characteristics and risk factors |journal=Paediatr Perinat Epidemiol |volume=20 |issue=4 |pages=270–8 |date=July 2006 |pmid=16879499 |doi=10.1111/j.1365-3016.2006.00723.x |url=}}</ref>
** increased number of prior [[miscarriage]]s
** increased [[gravidity]]
** risk decreased with increasing age
** [[twin]] births
** Increased risk of nausea and vomiting after [[first trimester]] is seen in women who are less well educated, have lower incomes, and more likely in black women.

*Risk factors for [[chemotherapy]] induced nausea and vomiting: <ref name="pmid23480814">{{cite journal |vauthors=Sekine I, Segawa Y, Kubota K, Saeki T |title=Risk factors of chemotherapy-induced nausea and vomiting: index for personalized antiemetic prophylaxis |journal=Cancer Sci |volume=104 |issue=6 |pages=711–7 |date=June 2013 |pmid=23480814 |pmc=7657206 |doi=10.1111/cas.12146 |url=}}</ref> <ref name="HeskethAapro2009">{{cite journal|last1=Hesketh|first1=Paul J.|last2=Aapro|first2=Matti|last3=Street|first3=James C.|last4=Carides|first4=Alexandra D.|title=Evaluation of risk factors predictive of nausea and vomiting with current standard-of-care antiemetic treatment: analysis of two phase III trials of aprepitant in patients receiving cisplatin-based chemotherapy|journal=Supportive Care in Cancer|volume=18|issue=9|year=2009|pages=1171–1177|issn=0941-4355|doi=10.1007/s00520-009-0737-9}}</ref>
** age less than 50 years
** female gender
** history of [[nausea]] and [[vomiting]] or [[motion sickness]]
** type of [[antineoplastic]] agent and how it is used

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting epidemiology and demographics

2021-01-21T02:24:56Z

Tayebah Chaudhry: /* Epidemiology and demographics */

__NOTOC__
{{Nausea and vomiting}}
==Overview==
==Epidemiology and demographics==
*In [[population studies]], at least one episode of [[nausea]] was reported in more than 50% of adults, and one episode of [[vomiting]] in more than 30% of adults within the preceding 12 months, with nausea seen more in women than men. <ref name="urlMechanisms and Control of Emesis: A Satellite Symposium of the European ... - Google Books">{{cite web |url=https://books.google.com/books?hl=en&lr=&id=vb3G_22QLI0C&oi=fnd&pg=PR5&ots=p93_bbQgbu&sig=J1lrOOLtvbICmdF_6qNiHaFZLrs#v=onepage&q&f=false |title=Mechanisms and Control of Emesis: A Satellite Symposium of the European ... - Google Books |format= |work= |accessdate=}}</ref> <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
*A significant [[psychological]] and economic impact of nausea and vomiting is seen with an estimated economic burden of $4-16 billion on US economy. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
*Only 25% of people with acute symptoms of nausea and vomiting seek medical help. <ref name="pmid17885699">{{cite journal |vauthors=Metz A, Hebbard G |title=Nausea and vomiting in adults--a diagnostic approach |journal=Aust Fam Physician |volume=36 |issue=9 |pages=688–92 |date=September 2007 |pmid=17885699 |doi= |url=}}</ref>

===Incidence===
*[[Incidence]] of nausea and vomiting varies with the underlying cause.
*Nausea and vomiting of pregnancy effects 70% to 80% of all pregnant women. <ref name="pmid21601782">{{cite journal |vauthors=Lee NM, Saha S |title=Nausea and vomiting of pregnancy |journal=Gastroenterol Clin North Am |volume=40 |issue=2 |pages=309–34, vii |date=June 2011 |pmid=21601782 |pmc=3676933 |doi=10.1016/j.gtc.2011.03.009 |url=}}</ref>
*Approximately 40% of patients experience nausea and 15%-25% patients experience vomiting with [[opioid]] use. <ref name="pmid29131554">{{cite journal |vauthors=Mallick-Searle T, Fillman M |title=The pathophysiology, incidence, impact, and treatment of opioid-induced nausea and vomiting |journal=J Am Assoc Nurse Pract |volume=29 |issue=11 |pages=704–710 |date=November 2017 |pmid=29131554 |doi=10.1002/2327-6924.12532 |url=}}</ref>
* Incidence of [[postoperative]] nausea and vomiting varies from 8%-92%. <ref name="pmid29131554">{{cite journal |vauthors=Mallick-Searle T, Fillman M |title=The pathophysiology, incidence, impact, and treatment of opioid-induced nausea and vomiting |journal=J Am Assoc Nurse Pract |volume=29 |issue=11 |pages=704–710 |date=November 2017 |pmid=29131554 |doi=10.1002/2327-6924.12532 |url=}}</ref>

===Prevalence===
*In population studies, at least one episode of nausea was reported in more than 50% of adults, and one episode of vomiting in more than 30% of adults within the preceding 12 months, with nausea seen more in women than men. <ref name="urlMechanisms and Control of Emesis: A Satellite Symposium of the European ... - Google Books">{{cite web |url=https://books.google.com/books?hl=en&lr=&id=vb3G_22QLI0C&oi=fnd&pg=PR5&ots=p93_bbQgbu&sig=J1lrOOLtvbICmdF_6qNiHaFZLrs#v=onepage&q&f=false |title=Mechanisms and Control of Emesis: A Satellite Symposium of the European ... - Google Books |format= |work= |accessdate=}}</ref>
*Only 25% of people with acute symptoms of nausea and vomiting seek medical help. <ref name="pmid17885699">{{cite journal |vauthors=Metz A, Hebbard G |title=Nausea and vomiting in adults--a diagnostic approach |journal=Aust Fam Physician |volume=36 |issue=9 |pages=688–92 |date=September 2007 |pmid=17885699 |doi= |url=}}</ref>
* The exact [[prevalence]] of [[idiopathic]] [[nausea]] and [[vomiting]] is not known. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>

===Age===
* In a study of patients with nausea and vomiting in Australia, between April 2000 and March 2006. vomiting was more often presented in children aged <15 years and decreased steadily with age. <ref name="pmid17885697">{{cite journal |vauthors=Britt H, Fahridin S |title=Presentations of nausea and vomiting |journal=Aust Fam Physician |volume=36 |issue=9 |pages=682–3 |date=September 2007 |pmid=17885697 |doi= |url=}}</ref>
* Nausea was more often presented in age 15-25 years and less frequently in all other age groups.

===Race===
*White/African-Americans experience less nausea than Asian/Asian-American subjects. <ref name="pmid8216144">{{cite journal |vauthors=Stern RM, Hu S, LeBlanc R, Koch KL |title=Chinese hyper-susceptibility to vection-induced motion sickness |journal=Aviat Space Environ Med |volume=64 |issue=9 Pt 1 |pages=827–30 |date=September 1993 |pmid=8216144 |doi= |url=}}</ref> <ref name="pmid8825456">{{cite journal |vauthors=Stern RM, Hu S, Uijtdehaage SH, Muth ER, Xu LH, Koch KL |title=Asian hypersusceptibility to motion sickness |journal=Hum Hered |volume=46 |issue=1 |pages=7–14 |date=1996 |pmid=8825456 |doi=10.1159/000154318 |url=}}</ref>

===Gender===
* [[Prevalence]] of nausea is more in females than males. <ref name="pmid11869741">{{cite journal |vauthors=Haug TT, Mykletun A, Dahl AA |title=The prevalence of nausea in the community: psychological, social and somatic factors |journal=Gen Hosp Psychiatry |volume=24 |issue=2 |pages=81–6 |date=2002 |pmid=11869741 |doi=10.1016/s0163-8343(01)00184-0 |url=}}</ref>
* Nausea and vomiting associated with [[gastroenteritis]] is significantly more in males than in females. <ref name="pmid17885697">{{cite journal |vauthors=Britt H, Fahridin S |title=Presentations of nausea and vomiting |journal=Aust Fam Physician |volume=36 |issue=9 |pages=682–3 |date=September 2007 |pmid=17885697 |doi= |url=}}</ref>
* Undiagnosed cases of nausea and vomiting are more commonly seen in females than males. <ref name="pmid17885697">{{cite journal |vauthors=Britt H, Fahridin S |title=Presentations of nausea and vomiting |journal=Aust Fam Physician |volume=36 |issue=9 |pages=682–3 |date=September 2007 |pmid=17885697 |doi= |url=}}</ref>

===Developed Countries===
* In a study, nausea and vomiting was reported more commonly by less educated pregnant females (hence less common in developed countries due to high literacy rate) <ref name="pmid16879499">{{cite journal |vauthors=Louik C, Hernandez-Diaz S, Werler MM, Mitchell AA |title=Nausea and vomiting in pregnancy: maternal characteristics and risk factors |journal=Paediatr Perinat Epidemiol |volume=20 |issue=4 |pages=270–8 |date=July 2006 |pmid=16879499 |doi=10.1111/j.1365-3016.2006.00723.x |url=}}</ref>

===Developing Countries===
* Developing countries may have more cases of nausea and vomiting due to low literacy and low socioeconomic status according to a study that involved cases of [[nausea]] and [[vomiting]] in pregnant females. <ref name="pmid16879499">{{cite journal |vauthors=Louik C, Hernandez-Diaz S, Werler MM, Mitchell AA |title=Nausea and vomiting in pregnancy: maternal characteristics and risk factors |journal=Paediatr Perinat Epidemiol |volume=20 |issue=4 |pages=270–8 |date=July 2006 |pmid=16879499 |doi=10.1111/j.1365-3016.2006.00723.x |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting

2021-01-18T08:59:07Z

Tayebah Chaudhry:

__NOTOC__
'''For patient information, click [[Nausea and vomiting (patient information)|here]]'''
{{Nausea and Vomiting}}
{{CMG}}; {{AE}} [[User:Tayebah Chaudhry|Tayebah Chaudhry]][mailto:dr.thch@yahoo.com]; '''Associate Editor-In-Chief:''' {{MUT}}

'''''Synonyms and Keywords:''''' Emesis

==[[Nausea and vomiting overview|Overview]]==

==[[Nausea and vomiting historical perspective|Historical Perspective]]==

==[[Nausea and vomiting classification|Classification]]==

==[[Nausea and vomiting pathophysiology|Pathophysiology]]==

==[[Nausea and vomiting causes|Causes]]==

==[[Nausea and vomiting differential diagnosis|Differentiating Nausea and Vomiting from other Conditions]]==

==[[Nausea and vomiting epidemiology and demographics|Epidemiology and Demographics]]==

==[[Nausea and vomiting risk factors|Risk Factors]]==

==[[Nausea and vomiting natural history, complications and prognosis|Natural History, Complications and Prognosis]]==

==Diagnosis==
[[Nausea and vomiting history and symptoms|History and Symptoms]] | [[Nausea and vomiting physical examination|Physical Examination]] | [[Nausea and vomiting laboratory findings|Laboratory Findings]] | [[Nausea and vomiting electrocardiogram|Electrocardiogram]] | [[Nausea and vomiting x ray|X Ray]] | [[Nausea and vomiting CT|CT]] | [[Nausea and vomiting MRI|MRI]] | [[Nausea and vomiting echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Nausea and vomiting other imaging findings|Other Imaging Findings]] | [[Nausea and vomiting other diagnostic studies|Other Diagnostic Studies]]

==Treatment==
[[Nausea and vomiting medical therapy|Medical Therapy]] | [[Nausea and vomiting surgery|Surgery]] | [[Nausea and vomiting primary prevention|Primary Prevention]] | [[Nausea and vomiting secondary prevention|Secondary Prevention]] | [[Nausea and vomiting cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Nausea and vomiting future or investigational therapies|Future or Investigational Therapies]]

==Case Studies==

[[Nausea and vomiting case study one|Case #1]]

{{Gastroenterology}}
[[es:Vómito]]
[[fr:Vomissement]]
[[ja:嘔吐]]
[[pt:Emese]]
[[pl:Wymioty]]
[[ru:Рвота]]
[[zh:呕吐]]
[[es:Náusea]]
[[fr:Nausée (médecine)]]
[[ja:吐き気]]
[[pl:Nudności]]
[[pt:Náusea]]
[[tr:Bulantı]]

{{WH}}
{{WS}}

[[Category:Symptoms]]
[[Category:Signs and symptoms]]
[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]

Nausea and vomiting natural history, complications and prognosis

2021-01-18T08:52:24Z

Tayebah Chaudhry: /* Natural history */

__NOTOC__

{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}}
==Overview==
==Natural history, complications and prognosis==
===Natural history===
* Nausea starts as an urge of vomiting. There is a diffuse sensation of unease and discomfort (often described as feeling sick or queasy feeling). Discomfort in chest, upper abdomen or back of throat might be present. It is often accompanied by excessive salivation. If vomiting follows, there is involuntary expulsion of stomach contents through mouth and sometimes nose. If nausea and vomiting are left untreated, the general feeing of distress can progress to life threatening complications.

===Complications===
*aspiration of gastric content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>
*dehydration <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*electrolyte imbalance leading to [[metabolic alkalosis]] (increased blood [[pH]]), showing [[hypokalemia]] and [[hypochloremia]] <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref> <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[cachexia]] due to loss of intake of food <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*antepartum hemorrhage of indeterminate origin in early pregnancy <ref name="pmid2599251">{{cite journal |vauthors=Chin RK |title=Antenatal complications and perinatal outcome in patients with nausea and vomiting-complicated pregnancy |journal=Eur J Obstet Gynecol Reprod Biol |volume=33 |issue=3 |pages=215–9 |date=December 1989 |pmid=2599251 |doi=10.1016/0028-2243(89)90132-9 |url=}}</ref>
*[[callus]] formation and [[abrasions]] on skin of hands in case of self induced vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*pressure on ear, nose and eyes sometimes leading to [[subconjunctival]] [[hemorrhage]] and nose bleeds due to prolonged retching <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*dental [[erosion]], discoloration and sensitivity of teeth, gum disease due to acidic gastric content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*cracking of corners of lips <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* mucositis of hard palate and throat <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*hoarseness <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*salivary gland enlargement and parotid gland hypertrophy in bulimics <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

*GERD in case of frequent vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*Mallory-Weiss tear <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* Boerhaauve's syndrome <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*elevated amylase level in case of repeated vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

* Cardiovascular symptoms including hypotention, sinus tachycardia, arrythmias and orthostasis in bulimic patients <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*

===Prognosis===
Prognosis for nausea and vomiting depends on the underlying cause.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]
[[Category:Needs overview]]

Nausea and vomiting natural history, complications and prognosis

2021-01-18T08:48:18Z

Tayebah Chaudhry: /* Natural history */

__NOTOC__

{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}}
==Overview==
==Natural history, complications and prognosis==
===Natural history===
* Nausea starts as an urge of vomiting. There is a diffuse sensation of unease and discomfort (often described as feeling sick or queasy feeling). Discomfort in chest, upper abdomen or back of throat might be present. It is often accompanied by excessive salivation. If vomiting follows, there is involuntary expulsion of stomach contents through mouth and sometimes nose.

===Complications===
*aspiration of gastric content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>
*dehydration <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*electrolyte imbalance leading to [[metabolic alkalosis]] (increased blood [[pH]]), showing [[hypokalemia]] and [[hypochloremia]] <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref> <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[cachexia]] due to loss of intake of food <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*antepartum hemorrhage of indeterminate origin in early pregnancy <ref name="pmid2599251">{{cite journal |vauthors=Chin RK |title=Antenatal complications and perinatal outcome in patients with nausea and vomiting-complicated pregnancy |journal=Eur J Obstet Gynecol Reprod Biol |volume=33 |issue=3 |pages=215–9 |date=December 1989 |pmid=2599251 |doi=10.1016/0028-2243(89)90132-9 |url=}}</ref>
*[[callus]] formation and [[abrasions]] on skin of hands in case of self induced vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*pressure on ear, nose and eyes sometimes leading to [[subconjunctival]] [[hemorrhage]] and nose bleeds due to prolonged retching <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*dental [[erosion]], discoloration and sensitivity of teeth, gum disease due to acidic gastric content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*cracking of corners of lips <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* mucositis of hard palate and throat <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*hoarseness <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*salivary gland enlargement and parotid gland hypertrophy in bulimics <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

*GERD in case of frequent vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*Mallory-Weiss tear <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* Boerhaauve's syndrome <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*elevated amylase level in case of repeated vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

* Cardiovascular symptoms including hypotention, sinus tachycardia, arrythmias and orthostasis in bulimic patients <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*

===Prognosis===
Prognosis for nausea and vomiting depends on the underlying cause.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]
[[Category:Needs overview]]

Nausea and vomiting history and symptoms

2021-01-18T08:41:11Z

Tayebah Chaudhry: /* Symptoms */

__NOTOC__
{{Nausea and vomiting}}
Please help WikiDoc by adding more content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.

{{CMG}}
==Overview==

==History and symptoms==
===History===
* Onset (acute onset likely in drugs, toxins and infections), duration and frequency
* Long standing history (points to chronic illness)
* Timing of nausea and vomiting after eating (may indicate site of obstruction in gut)
* Associated symptoms ([[abdominal pain]], [[fever]], [[diarrhea]], or [[headache]])
* Content and color of vomitus
* Presence of any [[blood]] or coffee ground content in the vomitus
* Projectile vomiting (indicating increased intracranial pressure)
* History of weight loss
* History of recent travel
* History of medication intake
* Symptoms in close contacts or people eating at the same place as the patient
* History of pregnancy

===Symptoms===
*discomfort in chest, abdomen or throat
*cold sweats
*headache
*sleepiness
*yawning
*loss of appetite
*increased salivation
*tiredness
*fever
*diarrhea
*indigestion
*inability to walk
*weight loss
*dizziness
*vertigo
*anxiety, depression or eating problems

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting natural history, complications and prognosis

2021-01-18T08:39:27Z

Tayebah Chaudhry: /* Natural history */

__NOTOC__

{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}}
==Overview==
==Natural history, complications and prognosis==
===Natural history===
* Nausea is the urge of vomiting. It starts as a diffuse sensation of unease and discomfort (often described as feeling sick or queasy feeling). There is a discomfort in chest, upper abdomen or back of throat. It could be accompanied by excessive salivation and flushing.

===Complications===
*aspiration of gastric content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>
*dehydration <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*electrolyte imbalance leading to [[metabolic alkalosis]] (increased blood [[pH]]), showing [[hypokalemia]] and [[hypochloremia]] <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref> <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*[[cachexia]] due to loss of intake of food <ref name="pmid29277090">{{cite journal |vauthors=Kim GH, Jung KW |title=[Vomiting] |language=Korean |journal=Korean J Gastroenterol |volume=70 |issue=6 |pages=283–287 |date=December 2017 |pmid=29277090 |doi=10.4166/kjg.2017.70.6.283 |url=}}</ref>
*antepartum hemorrhage of indeterminate origin in early pregnancy <ref name="pmid2599251">{{cite journal |vauthors=Chin RK |title=Antenatal complications and perinatal outcome in patients with nausea and vomiting-complicated pregnancy |journal=Eur J Obstet Gynecol Reprod Biol |volume=33 |issue=3 |pages=215–9 |date=December 1989 |pmid=2599251 |doi=10.1016/0028-2243(89)90132-9 |url=}}</ref>
*[[callus]] formation and [[abrasions]] on skin of hands in case of self induced vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*pressure on ear, nose and eyes sometimes leading to [[subconjunctival]] [[hemorrhage]] and nose bleeds due to prolonged retching <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*dental [[erosion]], discoloration and sensitivity of teeth, gum disease due to acidic gastric content <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*cracking of corners of lips <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* mucositis of hard palate and throat <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*hoarseness <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*salivary gland enlargement and parotid gland hypertrophy in bulimics <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

*GERD in case of frequent vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*Mallory-Weiss tear <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

* Boerhaauve's syndrome <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*elevated amylase level in case of repeated vomiting <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref> <ref name="pmid10356637">{{cite journal |vauthors=Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC |title=Salivary gland enlargement and elevated serum amylase in bulimia nervosa |journal=Biol Psychiatry |volume=45 |issue=11 |pages=1520–2 |date=June 1999 |pmid=10356637 |doi=10.1016/s0006-3223(98)00221-2 |url=}}</ref>

* Cardiovascular symptoms including hypotention, sinus tachycardia, arrythmias and orthostasis in bulimic patients <ref name="BrownMehler2013">{{cite journal|last1=Brown|first1=Carrie A.|last2=Mehler|first2=Philip S.|title=Medical Complications of Self-Induced Vomiting|journal=Eating Disorders|volume=21|issue=4|year=2013|pages=287–294|issn=1064-0266|doi=10.1080/10640266.2013.797317}}</ref>

*

===Prognosis===
Prognosis for nausea and vomiting depends on the underlying cause.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]
[[Category:Needs overview]]

Nausea and vomiting primary prevention

2021-01-18T08:28:31Z

Tayebah Chaudhry: /* Primary prevention */

__NOTOC__
{{Nausea and vomiting}}
Please help WikiDoc by adding content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.
==overview==
==Primary prevention==
Nausea can be prevented by:
* eating frequent small meals instead of three large meals <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* eating slowly
* consuming foods that are easy to digest <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* consuming food that is cold or at room temperature since smell of warm or hot food can cause nausea
* avoid triggers like unpleasant odor and site
* resting after eating keeping the head elevated
* drinking fluids between meals instead of during meals
Vomiting (after feeling nauseated) can be prevented by:
* keeping hydrated by consuming small amounts of clear, sweet liquids such as Ginger ale, Gatorade and fruit juices that are not too acidic
* eating sweetened icy treats like popsicles <ref name="pmid28403420">{{cite journal |vauthors=Johns DE, Gerling V, Pasker-de Jong PC |title=Ice pops in the recovery room: effects on postoperative nausea and vomiting |journal=Br J Anaesth |volume=118 |issue=4 |pages=637–638 |date=April 2017 |pmid=28403420 |doi=10.1093/bja/aex063 |url=}}</ref>
* avoid activity and rest in sitting or propped-up lying position
* ginger is shown to be useful in prevention of nausea and vomiting <ref name="pmid23638927">{{cite journal |vauthors=Palatty PL, Haniadka R, Valder B, Arora R, Baliga MS |title=Ginger in the prevention of nausea and vomiting: a review |journal=Crit Rev Food Sci Nutr |volume=53 |issue=7 |pages=659–69 |date=2013 |pmid=23638927 |doi=10.1080/10408398.2011.553751 |url=}}</ref>
* specific drugs can be used to prevent nausea and vomiting, for example, transdermal patch of anticholinergic agent Scopolamine for prophylaxis of motion sickness.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting primary prevention

2021-01-18T08:28:13Z

Tayebah Chaudhry: /* Primary prevention */

__NOTOC__
{{Nausea and vomiting}}
Please help WikiDoc by adding content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.
==overview==
==Primary prevention==
Nausea can be prevented by:
* eating frequent small meals instead of three large meals <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* eating slowly
* consuming foods that are easy to digest <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* consuming food that is cold or at room temperature since smell of warm or hot food can cause nausea
* avoid triggers like unpleasant odor
* resting after eating keeping the head elevated
* drinking fluids between meals instead of during meals
Vomiting (after feeling nauseated) can be prevented by:
* keeping hydrated by consuming small amounts of clear, sweet liquids such as Ginger ale, Gatorade and fruit juices that are not too acidic
* eating sweetened icy treats like popsicles <ref name="pmid28403420">{{cite journal |vauthors=Johns DE, Gerling V, Pasker-de Jong PC |title=Ice pops in the recovery room: effects on postoperative nausea and vomiting |journal=Br J Anaesth |volume=118 |issue=4 |pages=637–638 |date=April 2017 |pmid=28403420 |doi=10.1093/bja/aex063 |url=}}</ref>
* avoid activity and rest in sitting or propped-up lying position
* ginger is shown to be useful in prevention of nausea and vomiting <ref name="pmid23638927">{{cite journal |vauthors=Palatty PL, Haniadka R, Valder B, Arora R, Baliga MS |title=Ginger in the prevention of nausea and vomiting: a review |journal=Crit Rev Food Sci Nutr |volume=53 |issue=7 |pages=659–69 |date=2013 |pmid=23638927 |doi=10.1080/10408398.2011.553751 |url=}}</ref>
* specific drugs can be used to prevent nausea and vomiting, for example, transdermal patch of anticholinergic agent Scopolamine for prophylaxis of motion sickness.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting secondary prevention

2021-01-18T08:21:43Z

Tayebah Chaudhry: /* Secondary prevention */

__NOTOC__
{{Nausea and vomiting}}
==Overview==
==Secondary prevention==
* eating light, bland foods (such as crackers or plain bread)
* avoiding fatty and spicy food and eating proteing meals <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* eating and drinking slowly
* eating small frequent meals <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* consuming peppermint tea or aromatherapy with peppermint oil <ref name="pmid29850445">{{cite journal |vauthors=Joulaeerad N, Ozgoli G, Hajimehdipoor H, Ghasemi E, Salehimoghaddam F |title=Effect of Aromatherapy with Peppermint Oil on the Severity of Nausea and Vomiting in Pregnancy: A Single-blind, Randomized, Placebo-controlled trial |journal=J Reprod Infertil |volume=19 |issue=1 |pages=32–38 |date=2018 |pmid=29850445 |pmc=5960050 |doi= |url=}}</ref>
* avoiding physical activity after eating
* avoiding brushing teeth after eating
* keeping hydrated
* discontinuing any oral medication that can irritate the stomach
* acupressure and acupunture <ref name="pmid26348534">{{cite journal |vauthors=Matthews A, Haas DM, O'Mathúna DP, Dowswell T |title=Interventions for nausea and vomiting in early pregnancy |journal=Cochrane Database Syst Rev |volume= |issue=9 |pages=CD007575 |date=September 2015 |pmid=26348534 |pmc=7196889 |doi=10.1002/14651858.CD007575.pub4 |url=}}</ref> <ref name="pmid31517844">{{cite journal |vauthors=Hu J, Shen Y, Zhang G, He J, Sun M, Zhang H, Hua B, Zheng H |title=Effect of acupoint therapies on chemotherapy-induced nausea and vomiting: A systematic review protocol |journal=Medicine (Baltimore) |volume=98 |issue=37 |pages=e17109 |date=September 2019 |pmid=31517844 |pmc=6750289 |doi=10.1097/MD.0000000000017109 |url=}}</ref>
* Transcutaneous electrical nerve stimulation (TENS) with a wrist band is used to prevent nausea and vomiting postoperatively. <ref name="pmid32913634">{{cite journal |vauthors=Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H |title=Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review |journal=F1000Res |volume=9 |issue= |pages= |date=2020 |pmid=32913634 |pmc=7429924 |doi=10.12688/f1000research.21832.1 |url=}}</ref>
* using specific drugs for specific conditions to prevent nausea and vomiting. Eg, neurokinin-1 receptor antagonists (Aprepitant), 5-HT3 antagonists (Ondansetron) and corticosteroid (dexamethasone) to prevent chemotherapy induced nausea and vomiting <ref name="pmid31194593">{{cite journal |vauthors=Karthaus M, Schiel X, Ruhlmann CH, Celio L |title=Neurokinin-1 receptor antagonists: review of their role for the prevention of chemotherapy-induced nausea and vomiting in adults |journal=Expert Rev Clin Pharmacol |volume=12 |issue=7 |pages=661–680 |date=July 2019 |pmid=31194593 |doi=10.1080/17512433.2019.1621162 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting primary prevention

2021-01-18T08:21:11Z

Tayebah Chaudhry: /* Primary prevention */

__NOTOC__
{{Nausea and vomiting}}
Please help WikiDoc by adding content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.
==overview==
==Primary prevention==
Nausea can be prevented by:
* eating frequent small meals instead of three large meals <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* eating slowly
* consuming foods that are easy to digest <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* consuming food that is cold or at room temperature since smell of warm or hot food can cause nausea
* resting after eating keeping the head elevated
* drinking fluids between meals instead of during meals
Vomiting (after feeling nauseated) can be prevented by:
* keeping hydrated by consuming small amounts of clear, sweet liquids such as Ginger ale, Gatorade and fruit juices that are not too acidic
* eating sweetened icy treats like popsicles <ref name="pmid28403420">{{cite journal |vauthors=Johns DE, Gerling V, Pasker-de Jong PC |title=Ice pops in the recovery room: effects on postoperative nausea and vomiting |journal=Br J Anaesth |volume=118 |issue=4 |pages=637–638 |date=April 2017 |pmid=28403420 |doi=10.1093/bja/aex063 |url=}}</ref>
* avoid activity and rest in sitting or propped-up lying position
* ginger is shown to be useful in prevention of nausea and vomiting <ref name="pmid23638927">{{cite journal |vauthors=Palatty PL, Haniadka R, Valder B, Arora R, Baliga MS |title=Ginger in the prevention of nausea and vomiting: a review |journal=Crit Rev Food Sci Nutr |volume=53 |issue=7 |pages=659–69 |date=2013 |pmid=23638927 |doi=10.1080/10408398.2011.553751 |url=}}</ref>
* specific drugs can be used to prevent nausea and vomiting, for example, transdermal patch of anticholinergic agent Scopolamine for prophylaxis of motion sickness.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting secondary prevention

2021-01-18T08:16:37Z

Tayebah Chaudhry: /* Secondary prevention */

__NOTOC__
{{Nausea and vomiting}}
==Overview==
==Secondary prevention==
* eating light, bland foods (such as crackers or plain bread)
* avoiding fatty and spicy food and eating proteing meals <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* eating and drinking slowly
* eating small frequent meals <ref name="pmid31634919">{{cite journal |vauthors=Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T |title=The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines |journal=Obstet Gynecol Surv |volume=74 |issue=3 |pages=161–169 |date=March 2019 |pmid=31634919 |doi=10.1097/OGX.0000000000000654 |url=}}</ref>
* consuming peppermint tea or aromatherapy with peppermint oil <ref name="pmid29850445">{{cite journal |vauthors=Joulaeerad N, Ozgoli G, Hajimehdipoor H, Ghasemi E, Salehimoghaddam F |title=Effect of Aromatherapy with Peppermint Oil on the Severity of Nausea and Vomiting in Pregnancy: A Single-blind, Randomized, Placebo-controlled trial |journal=J Reprod Infertil |volume=19 |issue=1 |pages=32–38 |date=2018 |pmid=29850445 |pmc=5960050 |doi= |url=}}</ref>
* avoiding physical activity after eating
* avoiding brushing teeth after eating
* keeping hydrated
* discontinuing any oral medication that can irritate the stomach
* acupressure and acupunture <ref name="pmid26348534">{{cite journal |vauthors=Matthews A, Haas DM, O'Mathúna DP, Dowswell T |title=Interventions for nausea and vomiting in early pregnancy |journal=Cochrane Database Syst Rev |volume= |issue=9 |pages=CD007575 |date=September 2015 |pmid=26348534 |pmc=7196889 |doi=10.1002/14651858.CD007575.pub4 |url=}}</ref> <ref name="pmid31517844">{{cite journal |vauthors=Hu J, Shen Y, Zhang G, He J, Sun M, Zhang H, Hua B, Zheng H |title=Effect of acupoint therapies on chemotherapy-induced nausea and vomiting: A systematic review protocol |journal=Medicine (Baltimore) |volume=98 |issue=37 |pages=e17109 |date=September 2019 |pmid=31517844 |pmc=6750289 |doi=10.1097/MD.0000000000017109 |url=}}</ref>
* using specific drugs for specific conditions to prevent nausea and vomiting. Eg, neurokinin-1 receptor antagonists (Aprepitant), 5-HT3 antagonists (Ondansetron) and corticosteroid (dexamethasone) to prevent chemotherapy induced nausea and vomiting <ref name="pmid31194593">{{cite journal |vauthors=Karthaus M, Schiel X, Ruhlmann CH, Celio L |title=Neurokinin-1 receptor antagonists: review of their role for the prevention of chemotherapy-induced nausea and vomiting in adults |journal=Expert Rev Clin Pharmacol |volume=12 |issue=7 |pages=661–680 |date=July 2019 |pmid=31194593 |doi=10.1080/17512433.2019.1621162 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting secondary prevention

2021-01-18T08:06:39Z

Tayebah Chaudhry: /* Secondary prevention */

__NOTOC__
{{Nausea and vomiting}}
==Overview==
==Secondary prevention==
* eating light, bland foods (such as crackers or plain bread)
* avoiding heavy and solid food like fried food or desserts
* eating and drinking slowly
* eating small frequent meals
* consuming peppermint tea or aromatherapy with peppermint oil <ref name="pmid29850445">{{cite journal |vauthors=Joulaeerad N, Ozgoli G, Hajimehdipoor H, Ghasemi E, Salehimoghaddam F |title=Effect of Aromatherapy with Peppermint Oil on the Severity of Nausea and Vomiting in Pregnancy: A Single-blind, Randomized, Placebo-controlled trial |journal=J Reprod Infertil |volume=19 |issue=1 |pages=32–38 |date=2018 |pmid=29850445 |pmc=5960050 |doi= |url=}}</ref>
* avoiding physical activity after eating
* avoiding brushing teeth after eating
* keeping hydrated
* discontinuing any oral medication that can irritate the stomach
* acupressure and acupunture <ref name="pmid26348534">{{cite journal |vauthors=Matthews A, Haas DM, O'Mathúna DP, Dowswell T |title=Interventions for nausea and vomiting in early pregnancy |journal=Cochrane Database Syst Rev |volume= |issue=9 |pages=CD007575 |date=September 2015 |pmid=26348534 |pmc=7196889 |doi=10.1002/14651858.CD007575.pub4 |url=}}</ref> <ref name="pmid31517844">{{cite journal |vauthors=Hu J, Shen Y, Zhang G, He J, Sun M, Zhang H, Hua B, Zheng H |title=Effect of acupoint therapies on chemotherapy-induced nausea and vomiting: A systematic review protocol |journal=Medicine (Baltimore) |volume=98 |issue=37 |pages=e17109 |date=September 2019 |pmid=31517844 |pmc=6750289 |doi=10.1097/MD.0000000000017109 |url=}}</ref>
* using specific drugs for specific conditions to prevent nausea and vomiting. Eg, neurokinin-1 receptor antagonists (Aprepitant), 5-HT3 antagonists (Ondansetron) and corticosteroid (dexamethasone) to prevent chemotherapy induced nausea and vomiting <ref name="pmid31194593">{{cite journal |vauthors=Karthaus M, Schiel X, Ruhlmann CH, Celio L |title=Neurokinin-1 receptor antagonists: review of their role for the prevention of chemotherapy-induced nausea and vomiting in adults |journal=Expert Rev Clin Pharmacol |volume=12 |issue=7 |pages=661–680 |date=July 2019 |pmid=31194593 |doi=10.1080/17512433.2019.1621162 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting secondary prevention

2021-01-18T08:00:07Z

Tayebah Chaudhry: /* Secondary prevention */

Nausea and vomiting primary prevention

2021-01-18T07:59:04Z

Tayebah Chaudhry: /* Primary prevention */

__NOTOC__
{{Nausea and vomiting}}
Please help WikiDoc by adding content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.
==overview==
==Primary prevention==
Nausea can be prevented by:
* eating frequent small meals instead of three large meals
* eating slowly
* consuming foods that are easy to digest
* consuming food that is cold or at room temperature since smell of warm or hot food can cause nausea
* resting after eating keeping the head elevated
* drinking fluids between meals instead of during meals
Vomiting (after feeling nauseated) can be prevented by:
* keeping hydrated by consuming small amounts of clear, sweet liquids such as Ginger ale, Gatorade and fruit juices that are not too acidic
* eating sweetened icy treats like popsicles <ref name="pmid28403420">{{cite journal |vauthors=Johns DE, Gerling V, Pasker-de Jong PC |title=Ice pops in the recovery room: effects on postoperative nausea and vomiting |journal=Br J Anaesth |volume=118 |issue=4 |pages=637–638 |date=April 2017 |pmid=28403420 |doi=10.1093/bja/aex063 |url=}}</ref>
* avoid activity and rest in sitting or propped-up lying position
* ginger is shown to be useful in prevention of nausea and vomiting <ref name="pmid23638927">{{cite journal |vauthors=Palatty PL, Haniadka R, Valder B, Arora R, Baliga MS |title=Ginger in the prevention of nausea and vomiting: a review |journal=Crit Rev Food Sci Nutr |volume=53 |issue=7 |pages=659–69 |date=2013 |pmid=23638927 |doi=10.1080/10408398.2011.553751 |url=}}</ref>
* specific drugs can be used to prevent nausea and vomiting, for example, transdermal patch of anticholinergic agent Scopolamine for prophylaxis of motion sickness.
* Transcutaneous electrical nerve stimulation (TENS) with a wrist band is used to control symptoms postoperatively. <ref name="pmid32913634">{{cite journal |vauthors=Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H |title=Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review |journal=F1000Res |volume=9 |issue= |pages= |date=2020 |pmid=32913634 |pmc=7429924 |doi=10.12688/f1000research.21832.1 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting medical therapy

2021-01-18T07:54:41Z

Tayebah Chaudhry: /* Antiemetics */

__NOTOC__
{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}
==Overview==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.

== Medical Therapy ==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.
===Antiemetics===
* Benzodiazepines are used for anticipatory nausea and postoperative nausea and vomiting. Eg., Lorazepam 0.5-2mg oral, SL (sublingual) or IM (intramuscular), Alprazolam 0.25-1mg oral or IV (intravenous). <ref name="pmid8123420">{{cite journal |vauthors=Di Florio T, Goucke R |title=Reduction of dopamine release and postoperative emesis by benzodiazepines |journal=Br J Anaesth |volume=71 |issue=2 |pages=325 |date=August 1993 |pmid=8123420 |doi=10.1093/bja/71.2.325 |url=}}</ref>
*Serotonin 5-HT3 antagonists are used in postoperative, post-radiation and chemotherapy induced nausea and vomiting. Eg., Ondansetron 4-8mg oral or IV, Granisetron 1-2 mg every 4-8 hours or 0.075mg-0.25mg every 24 hours oral or IV. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
*Antihistamines are used in motion sickness and labrythitis. Eg., Meclizine 25-50mg every 24 hours oral, Diphenhydramine, Cyclizine, Hydroxazine 25-50mg every 6-8 hours, 25–75 mg every 8 hours, 25–50 mg every 4–6 hours, 25–100 mg every 6–8 hours oral, IM or IV. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref> <ref name="pmid15023018">{{cite journal |vauthors=Flake ZA, Scalley RD, Bailey AG |title=Practical selection of antiemetics |journal=Am Fam Physician |volume=69 |issue=5 |pages=1169–74 |date=March 2004 |pmid=15023018 |doi= |url=}}</ref>
*Anticholenergic agents are used in motion sickness. Eg., Scopolamine 0.3–0.6 mg every 24 hours SL, IV, IM or transdermal. <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref> <ref name="pmid9205824">{{cite journal |vauthors=Golding JF, Stott JR |title=Comparison of the effects of a selective muscarinic receptor antagonist and hyoscine (scopolamine) on motion sickness, skin conductance and heart rate |journal=Br J Clin Pharmacol |volume=43 |issue=6 |pages=633–7 |date=June 1997 |pmid=9205824 |pmc=2042789 |doi=10.1046/j.1365-2125.1997.00606.x |url=}}</ref>
*Phenothiazines are antidopaminergics which are effective for migraine, motion sickness, vertigo, postoperative and chemotherapy induced nausea nd vomiting. Eg., Prochlorperazine, Promethazine, Chlorpromazine, Perphenazine 5–10 mg every 6–8 hours, 12.5 –25 mg every 4–6 hours, 10–25 mg every 4–6 hours, 4–8 mg every 8–12 hours Oral, IV or IM. <ref name="pmid16934536">{{cite journal |vauthors=Sanger GJ, Andrews PL |title=Treatment of nausea and vomiting: gaps in our knowledge |journal=Auton Neurosci |volume=129 |issue=1-2 |pages=3–16 |date=October 2006 |pmid=16934536 |doi=10.1016/j.autneu.2006.07.009 |url=}}</ref> <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref>
*Droperidol is a Butyrophenone and a restricted drug used for postoperative and chemotherapy induced nausea and vomiting, 0.625–1.25 mg every 24hours IM or IV <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref>
* Cannabinoids are used for chemotherapy induced nausea and vomiting. Eg., Dronabinol, Nabilone 2.5–10 mg every 6–8 hours, 1–2 mg every 8–12 hours oral. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid375088">{{cite journal |vauthors=Herman TS, Einhorn LH, Jones SE, Nagy C, Chester AB, Dean JC, Furnas B, Williams SD, Leigh SA, Dorr RT, Moon TE |title=Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy |journal=N Engl J Med |volume=300 |issue=23 |pages=1295–7 |date=June 1979 |pmid=375088 |doi=10.1056/NEJM197906073002302 |url=}}</ref>
* Corticosteroids are used for acute or delayed chemotherapy induced or postoperative nausea and vomiting. Eg., Dexamethasone 4–8 mg every 4–6 hours Oral, IM or IV. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid15190136">{{cite journal |vauthors=Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N |title=A factorial trial of six interventions for the prevention of postoperative nausea and vomiting |journal=N Engl J Med |volume=350 |issue=24 |pages=2441–51 |date=June 2004 |pmid=15190136 |pmc=1307533 |doi=10.1056/NEJMoa032196 |url=}}</ref>
* NK-1 Receptor Antagonist is used in acute as well as delayed chemotherapy-induced nausea and vomiting. It has also been used in gastroparesis-associated nausea and vomiting. Eg., Aprepitant 80–125 mg every 24 hours oral. <ref name="pmid18208572">{{cite journal |vauthors=Madsen JL, Fuglsang S |title=A randomized, placebo-controlled, crossover, double-blind trial of the NK1 receptor antagonist aprepitant on gastrointestinal motor function in healthy humans |journal=Aliment Pharmacol Ther |volume=27 |issue=7 |pages=609–15 |date=April 2008 |pmid=18208572 |doi=10.1111/j.1365-2036.2008.03618.x |url=}}</ref> <ref name="pmid19719336">{{cite journal |vauthors=Curran MP, Robinson DM |title=Aprepitant: a review of its use in the prevention of nausea and vomiting |journal=Drugs |volume=69 |issue=13 |pages=1853–78 |date=2009 |pmid=19719336 |doi=10.2165/11203680-000000000-00000 |url=}}</ref> <ref name="pmid19444262">{{cite journal |vauthors=Chong K, Dhatariya K |title=A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant |journal=Nat Rev Endocrinol |volume=5 |issue=5 |pages=285–8 |date=May 2009 |pmid=19444262 |doi=10.1038/nrendo.2009.50 |url=}}</ref>

===Prokinetics===
*Prokinetic agents are used for only prokinetic activity (eg, Erythromycin) or both prokinetic and antiemetic activity (eg, Benzamides like Metoclopramide and Domperidone are shown to be efficacious in chemotherapy induced vomiting and gastroparesis). Metoclopramide 10–20 mg every 6–8 hours Oral, IM or IV, Domperidone 10mg every 8–24 hours oral, Erythromycin 250–500mg every 8 hours oral or IV. <ref name="pmid23201066">{{cite journal |vauthors=Javid FA, Bulmer DC, Broad J, Aziz Q, Dukes GE, Sanger GJ |title=Anti-emetic and emetic effects of erythromycin in Suncus murinus: role of vagal nerve activation, gastric motility stimulation and motilin receptors |journal=Eur J Pharmacol |volume=699 |issue=1-3 |pages=48–54 |date=January 2013 |pmid=23201066 |doi=10.1016/j.ejphar.2012.11.035 |url=}}</ref> <ref name="pmid1612359">{{cite journal |vauthors=Tack J, Janssens J, Vantrappen G, Peeters T, Annese V, Depoortere I, Muls E, Bouillon R |title=Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis |journal=Gastroenterology |volume=103 |issue=1 |pages=72–9 |date=July 1992 |pmid=1612359 |doi=10.1016/0016-5085(92)91097-n |url=}}</ref>

===Miscellaneous therapy===
* Novel and non-traditional therapies for nausea and vomiting include Tricyclic antidepressants (TCAs), Gabapentin and Olanzapine. Gabapentin is shown effective in life-threatening refractory emesis following posterior fossa surgery. TCAs (Amitriptyline, Nortriptyline, Doxepin, Desipramine, Imipramine) 10–100 mg/day oral, Gabapentin 300–900 mg three times daily oral, Olanzapine 5–10 mg/day oral. <ref name="pmid9753257">{{cite journal |vauthors=Prakash C, Lustman PJ, Freedland KE, Clouse RE |title=Tricyclic antidepressants for functional nausea and vomiting: clinical outcome in 37 patients |journal=Dig Dis Sci |volume=43 |issue=9 |pages=1951–6 |date=September 1998 |pmid=9753257 |doi=10.1023/a:1018878324327 |url=}}</ref> <ref name="pmid24668130">{{cite journal |vauthors=Guttuso T |title=Gabapentin's anti-nausea and anti-emetic effects: a review |journal=Exp Brain Res |volume=232 |issue=8 |pages=2535–9 |date=August 2014 |pmid=24668130 |doi=10.1007/s00221-014-3905-1 |url=}}</ref> <ref name="pmid15796394">{{cite journal |vauthors=Guttuso T, Vitticore P, Holloway RG |title=Responsiveness of life-threatening refractory emesis to gabapentin-scopolamine therapy following posterior fossa surgery. Case report |journal=J Neurosurg |volume=102 |issue=3 |pages=547–9 |date=March 2005 |pmid=15796394 |doi=10.3171/jns.2005.102.3.0547 |url=}}</ref> <ref name="pmid15700131">{{cite journal |vauthors=Navari RM, Einhorn LH, Passik SD, Loehrer PJ, Johnson C, Mayer ML, McClean J, Vinson J, Pletcher W |title=A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: a Hoosier Oncology Group study |journal=Support Care Cancer |volume=13 |issue=7 |pages=529–34 |date=July 2005 |pmid=15700131 |doi=10.1007/s00520-004-0755-6 |url=}}</ref> <ref name="pmid15493359">{{cite journal |vauthors=Passik SD, Navari RM, Jung SH, Nagy C, Vinson J, Kirsh KL, Loehrer P |title=A phase I trial of olanzapine (Zyprexa) for the prevention of delayed emesis in cancer patients: a Hoosier Oncology Group study |journal=Cancer Invest |volume=22 |issue=3 |pages=383–8 |date=2004 |pmid=15493359 |doi=10.1081/cnv-200029066 |url=}}</ref>
* Ginger has some efficacy to reduce postoperative nausea and vomiting, morning sickness and motion sickness. <ref name="pmid10793599">{{cite journal |vauthors=Ernst E, Pittler MH |title=Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials |journal=Br J Anaesth |volume=84 |issue=3 |pages=367–71 |date=March 2000 |pmid=10793599 |doi=10.1093/oxfordjournals.bja.a013442 |url=}}</ref> <ref name="pmid12233808">{{cite journal |vauthors=Keating A, Chez RA |title=Ginger syrup as an antiemetic in early pregnancy |journal=Altern Ther Health Med |volume=8 |issue=5 |pages=89–91 |date=2002 |pmid=12233808 |doi= |url=}}</ref>
* Gastric electric stimulation(GES) is a surgical procedure used in refractory gastroparesis. <ref name="pmid19719511">{{cite journal |vauthors=McCallum RW, Dusing RW, Sarosiek I, Cocjin J, Forster J, Lin Z |title=Mechanisms of symptomatic improvement after gastric electrical stimulation in gastroparetic patients |journal=Neurogastroenterol Motil |volume=22 |issue=2 |pages=161–7, e50–1 |date=February 2010 |pmid=19719511 |doi=10.1111/j.1365-2982.2009.01389.x |url=}}</ref>
* Transcutaneous electrical nerve stimulation (TENS) with a wrist band is used to control symptoms postoperatively. <ref name="pmid32913634">{{cite journal |vauthors=Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H |title=Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review |journal=F1000Res |volume=9 |issue= |pages= |date=2020 |pmid=32913634 |pmc=7429924 |doi=10.12688/f1000research.21832.1 |url=}}</ref>
* Alternative approaches include hypnosis, acupressure and acupuncture. <ref name="pmid10971166">{{cite journal |vauthors=Marchioro G, Azzarello G, Viviani F, Barbato F, Pavanetto M, Rosetti F, Pappagallo GL, Vinante O |title=Hypnosis in the treatment of anticipatory nausea and vomiting in patients receiving cancer chemotherapy |journal=Oncology |volume=59 |issue=2 |pages=100–4 |date=August 2000 |pmid=10971166 |doi=10.1159/000012144 |url=}}</ref> <ref name="pmid19370583">{{cite journal |vauthors=Lee A, Fan LT |title=Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD003281 |date=April 2009 |pmid=19370583 |pmc=3113464 |doi=10.1002/14651858.CD003281.pub3 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs overview]]

Nausea and vomiting secondary prevention

2021-01-18T07:53:12Z

Tayebah Chaudhry: /* Secondary prevention */

Nausea and vomiting primary prevention

2021-01-18T07:44:35Z

Tayebah Chaudhry: /* Primary prevention */

__NOTOC__
{{Nausea and vomiting}}
Please help WikiDoc by adding content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.
==overview==
==Primary prevention==
Nausea can be prevented by:
* eating frequent small meals instead of three large meals
* eating slowly
* consuming foods that are easy to digest
* consuming food that is cold or at room temperature since smell of warm or hot food can cause nausea
* resting after eating keeping the head elevated
* drinking fluids between meals instead of during meals
Vomiting (after feeling nauseated) can be prevented by:
* keeping hydrated by consuming small amounts of clear, sweet liquids such as Ginger ale, Gatorade and fruit juices that are not too acidic
* eating sweetened icy treats like popsicles <ref name="pmid28403420">{{cite journal |vauthors=Johns DE, Gerling V, Pasker-de Jong PC |title=Ice pops in the recovery room: effects on postoperative nausea and vomiting |journal=Br J Anaesth |volume=118 |issue=4 |pages=637–638 |date=April 2017 |pmid=28403420 |doi=10.1093/bja/aex063 |url=}}</ref>
* avoid activity and rest in sitting or propped-up lying position
* ginger is shown to be useful in prevention of nausea and vomiting <ref name="pmid23638927">{{cite journal |vauthors=Palatty PL, Haniadka R, Valder B, Arora R, Baliga MS |title=Ginger in the prevention of nausea and vomiting: a review |journal=Crit Rev Food Sci Nutr |volume=53 |issue=7 |pages=659–69 |date=2013 |pmid=23638927 |doi=10.1080/10408398.2011.553751 |url=}}</ref>
* specific drugs can be used to prevent nausea and vomiting, for example, in case of motion sickness and chemotherapy related nausea and vomiting.
* Transcutaneous electrical nerve stimulation (TENS) with a wrist band is used to control symptoms postoperatively. <ref name="pmid32913634">{{cite journal |vauthors=Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H |title=Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review |journal=F1000Res |volume=9 |issue= |pages= |date=2020 |pmid=32913634 |pmc=7429924 |doi=10.12688/f1000research.21832.1 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting medical therapy

2021-01-18T07:35:55Z

Tayebah Chaudhry: /* Miscellaneous therapy */

__NOTOC__
{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}
==Overview==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.

== Medical Therapy ==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.
===Antiemetics===
* Benzodiazepines are used for anticipatory nausea and postoperative nausea and vomiting. Eg., Lorazepam 0.5-2mg oral, SL (sublingual) or IM (intramuscular), Alprazolam 0.25-1mg oral or IV (intravenous). <ref name="pmid8123420">{{cite journal |vauthors=Di Florio T, Goucke R |title=Reduction of dopamine release and postoperative emesis by benzodiazepines |journal=Br J Anaesth |volume=71 |issue=2 |pages=325 |date=August 1993 |pmid=8123420 |doi=10.1093/bja/71.2.325 |url=}}</ref>
*Serotonin antagonists are used in postoperative, post-radiation and chemotherapy induced nausea and vomiting. Eg., Ondansetron 4-8mg oral or IV, Granisetron 1-2 mg every 4-8 hours or 0.075mg-0.25mg every 24 hours oral or IV. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
*Antihistamines are used in motion sickness and labrythitis. Eg., Meclizine 25-50mg every 24 hours oral, Diphenhydramine, Cyclizine, Hydroxazine 25-50mg every 6-8 hours, 25–75 mg every 8 hours, 25–50 mg every 4–6 hours, 25–100 mg every 6–8 hours oral, IM or IV. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref> <ref name="pmid15023018">{{cite journal |vauthors=Flake ZA, Scalley RD, Bailey AG |title=Practical selection of antiemetics |journal=Am Fam Physician |volume=69 |issue=5 |pages=1169–74 |date=March 2004 |pmid=15023018 |doi= |url=}}</ref>
*Anticholenergic agents are used in motion sickness. Eg., Scopolamine 0.3–0.6 mg every 24 hours SL, IV, IM or transdermal. <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref> <ref name="pmid9205824">{{cite journal |vauthors=Golding JF, Stott JR |title=Comparison of the effects of a selective muscarinic receptor antagonist and hyoscine (scopolamine) on motion sickness, skin conductance and heart rate |journal=Br J Clin Pharmacol |volume=43 |issue=6 |pages=633–7 |date=June 1997 |pmid=9205824 |pmc=2042789 |doi=10.1046/j.1365-2125.1997.00606.x |url=}}</ref>
*Phenothiazines are antidopaminergics which are effective for migraine, motion sickness, vertigo, postoperative and chemotherapy induced nausea nd vomiting. Eg., Prochlorperazine, Promethazine, Chlorpromazine, Perphenazine 5–10 mg every 6–8 hours, 12.5 –25 mg every 4–6 hours, 10–25 mg every 4–6 hours, 4–8 mg every 8–12 hours Oral, IV or IM. <ref name="pmid16934536">{{cite journal |vauthors=Sanger GJ, Andrews PL |title=Treatment of nausea and vomiting: gaps in our knowledge |journal=Auton Neurosci |volume=129 |issue=1-2 |pages=3–16 |date=October 2006 |pmid=16934536 |doi=10.1016/j.autneu.2006.07.009 |url=}}</ref> <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref>
*Droperidol is a Butyrophenone and a restricted drug used for postoperative and chemotherapy induced nausea and vomiting, 0.625–1.25 mg every 24hours IM or IV <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref>
* Cannabinoids are used for chemotherapy induced nausea and vomiting. Eg., Dronabinol, Nabilone 2.5–10 mg every 6–8 hours, 1–2 mg every 8–12 hours oral. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid375088">{{cite journal |vauthors=Herman TS, Einhorn LH, Jones SE, Nagy C, Chester AB, Dean JC, Furnas B, Williams SD, Leigh SA, Dorr RT, Moon TE |title=Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy |journal=N Engl J Med |volume=300 |issue=23 |pages=1295–7 |date=June 1979 |pmid=375088 |doi=10.1056/NEJM197906073002302 |url=}}</ref>
* Corticosteroids are used for acute or delayed chemotherapy induced or postoperative nausea and vomiting. Eg., Dexamethasone 4–8 mg every 4–6 hours Oral, IM or IV. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid15190136">{{cite journal |vauthors=Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N |title=A factorial trial of six interventions for the prevention of postoperative nausea and vomiting |journal=N Engl J Med |volume=350 |issue=24 |pages=2441–51 |date=June 2004 |pmid=15190136 |pmc=1307533 |doi=10.1056/NEJMoa032196 |url=}}</ref>
* NK-1 Receptor Antagonist is used in acute as well as delayed chemotherapy-induced nausea and vomiting. It has also been used in gastroparesis-associated nausea and vomiting. Eg., Aprepitant 80–125 mg every 24 hours oral. <ref name="pmid18208572">{{cite journal |vauthors=Madsen JL, Fuglsang S |title=A randomized, placebo-controlled, crossover, double-blind trial of the NK1 receptor antagonist aprepitant on gastrointestinal motor function in healthy humans |journal=Aliment Pharmacol Ther |volume=27 |issue=7 |pages=609–15 |date=April 2008 |pmid=18208572 |doi=10.1111/j.1365-2036.2008.03618.x |url=}}</ref> <ref name="pmid19719336">{{cite journal |vauthors=Curran MP, Robinson DM |title=Aprepitant: a review of its use in the prevention of nausea and vomiting |journal=Drugs |volume=69 |issue=13 |pages=1853–78 |date=2009 |pmid=19719336 |doi=10.2165/11203680-000000000-00000 |url=}}</ref> <ref name="pmid19444262">{{cite journal |vauthors=Chong K, Dhatariya K |title=A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant |journal=Nat Rev Endocrinol |volume=5 |issue=5 |pages=285–8 |date=May 2009 |pmid=19444262 |doi=10.1038/nrendo.2009.50 |url=}}</ref>

===Prokinetics===
*Prokinetic agents are used for only prokinetic activity (eg, Erythromycin) or both prokinetic and antiemetic activity (eg, Benzamides like Metoclopramide and Domperidone are shown to be efficacious in chemotherapy induced vomiting and gastroparesis). Metoclopramide 10–20 mg every 6–8 hours Oral, IM or IV, Domperidone 10mg every 8–24 hours oral, Erythromycin 250–500mg every 8 hours oral or IV. <ref name="pmid23201066">{{cite journal |vauthors=Javid FA, Bulmer DC, Broad J, Aziz Q, Dukes GE, Sanger GJ |title=Anti-emetic and emetic effects of erythromycin in Suncus murinus: role of vagal nerve activation, gastric motility stimulation and motilin receptors |journal=Eur J Pharmacol |volume=699 |issue=1-3 |pages=48–54 |date=January 2013 |pmid=23201066 |doi=10.1016/j.ejphar.2012.11.035 |url=}}</ref> <ref name="pmid1612359">{{cite journal |vauthors=Tack J, Janssens J, Vantrappen G, Peeters T, Annese V, Depoortere I, Muls E, Bouillon R |title=Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis |journal=Gastroenterology |volume=103 |issue=1 |pages=72–9 |date=July 1992 |pmid=1612359 |doi=10.1016/0016-5085(92)91097-n |url=}}</ref>

===Miscellaneous therapy===
* Novel and non-traditional therapies for nausea and vomiting include Tricyclic antidepressants (TCAs), Gabapentin and Olanzapine. Gabapentin is shown effective in life-threatening refractory emesis following posterior fossa surgery. TCAs (Amitriptyline, Nortriptyline, Doxepin, Desipramine, Imipramine) 10–100 mg/day oral, Gabapentin 300–900 mg three times daily oral, Olanzapine 5–10 mg/day oral. <ref name="pmid9753257">{{cite journal |vauthors=Prakash C, Lustman PJ, Freedland KE, Clouse RE |title=Tricyclic antidepressants for functional nausea and vomiting: clinical outcome in 37 patients |journal=Dig Dis Sci |volume=43 |issue=9 |pages=1951–6 |date=September 1998 |pmid=9753257 |doi=10.1023/a:1018878324327 |url=}}</ref> <ref name="pmid24668130">{{cite journal |vauthors=Guttuso T |title=Gabapentin's anti-nausea and anti-emetic effects: a review |journal=Exp Brain Res |volume=232 |issue=8 |pages=2535–9 |date=August 2014 |pmid=24668130 |doi=10.1007/s00221-014-3905-1 |url=}}</ref> <ref name="pmid15796394">{{cite journal |vauthors=Guttuso T, Vitticore P, Holloway RG |title=Responsiveness of life-threatening refractory emesis to gabapentin-scopolamine therapy following posterior fossa surgery. Case report |journal=J Neurosurg |volume=102 |issue=3 |pages=547–9 |date=March 2005 |pmid=15796394 |doi=10.3171/jns.2005.102.3.0547 |url=}}</ref> <ref name="pmid15700131">{{cite journal |vauthors=Navari RM, Einhorn LH, Passik SD, Loehrer PJ, Johnson C, Mayer ML, McClean J, Vinson J, Pletcher W |title=A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: a Hoosier Oncology Group study |journal=Support Care Cancer |volume=13 |issue=7 |pages=529–34 |date=July 2005 |pmid=15700131 |doi=10.1007/s00520-004-0755-6 |url=}}</ref> <ref name="pmid15493359">{{cite journal |vauthors=Passik SD, Navari RM, Jung SH, Nagy C, Vinson J, Kirsh KL, Loehrer P |title=A phase I trial of olanzapine (Zyprexa) for the prevention of delayed emesis in cancer patients: a Hoosier Oncology Group study |journal=Cancer Invest |volume=22 |issue=3 |pages=383–8 |date=2004 |pmid=15493359 |doi=10.1081/cnv-200029066 |url=}}</ref>
* Ginger has some efficacy to reduce postoperative nausea and vomiting, morning sickness and motion sickness. <ref name="pmid10793599">{{cite journal |vauthors=Ernst E, Pittler MH |title=Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials |journal=Br J Anaesth |volume=84 |issue=3 |pages=367–71 |date=March 2000 |pmid=10793599 |doi=10.1093/oxfordjournals.bja.a013442 |url=}}</ref> <ref name="pmid12233808">{{cite journal |vauthors=Keating A, Chez RA |title=Ginger syrup as an antiemetic in early pregnancy |journal=Altern Ther Health Med |volume=8 |issue=5 |pages=89–91 |date=2002 |pmid=12233808 |doi= |url=}}</ref>
* Gastric electric stimulation(GES) is a surgical procedure used in refractory gastroparesis. <ref name="pmid19719511">{{cite journal |vauthors=McCallum RW, Dusing RW, Sarosiek I, Cocjin J, Forster J, Lin Z |title=Mechanisms of symptomatic improvement after gastric electrical stimulation in gastroparetic patients |journal=Neurogastroenterol Motil |volume=22 |issue=2 |pages=161–7, e50–1 |date=February 2010 |pmid=19719511 |doi=10.1111/j.1365-2982.2009.01389.x |url=}}</ref>
* Transcutaneous electrical nerve stimulation (TENS) with a wrist band is used to control symptoms postoperatively. <ref name="pmid32913634">{{cite journal |vauthors=Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H |title=Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review |journal=F1000Res |volume=9 |issue= |pages= |date=2020 |pmid=32913634 |pmc=7429924 |doi=10.12688/f1000research.21832.1 |url=}}</ref>
* Alternative approaches include hypnosis, acupressure and acupuncture. <ref name="pmid10971166">{{cite journal |vauthors=Marchioro G, Azzarello G, Viviani F, Barbato F, Pavanetto M, Rosetti F, Pappagallo GL, Vinante O |title=Hypnosis in the treatment of anticipatory nausea and vomiting in patients receiving cancer chemotherapy |journal=Oncology |volume=59 |issue=2 |pages=100–4 |date=August 2000 |pmid=10971166 |doi=10.1159/000012144 |url=}}</ref> <ref name="pmid19370583">{{cite journal |vauthors=Lee A, Fan LT |title=Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD003281 |date=April 2009 |pmid=19370583 |pmc=3113464 |doi=10.1002/14651858.CD003281.pub3 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs overview]]

Nausea and vomiting secondary prevention

2021-01-18T07:33:18Z

Tayebah Chaudhry: /* Secondary prevention */

Nausea and vomiting secondary prevention

2021-01-18T07:29:51Z

Tayebah Chaudhry: /* Secondary prevention */

Nausea and vomiting primary prevention

2021-01-18T07:26:35Z

Tayebah Chaudhry: /* Primary prevention */

Nausea and vomiting primary prevention

2021-01-18T07:20:11Z

Tayebah Chaudhry: /* Primary prevention */

Nausea and vomiting primary prevention

2021-01-18T07:12:01Z

Tayebah Chaudhry: /* Primary prevention */

Nausea and vomiting secondary prevention

2021-01-18T07:08:59Z

Tayebah Chaudhry: /* Secondary prevention */

__NOTOC__
{{Nausea and vomiting}}
==Overview==
==Secondary prevention==
* Eat light, bland foods (such as crackers or plain bread).
* Avoid heavy and solid food like fried food or desserts.
* Eat and drink slowly
* Eat small frequent meals.
* Avoid activity after eating.
* Avoid brushing teeth after eating.
* Drink clear fluids to avoid dehydration.
* Discontinue any oral medication that can irritate the stomach.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting primary prevention

2021-01-18T07:01:03Z

Tayebah Chaudhry: /* Primary prevention */

Nausea and vomiting surgery

2021-01-18T06:44:42Z

Tayebah Chaudhry: /* Surgery */

__NOTOC__
Please help WikiDoc by adding content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.

{{Nausea and vomiting}}
==Overview==
==Surgery==
* Gastric electrical stimulation (GES) is a surgical procedure to implant an electronic device into the abdomen, with wires (electrodes) that are attached to the stomach wall. It may not improve stomach emptying but may improve nausea nd vomiting in most cases. <ref name="pmid23358845">{{cite journal |vauthors=Keller DS, Parkman HP, Boucek DO, Sankineni A, Meilahn JE, Gaughan JP, Harbison S |title=Surgical outcomes after gastric electric stimulator placement for refractory gastroparesis |journal=J Gastrointest Surg |volume=17 |issue=4 |pages=620–6 |date=April 2013 |pmid=23358845 |doi=10.1007/s11605-013-2147-z |url=}}</ref> <ref name="pmid23433238">{{cite journal |vauthors=Lu PL, Teich S, Di Lorenzo C, Lorenzo CD, Skaggs B, Alhajj M, Mousa HM |title=Improvement of quality of life and symptoms after gastric electrical stimulation in children with functional dyspepsia |journal=Neurogastroenterol Motil |volume=25 |issue=7 |pages=567–e456 |date=July 2013 |pmid=23433238 |doi=10.1111/nmo.12104 |url=}}</ref>
* Other surgical procedures depend on the underlying cause of nausea and vomiting.

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs content]]

Nausea and vomiting medical therapy

2021-01-18T06:42:09Z

Tayebah Chaudhry: /* Miscellaneous therapy */

__NOTOC__
{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}
==Overview==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.

== Medical Therapy ==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.
===Antiemetics===
* Benzodiazepines are used for anticipatory nausea and postoperative nausea and vomiting. Eg., Lorazepam 0.5-2mg oral, SL (sublingual) or IM (intramuscular), Alprazolam 0.25-1mg oral or IV (intravenous). <ref name="pmid8123420">{{cite journal |vauthors=Di Florio T, Goucke R |title=Reduction of dopamine release and postoperative emesis by benzodiazepines |journal=Br J Anaesth |volume=71 |issue=2 |pages=325 |date=August 1993 |pmid=8123420 |doi=10.1093/bja/71.2.325 |url=}}</ref>
*Serotonin antagonists are used in postoperative, post-radiation and chemotherapy induced nausea and vomiting. Eg., Ondansetron 4-8mg oral or IV, Granisetron 1-2 mg every 4-8 hours or 0.075mg-0.25mg every 24 hours oral or IV. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
*Antihistamines are used in motion sickness and labrythitis. Eg., Meclizine 25-50mg every 24 hours oral, Diphenhydramine, Cyclizine, Hydroxazine 25-50mg every 6-8 hours, 25–75 mg every 8 hours, 25–50 mg every 4–6 hours, 25–100 mg every 6–8 hours oral, IM or IV. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref> <ref name="pmid15023018">{{cite journal |vauthors=Flake ZA, Scalley RD, Bailey AG |title=Practical selection of antiemetics |journal=Am Fam Physician |volume=69 |issue=5 |pages=1169–74 |date=March 2004 |pmid=15023018 |doi= |url=}}</ref>
*Anticholenergic agents are used in motion sickness. Eg., Scopolamine 0.3–0.6 mg every 24 hours SL, IV, IM or transdermal. <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref> <ref name="pmid9205824">{{cite journal |vauthors=Golding JF, Stott JR |title=Comparison of the effects of a selective muscarinic receptor antagonist and hyoscine (scopolamine) on motion sickness, skin conductance and heart rate |journal=Br J Clin Pharmacol |volume=43 |issue=6 |pages=633–7 |date=June 1997 |pmid=9205824 |pmc=2042789 |doi=10.1046/j.1365-2125.1997.00606.x |url=}}</ref>
*Phenothiazines are antidopaminergics which are effective for migraine, motion sickness, vertigo, postoperative and chemotherapy induced nausea nd vomiting. Eg., Prochlorperazine, Promethazine, Chlorpromazine, Perphenazine 5–10 mg every 6–8 hours, 12.5 –25 mg every 4–6 hours, 10–25 mg every 4–6 hours, 4–8 mg every 8–12 hours Oral, IV or IM. <ref name="pmid16934536">{{cite journal |vauthors=Sanger GJ, Andrews PL |title=Treatment of nausea and vomiting: gaps in our knowledge |journal=Auton Neurosci |volume=129 |issue=1-2 |pages=3–16 |date=October 2006 |pmid=16934536 |doi=10.1016/j.autneu.2006.07.009 |url=}}</ref> <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref>
*Droperidol is a Butyrophenone and a restricted drug used for postoperative and chemotherapy induced nausea and vomiting, 0.625–1.25 mg every 24hours IM or IV <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref>
* Cannabinoids are used for chemotherapy induced nausea and vomiting. Eg., Dronabinol, Nabilone 2.5–10 mg every 6–8 hours, 1–2 mg every 8–12 hours oral. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid375088">{{cite journal |vauthors=Herman TS, Einhorn LH, Jones SE, Nagy C, Chester AB, Dean JC, Furnas B, Williams SD, Leigh SA, Dorr RT, Moon TE |title=Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy |journal=N Engl J Med |volume=300 |issue=23 |pages=1295–7 |date=June 1979 |pmid=375088 |doi=10.1056/NEJM197906073002302 |url=}}</ref>
* Corticosteroids are used for acute or delayed chemotherapy induced or postoperative nausea and vomiting. Eg., Dexamethasone 4–8 mg every 4–6 hours Oral, IM or IV. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid15190136">{{cite journal |vauthors=Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N |title=A factorial trial of six interventions for the prevention of postoperative nausea and vomiting |journal=N Engl J Med |volume=350 |issue=24 |pages=2441–51 |date=June 2004 |pmid=15190136 |pmc=1307533 |doi=10.1056/NEJMoa032196 |url=}}</ref>
* NK-1 Receptor Antagonist is used in acute as well as delayed chemotherapy-induced nausea and vomiting. It has also been used in gastroparesis-associated nausea and vomiting. Eg., Aprepitant 80–125 mg every 24 hours oral. <ref name="pmid18208572">{{cite journal |vauthors=Madsen JL, Fuglsang S |title=A randomized, placebo-controlled, crossover, double-blind trial of the NK1 receptor antagonist aprepitant on gastrointestinal motor function in healthy humans |journal=Aliment Pharmacol Ther |volume=27 |issue=7 |pages=609–15 |date=April 2008 |pmid=18208572 |doi=10.1111/j.1365-2036.2008.03618.x |url=}}</ref> <ref name="pmid19719336">{{cite journal |vauthors=Curran MP, Robinson DM |title=Aprepitant: a review of its use in the prevention of nausea and vomiting |journal=Drugs |volume=69 |issue=13 |pages=1853–78 |date=2009 |pmid=19719336 |doi=10.2165/11203680-000000000-00000 |url=}}</ref> <ref name="pmid19444262">{{cite journal |vauthors=Chong K, Dhatariya K |title=A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant |journal=Nat Rev Endocrinol |volume=5 |issue=5 |pages=285–8 |date=May 2009 |pmid=19444262 |doi=10.1038/nrendo.2009.50 |url=}}</ref>

===Prokinetics===
*Prokinetic agents are used for only prokinetic activity (eg, Erythromycin) or both prokinetic and antiemetic activity (eg, Benzamides like Metoclopramide and Domperidone are shown to be efficacious in chemotherapy induced vomiting and gastroparesis). Metoclopramide 10–20 mg every 6–8 hours Oral, IM or IV, Domperidone 10mg every 8–24 hours oral, Erythromycin 250–500mg every 8 hours oral or IV. <ref name="pmid23201066">{{cite journal |vauthors=Javid FA, Bulmer DC, Broad J, Aziz Q, Dukes GE, Sanger GJ |title=Anti-emetic and emetic effects of erythromycin in Suncus murinus: role of vagal nerve activation, gastric motility stimulation and motilin receptors |journal=Eur J Pharmacol |volume=699 |issue=1-3 |pages=48–54 |date=January 2013 |pmid=23201066 |doi=10.1016/j.ejphar.2012.11.035 |url=}}</ref> <ref name="pmid1612359">{{cite journal |vauthors=Tack J, Janssens J, Vantrappen G, Peeters T, Annese V, Depoortere I, Muls E, Bouillon R |title=Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis |journal=Gastroenterology |volume=103 |issue=1 |pages=72–9 |date=July 1992 |pmid=1612359 |doi=10.1016/0016-5085(92)91097-n |url=}}</ref>

===Miscellaneous therapy===
* Novel and non-traditional therapies for nausea and vomiting include Tricyclic antidepressants (TCAs), Gabapentin and Olanzapine. Gabapentin is shown effective in life-threatening refractory emesis following posterior fossa surgery. TCAs (Amitriptyline, Nortriptyline, Doxepin, Desipramine, Imipramine) 10–100 mg/day oral, Gabapentin 300–900 mg three times daily oral, Olanzapine 5–10 mg/day oral. <ref name="pmid9753257">{{cite journal |vauthors=Prakash C, Lustman PJ, Freedland KE, Clouse RE |title=Tricyclic antidepressants for functional nausea and vomiting: clinical outcome in 37 patients |journal=Dig Dis Sci |volume=43 |issue=9 |pages=1951–6 |date=September 1998 |pmid=9753257 |doi=10.1023/a:1018878324327 |url=}}</ref> <ref name="pmid24668130">{{cite journal |vauthors=Guttuso T |title=Gabapentin's anti-nausea and anti-emetic effects: a review |journal=Exp Brain Res |volume=232 |issue=8 |pages=2535–9 |date=August 2014 |pmid=24668130 |doi=10.1007/s00221-014-3905-1 |url=}}</ref> <ref name="pmid15796394">{{cite journal |vauthors=Guttuso T, Vitticore P, Holloway RG |title=Responsiveness of life-threatening refractory emesis to gabapentin-scopolamine therapy following posterior fossa surgery. Case report |journal=J Neurosurg |volume=102 |issue=3 |pages=547–9 |date=March 2005 |pmid=15796394 |doi=10.3171/jns.2005.102.3.0547 |url=}}</ref> <ref name="pmid15700131">{{cite journal |vauthors=Navari RM, Einhorn LH, Passik SD, Loehrer PJ, Johnson C, Mayer ML, McClean J, Vinson J, Pletcher W |title=A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: a Hoosier Oncology Group study |journal=Support Care Cancer |volume=13 |issue=7 |pages=529–34 |date=July 2005 |pmid=15700131 |doi=10.1007/s00520-004-0755-6 |url=}}</ref> <ref name="pmid15493359">{{cite journal |vauthors=Passik SD, Navari RM, Jung SH, Nagy C, Vinson J, Kirsh KL, Loehrer P |title=A phase I trial of olanzapine (Zyprexa) for the prevention of delayed emesis in cancer patients: a Hoosier Oncology Group study |journal=Cancer Invest |volume=22 |issue=3 |pages=383–8 |date=2004 |pmid=15493359 |doi=10.1081/cnv-200029066 |url=}}</ref>
* Ginger has some efficacy to reduce postoperative nausea and vomiting, morning sickness and motion sickness. <ref name="pmid10793599">{{cite journal |vauthors=Ernst E, Pittler MH |title=Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials |journal=Br J Anaesth |volume=84 |issue=3 |pages=367–71 |date=March 2000 |pmid=10793599 |doi=10.1093/oxfordjournals.bja.a013442 |url=}}</ref> <ref name="pmid12233808">{{cite journal |vauthors=Keating A, Chez RA |title=Ginger syrup as an antiemetic in early pregnancy |journal=Altern Ther Health Med |volume=8 |issue=5 |pages=89–91 |date=2002 |pmid=12233808 |doi= |url=}}</ref>
* Gastric electric stimulation(GES) is a surgical procedure used in refractory gastroparesis. <ref name="pmid19719511">{{cite journal |vauthors=McCallum RW, Dusing RW, Sarosiek I, Cocjin J, Forster J, Lin Z |title=Mechanisms of symptomatic improvement after gastric electrical stimulation in gastroparetic patients |journal=Neurogastroenterol Motil |volume=22 |issue=2 |pages=161–7, e50–1 |date=February 2010 |pmid=19719511 |doi=10.1111/j.1365-2982.2009.01389.x |url=}}</ref>
* Alternative approaches include hypnosis, acupressure and acupuncture. <ref name="pmid10971166">{{cite journal |vauthors=Marchioro G, Azzarello G, Viviani F, Barbato F, Pavanetto M, Rosetti F, Pappagallo GL, Vinante O |title=Hypnosis in the treatment of anticipatory nausea and vomiting in patients receiving cancer chemotherapy |journal=Oncology |volume=59 |issue=2 |pages=100–4 |date=August 2000 |pmid=10971166 |doi=10.1159/000012144 |url=}}</ref> <ref name="pmid19370583">{{cite journal |vauthors=Lee A, Fan LT |title=Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD003281 |date=April 2009 |pmid=19370583 |pmc=3113464 |doi=10.1002/14651858.CD003281.pub3 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs overview]]

Nausea and vomiting medical therapy

2021-01-18T06:35:03Z

Tayebah Chaudhry: /* Miscellaneous therapy */

__NOTOC__
{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}
==Overview==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.

== Medical Therapy ==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.
===Antiemetics===
* Benzodiazepines are used for anticipatory nausea and postoperative nausea and vomiting. Eg., Lorazepam 0.5-2mg oral, SL (sublingual) or IM (intramuscular), Alprazolam 0.25-1mg oral or IV (intravenous). <ref name="pmid8123420">{{cite journal |vauthors=Di Florio T, Goucke R |title=Reduction of dopamine release and postoperative emesis by benzodiazepines |journal=Br J Anaesth |volume=71 |issue=2 |pages=325 |date=August 1993 |pmid=8123420 |doi=10.1093/bja/71.2.325 |url=}}</ref>
*Serotonin antagonists are used in postoperative, post-radiation and chemotherapy induced nausea and vomiting. Eg., Ondansetron 4-8mg oral or IV, Granisetron 1-2 mg every 4-8 hours or 0.075mg-0.25mg every 24 hours oral or IV. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
*Antihistamines are used in motion sickness and labrythitis. Eg., Meclizine 25-50mg every 24 hours oral, Diphenhydramine, Cyclizine, Hydroxazine 25-50mg every 6-8 hours, 25–75 mg every 8 hours, 25–50 mg every 4–6 hours, 25–100 mg every 6–8 hours oral, IM or IV. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref> <ref name="pmid15023018">{{cite journal |vauthors=Flake ZA, Scalley RD, Bailey AG |title=Practical selection of antiemetics |journal=Am Fam Physician |volume=69 |issue=5 |pages=1169–74 |date=March 2004 |pmid=15023018 |doi= |url=}}</ref>
*Anticholenergic agents are used in motion sickness. Eg., Scopolamine 0.3–0.6 mg every 24 hours SL, IV, IM or transdermal. <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref> <ref name="pmid9205824">{{cite journal |vauthors=Golding JF, Stott JR |title=Comparison of the effects of a selective muscarinic receptor antagonist and hyoscine (scopolamine) on motion sickness, skin conductance and heart rate |journal=Br J Clin Pharmacol |volume=43 |issue=6 |pages=633–7 |date=June 1997 |pmid=9205824 |pmc=2042789 |doi=10.1046/j.1365-2125.1997.00606.x |url=}}</ref>
*Phenothiazines are antidopaminergics which are effective for migraine, motion sickness, vertigo, postoperative and chemotherapy induced nausea nd vomiting. Eg., Prochlorperazine, Promethazine, Chlorpromazine, Perphenazine 5–10 mg every 6–8 hours, 12.5 –25 mg every 4–6 hours, 10–25 mg every 4–6 hours, 4–8 mg every 8–12 hours Oral, IV or IM. <ref name="pmid16934536">{{cite journal |vauthors=Sanger GJ, Andrews PL |title=Treatment of nausea and vomiting: gaps in our knowledge |journal=Auton Neurosci |volume=129 |issue=1-2 |pages=3–16 |date=October 2006 |pmid=16934536 |doi=10.1016/j.autneu.2006.07.009 |url=}}</ref> <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref>
*Droperidol is a Butyrophenone and a restricted drug used for postoperative and chemotherapy induced nausea and vomiting, 0.625–1.25 mg every 24hours IM or IV <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref>
* Cannabinoids are used for chemotherapy induced nausea and vomiting. Eg., Dronabinol, Nabilone 2.5–10 mg every 6–8 hours, 1–2 mg every 8–12 hours oral. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid375088">{{cite journal |vauthors=Herman TS, Einhorn LH, Jones SE, Nagy C, Chester AB, Dean JC, Furnas B, Williams SD, Leigh SA, Dorr RT, Moon TE |title=Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy |journal=N Engl J Med |volume=300 |issue=23 |pages=1295–7 |date=June 1979 |pmid=375088 |doi=10.1056/NEJM197906073002302 |url=}}</ref>
* Corticosteroids are used for acute or delayed chemotherapy induced or postoperative nausea and vomiting. Eg., Dexamethasone 4–8 mg every 4–6 hours Oral, IM or IV. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid15190136">{{cite journal |vauthors=Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N |title=A factorial trial of six interventions for the prevention of postoperative nausea and vomiting |journal=N Engl J Med |volume=350 |issue=24 |pages=2441–51 |date=June 2004 |pmid=15190136 |pmc=1307533 |doi=10.1056/NEJMoa032196 |url=}}</ref>
* NK-1 Receptor Antagonist is used in acute as well as delayed chemotherapy-induced nausea and vomiting. It has also been used in gastroparesis-associated nausea and vomiting. Eg., Aprepitant 80–125 mg every 24 hours oral. <ref name="pmid18208572">{{cite journal |vauthors=Madsen JL, Fuglsang S |title=A randomized, placebo-controlled, crossover, double-blind trial of the NK1 receptor antagonist aprepitant on gastrointestinal motor function in healthy humans |journal=Aliment Pharmacol Ther |volume=27 |issue=7 |pages=609–15 |date=April 2008 |pmid=18208572 |doi=10.1111/j.1365-2036.2008.03618.x |url=}}</ref> <ref name="pmid19719336">{{cite journal |vauthors=Curran MP, Robinson DM |title=Aprepitant: a review of its use in the prevention of nausea and vomiting |journal=Drugs |volume=69 |issue=13 |pages=1853–78 |date=2009 |pmid=19719336 |doi=10.2165/11203680-000000000-00000 |url=}}</ref> <ref name="pmid19444262">{{cite journal |vauthors=Chong K, Dhatariya K |title=A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant |journal=Nat Rev Endocrinol |volume=5 |issue=5 |pages=285–8 |date=May 2009 |pmid=19444262 |doi=10.1038/nrendo.2009.50 |url=}}</ref>

===Prokinetics===
*Prokinetic agents are used for only prokinetic activity (eg, Erythromycin) or both prokinetic and antiemetic activity (eg, Benzamides like Metoclopramide and Domperidone are shown to be efficacious in chemotherapy induced vomiting and gastroparesis). Metoclopramide 10–20 mg every 6–8 hours Oral, IM or IV, Domperidone 10mg every 8–24 hours oral, Erythromycin 250–500mg every 8 hours oral or IV. <ref name="pmid23201066">{{cite journal |vauthors=Javid FA, Bulmer DC, Broad J, Aziz Q, Dukes GE, Sanger GJ |title=Anti-emetic and emetic effects of erythromycin in Suncus murinus: role of vagal nerve activation, gastric motility stimulation and motilin receptors |journal=Eur J Pharmacol |volume=699 |issue=1-3 |pages=48–54 |date=January 2013 |pmid=23201066 |doi=10.1016/j.ejphar.2012.11.035 |url=}}</ref> <ref name="pmid1612359">{{cite journal |vauthors=Tack J, Janssens J, Vantrappen G, Peeters T, Annese V, Depoortere I, Muls E, Bouillon R |title=Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis |journal=Gastroenterology |volume=103 |issue=1 |pages=72–9 |date=July 1992 |pmid=1612359 |doi=10.1016/0016-5085(92)91097-n |url=}}</ref>

===Miscellaneous therapy===
* Novel and non-traditional therapies for nausea and vomiting include Tricyclic antidepressants (TCAs), Gabapentin and Olanzapine. Tricyclic antidepressants (Amitriptyline, Nortriptyline, Doxepin, Desipramine, Imipramine) 10–100 mg/day oral, Gabapentin 300–900 mg three times daily oral, Olanzapine 5–10 mg/day oral. <ref name="pmid9753257">{{cite journal |vauthors=Prakash C, Lustman PJ, Freedland KE, Clouse RE |title=Tricyclic antidepressants for functional nausea and vomiting: clinical outcome in 37 patients |journal=Dig Dis Sci |volume=43 |issue=9 |pages=1951–6 |date=September 1998 |pmid=9753257 |doi=10.1023/a:1018878324327 |url=}}</ref> <ref name="pmid15796394">{{cite journal |vauthors=Guttuso T, Vitticore P, Holloway RG |title=Responsiveness of life-threatening refractory emesis to gabapentin-scopolamine therapy following posterior fossa surgery. Case report |journal=J Neurosurg |volume=102 |issue=3 |pages=547–9 |date=March 2005 |pmid=15796394 |doi=10.3171/jns.2005.102.3.0547 |url=}}</ref> <ref name="pmid15700131">{{cite journal |vauthors=Navari RM, Einhorn LH, Passik SD, Loehrer PJ, Johnson C, Mayer ML, McClean J, Vinson J, Pletcher W |title=A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: a Hoosier Oncology Group study |journal=Support Care Cancer |volume=13 |issue=7 |pages=529–34 |date=July 2005 |pmid=15700131 |doi=10.1007/s00520-004-0755-6 |url=}}</ref> <ref name="pmid15493359">{{cite journal |vauthors=Passik SD, Navari RM, Jung SH, Nagy C, Vinson J, Kirsh KL, Loehrer P |title=A phase I trial of olanzapine (Zyprexa) for the prevention of delayed emesis in cancer patients: a Hoosier Oncology Group study |journal=Cancer Invest |volume=22 |issue=3 |pages=383–8 |date=2004 |pmid=15493359 |doi=10.1081/cnv-200029066 |url=}}</ref>
* Ginger has some efficacy to reduce postoperative nausea and vomiting, morning sickness and motion sickness. <ref name="pmid10793599">{{cite journal |vauthors=Ernst E, Pittler MH |title=Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials |journal=Br J Anaesth |volume=84 |issue=3 |pages=367–71 |date=March 2000 |pmid=10793599 |doi=10.1093/oxfordjournals.bja.a013442 |url=}}</ref> <ref name="pmid12233808">{{cite journal |vauthors=Keating A, Chez RA |title=Ginger syrup as an antiemetic in early pregnancy |journal=Altern Ther Health Med |volume=8 |issue=5 |pages=89–91 |date=2002 |pmid=12233808 |doi= |url=}}</ref>
* Gastric electric stimulation(GES) is a surgical procedure used in refractory gastroparesis. <ref name="pmid19719511">{{cite journal |vauthors=McCallum RW, Dusing RW, Sarosiek I, Cocjin J, Forster J, Lin Z |title=Mechanisms of symptomatic improvement after gastric electrical stimulation in gastroparetic patients |journal=Neurogastroenterol Motil |volume=22 |issue=2 |pages=161–7, e50–1 |date=February 2010 |pmid=19719511 |doi=10.1111/j.1365-2982.2009.01389.x |url=}}</ref>
* Alternative approaches include hypnosis, acupressure and acupuncture. <ref name="pmid10971166">{{cite journal |vauthors=Marchioro G, Azzarello G, Viviani F, Barbato F, Pavanetto M, Rosetti F, Pappagallo GL, Vinante O |title=Hypnosis in the treatment of anticipatory nausea and vomiting in patients receiving cancer chemotherapy |journal=Oncology |volume=59 |issue=2 |pages=100–4 |date=August 2000 |pmid=10971166 |doi=10.1159/000012144 |url=}}</ref> <ref name="pmid19370583">{{cite journal |vauthors=Lee A, Fan LT |title=Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD003281 |date=April 2009 |pmid=19370583 |pmc=3113464 |doi=10.1002/14651858.CD003281.pub3 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs overview]]

Nausea and vomiting medical therapy

2021-01-18T06:33:27Z

Tayebah Chaudhry: /* Prokinetics */

__NOTOC__
{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}
==Overview==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.

== Medical Therapy ==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.
===Antiemetics===
* Benzodiazepines are used for anticipatory nausea and postoperative nausea and vomiting. Eg., Lorazepam 0.5-2mg oral, SL (sublingual) or IM (intramuscular), Alprazolam 0.25-1mg oral or IV (intravenous). <ref name="pmid8123420">{{cite journal |vauthors=Di Florio T, Goucke R |title=Reduction of dopamine release and postoperative emesis by benzodiazepines |journal=Br J Anaesth |volume=71 |issue=2 |pages=325 |date=August 1993 |pmid=8123420 |doi=10.1093/bja/71.2.325 |url=}}</ref>
*Serotonin antagonists are used in postoperative, post-radiation and chemotherapy induced nausea and vomiting. Eg., Ondansetron 4-8mg oral or IV, Granisetron 1-2 mg every 4-8 hours or 0.075mg-0.25mg every 24 hours oral or IV. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
*Antihistamines are used in motion sickness and labrythitis. Eg., Meclizine 25-50mg every 24 hours oral, Diphenhydramine, Cyclizine, Hydroxazine 25-50mg every 6-8 hours, 25–75 mg every 8 hours, 25–50 mg every 4–6 hours, 25–100 mg every 6–8 hours oral, IM or IV. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref> <ref name="pmid15023018">{{cite journal |vauthors=Flake ZA, Scalley RD, Bailey AG |title=Practical selection of antiemetics |journal=Am Fam Physician |volume=69 |issue=5 |pages=1169–74 |date=March 2004 |pmid=15023018 |doi= |url=}}</ref>
*Anticholenergic agents are used in motion sickness. Eg., Scopolamine 0.3–0.6 mg every 24 hours SL, IV, IM or transdermal. <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref> <ref name="pmid9205824">{{cite journal |vauthors=Golding JF, Stott JR |title=Comparison of the effects of a selective muscarinic receptor antagonist and hyoscine (scopolamine) on motion sickness, skin conductance and heart rate |journal=Br J Clin Pharmacol |volume=43 |issue=6 |pages=633–7 |date=June 1997 |pmid=9205824 |pmc=2042789 |doi=10.1046/j.1365-2125.1997.00606.x |url=}}</ref>
*Phenothiazines are antidopaminergics which are effective for migraine, motion sickness, vertigo, postoperative and chemotherapy induced nausea nd vomiting. Eg., Prochlorperazine, Promethazine, Chlorpromazine, Perphenazine 5–10 mg every 6–8 hours, 12.5 –25 mg every 4–6 hours, 10–25 mg every 4–6 hours, 4–8 mg every 8–12 hours Oral, IV or IM. <ref name="pmid16934536">{{cite journal |vauthors=Sanger GJ, Andrews PL |title=Treatment of nausea and vomiting: gaps in our knowledge |journal=Auton Neurosci |volume=129 |issue=1-2 |pages=3–16 |date=October 2006 |pmid=16934536 |doi=10.1016/j.autneu.2006.07.009 |url=}}</ref> <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref>
*Droperidol is a Butyrophenone and a restricted drug used for postoperative and chemotherapy induced nausea and vomiting, 0.625–1.25 mg every 24hours IM or IV <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref>
* Cannabinoids are used for chemotherapy induced nausea and vomiting. Eg., Dronabinol, Nabilone 2.5–10 mg every 6–8 hours, 1–2 mg every 8–12 hours oral. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid375088">{{cite journal |vauthors=Herman TS, Einhorn LH, Jones SE, Nagy C, Chester AB, Dean JC, Furnas B, Williams SD, Leigh SA, Dorr RT, Moon TE |title=Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy |journal=N Engl J Med |volume=300 |issue=23 |pages=1295–7 |date=June 1979 |pmid=375088 |doi=10.1056/NEJM197906073002302 |url=}}</ref>
* Corticosteroids are used for acute or delayed chemotherapy induced or postoperative nausea and vomiting. Eg., Dexamethasone 4–8 mg every 4–6 hours Oral, IM or IV. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid15190136">{{cite journal |vauthors=Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N |title=A factorial trial of six interventions for the prevention of postoperative nausea and vomiting |journal=N Engl J Med |volume=350 |issue=24 |pages=2441–51 |date=June 2004 |pmid=15190136 |pmc=1307533 |doi=10.1056/NEJMoa032196 |url=}}</ref>
* NK-1 Receptor Antagonist is used in acute as well as delayed chemotherapy-induced nausea and vomiting. It has also been used in gastroparesis-associated nausea and vomiting. Eg., Aprepitant 80–125 mg every 24 hours oral. <ref name="pmid18208572">{{cite journal |vauthors=Madsen JL, Fuglsang S |title=A randomized, placebo-controlled, crossover, double-blind trial of the NK1 receptor antagonist aprepitant on gastrointestinal motor function in healthy humans |journal=Aliment Pharmacol Ther |volume=27 |issue=7 |pages=609–15 |date=April 2008 |pmid=18208572 |doi=10.1111/j.1365-2036.2008.03618.x |url=}}</ref> <ref name="pmid19719336">{{cite journal |vauthors=Curran MP, Robinson DM |title=Aprepitant: a review of its use in the prevention of nausea and vomiting |journal=Drugs |volume=69 |issue=13 |pages=1853–78 |date=2009 |pmid=19719336 |doi=10.2165/11203680-000000000-00000 |url=}}</ref> <ref name="pmid19444262">{{cite journal |vauthors=Chong K, Dhatariya K |title=A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant |journal=Nat Rev Endocrinol |volume=5 |issue=5 |pages=285–8 |date=May 2009 |pmid=19444262 |doi=10.1038/nrendo.2009.50 |url=}}</ref>

===Prokinetics===
*Prokinetic agents are used for only prokinetic activity (eg, Erythromycin) or both prokinetic and antiemetic activity (eg, Benzamides like Metoclopramide and Domperidone are shown to be efficacious in chemotherapy induced vomiting and gastroparesis). Metoclopramide 10–20 mg every 6–8 hours Oral, IM or IV, Domperidone 10mg every 8–24 hours oral, Erythromycin 250–500mg every 8 hours oral or IV. <ref name="pmid23201066">{{cite journal |vauthors=Javid FA, Bulmer DC, Broad J, Aziz Q, Dukes GE, Sanger GJ |title=Anti-emetic and emetic effects of erythromycin in Suncus murinus: role of vagal nerve activation, gastric motility stimulation and motilin receptors |journal=Eur J Pharmacol |volume=699 |issue=1-3 |pages=48–54 |date=January 2013 |pmid=23201066 |doi=10.1016/j.ejphar.2012.11.035 |url=}}</ref> <ref name="pmid1612359">{{cite journal |vauthors=Tack J, Janssens J, Vantrappen G, Peeters T, Annese V, Depoortere I, Muls E, Bouillon R |title=Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis |journal=Gastroenterology |volume=103 |issue=1 |pages=72–9 |date=July 1992 |pmid=1612359 |doi=10.1016/0016-5085(92)91097-n |url=}}</ref>

===Miscellaneous therapy===
* Novel and non-traditional therapies for nausea and vomiting include Tricyclic antidepressants (TCAs), Gabapentin and Olanzapine. Tricyclic antidepressants (Amitriptyline, Nortriptyline, Doxepin, Desipramine, Imipramine) 10–100 mg/day oral, Gabapentin 300–900 mg three times daily oral, Olanzapine 5–10 mg/day oral. <ref name="pmid9753257">{{cite journal |vauthors=Prakash C, Lustman PJ, Freedland KE, Clouse RE |title=Tricyclic antidepressants for functional nausea and vomiting: clinical outcome in 37 patients |journal=Dig Dis Sci |volume=43 |issue=9 |pages=1951–6 |date=September 1998 |pmid=9753257 |doi=10.1023/a:1018878324327 |url=}}</ref> <ref name="pmid15796394">{{cite journal |vauthors=Guttuso T, Vitticore P, Holloway RG |title=Responsiveness of life-threatening refractory emesis to gabapentin-scopolamine therapy following posterior fossa surgery. Case report |journal=J Neurosurg |volume=102 |issue=3 |pages=547–9 |date=March 2005 |pmid=15796394 |doi=10.3171/jns.2005.102.3.0547 |url=}}</ref> <ref name="pmid15700131">{{cite journal |vauthors=Navari RM, Einhorn LH, Passik SD, Loehrer PJ, Johnson C, Mayer ML, McClean J, Vinson J, Pletcher W |title=A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: a Hoosier Oncology Group study |journal=Support Care Cancer |volume=13 |issue=7 |pages=529–34 |date=July 2005 |pmid=15700131 |doi=10.1007/s00520-004-0755-6 |url=}}</ref> <ref name="pmid15493359">{{cite journal |vauthors=Passik SD, Navari RM, Jung SH, Nagy C, Vinson J, Kirsh KL, Loehrer P |title=A phase I trial of olanzapine (Zyprexa) for the prevention of delayed emesis in cancer patients: a Hoosier Oncology Group study |journal=Cancer Invest |volume=22 |issue=3 |pages=383–8 |date=2004 |pmid=15493359 |doi=10.1081/cnv-200029066 |url=}}</ref>
* Ginger has some efficacy to reduce post-operative nausea and vomiting, morning sickness and motion sickness. <ref name="pmid10793599">{{cite journal |vauthors=Ernst E, Pittler MH |title=Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials |journal=Br J Anaesth |volume=84 |issue=3 |pages=367–71 |date=March 2000 |pmid=10793599 |doi=10.1093/oxfordjournals.bja.a013442 |url=}}</ref> <ref name="pmid12233808">{{cite journal |vauthors=Keating A, Chez RA |title=Ginger syrup as an antiemetic in early pregnancy |journal=Altern Ther Health Med |volume=8 |issue=5 |pages=89–91 |date=2002 |pmid=12233808 |doi= |url=}}</ref>
* Gastric electric stimulation is a surgical procedure used in refractory gastroparesis. <ref name="pmid19719511">{{cite journal |vauthors=McCallum RW, Dusing RW, Sarosiek I, Cocjin J, Forster J, Lin Z |title=Mechanisms of symptomatic improvement after gastric electrical stimulation in gastroparetic patients |journal=Neurogastroenterol Motil |volume=22 |issue=2 |pages=161–7, e50–1 |date=February 2010 |pmid=19719511 |doi=10.1111/j.1365-2982.2009.01389.x |url=}}</ref>
* Alternative approaches include hypnosis, acupressure and acupuncture. <ref name="pmid10971166">{{cite journal |vauthors=Marchioro G, Azzarello G, Viviani F, Barbato F, Pavanetto M, Rosetti F, Pappagallo GL, Vinante O |title=Hypnosis in the treatment of anticipatory nausea and vomiting in patients receiving cancer chemotherapy |journal=Oncology |volume=59 |issue=2 |pages=100–4 |date=August 2000 |pmid=10971166 |doi=10.1159/000012144 |url=}}</ref> <ref name="pmid19370583">{{cite journal |vauthors=Lee A, Fan LT |title=Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD003281 |date=April 2009 |pmid=19370583 |pmc=3113464 |doi=10.1002/14651858.CD003281.pub3 |url=}}</ref>

==References==
{{reflist|2}}
{{WH}}
{{WS}}

[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs overview]]

Nausea and vomiting medical therapy

2021-01-18T06:27:51Z

Tayebah Chaudhry: /* Antiemetics */

__NOTOC__
{{Nausea and vomiting}}
{{CMG}} {{AE}} {{VVS}
==Overview==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.

== Medical Therapy ==
* Mainstay of treatment of nausea and vomiting is correcting any electrolyte imbalance, dehydration, malnutrition, and suppression of symptoms while evaluating and treating the underlying cause. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
* Dietary recommendations include a low-fat, low-fiber diet with frequent small meals if able to tolerate oral intake. Liquid diet is recommended in case solid diet is not well tolerated. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref>
* Medical therapy involves two groups of drugs i.e., antiemetics and prokinetics. Antiemetics suppress nausea and vomiting and typically act centrally. Prokinetics modulate gastrointestinal motility.
===Antiemetics===
* Benzodiazepines are used for anticipatory nausea and postoperative nausea and vomiting. Eg., Lorazepam 0.5-2mg oral, SL (sublingual) or IM (intramuscular), Alprazolam 0.25-1mg oral or IV (intravenous). <ref name="pmid8123420">{{cite journal |vauthors=Di Florio T, Goucke R |title=Reduction of dopamine release and postoperative emesis by benzodiazepines |journal=Br J Anaesth |volume=71 |issue=2 |pages=325 |date=August 1993 |pmid=8123420 |doi=10.1093/bja/71.2.325 |url=}}</ref>
*Serotonin antagonists are used in postoperative, post-radiation and chemotherapy induced nausea and vomiting. Eg., Ondansetron 4-8mg oral or IV, Granisetron 1-2 mg every 4-8 hours or 0.075mg-0.25mg every 24 hours oral or IV. <ref name="pmid14724837">{{cite journal |vauthors=Hasler WL, Chey WD |title=Nausea and vomiting |journal=Gastroenterology |volume=125 |issue=6 |pages=1860–7 |date=December 2003 |pmid=14724837 |doi=10.1053/j.gastro.2003.09.040 |url=}}</ref>
*Antihistamines are used in motion sickness and labrythitis. Eg., Meclizine 25-50mg every 24 hours oral, Diphenhydramine, Cyclizine, Hydroxazine 25-50mg every 6-8 hours, 25–75 mg every 8 hours, 25–50 mg every 4–6 hours, 25–100 mg every 6–8 hours oral, IM or IV. <ref name="pmid26770271">{{cite journal |vauthors=Singh P, Yoon SS, Kuo B |title=Nausea: a review of pathophysiology and therapeutics |journal=Therap Adv Gastroenterol |volume=9 |issue=1 |pages=98–112 |date=January 2016 |pmid=26770271 |pmc=4699282 |doi=10.1177/1756283X15618131 |url=}}</ref> <ref name="pmid15023018">{{cite journal |vauthors=Flake ZA, Scalley RD, Bailey AG |title=Practical selection of antiemetics |journal=Am Fam Physician |volume=69 |issue=5 |pages=1169–74 |date=March 2004 |pmid=15023018 |doi= |url=}}</ref>
*Anticholenergic agents are used in motion sickness. Eg., Scopolamine 0.3–0.6 mg every 24 hours SL, IV, IM or transdermal. <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref> <ref name="pmid9205824">{{cite journal |vauthors=Golding JF, Stott JR |title=Comparison of the effects of a selective muscarinic receptor antagonist and hyoscine (scopolamine) on motion sickness, skin conductance and heart rate |journal=Br J Clin Pharmacol |volume=43 |issue=6 |pages=633–7 |date=June 1997 |pmid=9205824 |pmc=2042789 |doi=10.1046/j.1365-2125.1997.00606.x |url=}}</ref>
*Phenothiazines are antidopaminergics which are effective for migraine, motion sickness, vertigo, postoperative and chemotherapy induced nausea nd vomiting. Eg., Prochlorperazine, Promethazine, Chlorpromazine, Perphenazine 5–10 mg every 6–8 hours, 12.5 –25 mg every 4–6 hours, 10–25 mg every 4–6 hours, 4–8 mg every 8–12 hours Oral, IV or IM. <ref name="pmid16934536">{{cite journal |vauthors=Sanger GJ, Andrews PL |title=Treatment of nausea and vomiting: gaps in our knowledge |journal=Auton Neurosci |volume=129 |issue=1-2 |pages=3–16 |date=October 2006 |pmid=16934536 |doi=10.1016/j.autneu.2006.07.009 |url=}}</ref> <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref>
*Droperidol is a Butyrophenone and a restricted drug used for postoperative and chemotherapy induced nausea and vomiting, 0.625–1.25 mg every 24hours IM or IV <ref name="pmid11208736">{{cite journal |vauthors=Quigley EM, Hasler WL, Parkman HP |title=AGA technical review on nausea and vomiting |journal=Gastroenterology |volume=120 |issue=1 |pages=263–86 |date=January 2001 |pmid=11208736 |doi=10.1053/gast.2001.20516 |url=}}</ref>
* Cannabinoids are used for chemotherapy induced nausea and vomiting. Eg., Dronabinol, Nabilone 2.5–10 mg every 6–8 hours, 1–2 mg every 8–12 hours oral. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid375088">{{cite journal |vauthors=Herman TS, Einhorn LH, Jones SE, Nagy C, Chester AB, Dean JC, Furnas B, Williams SD, Leigh SA, Dorr RT, Moon TE |title=Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy |journal=N Engl J Med |volume=300 |issue=23 |pages=1295–7 |date=June 1979 |pmid=375088 |doi=10.1056/NEJM197906073002302 |url=}}</ref>
* Corticosteroids are used for acute or delayed chemotherapy induced or postoperative nausea and vomiting. Eg., Dexamethasone 4–8 mg every 4–6 hours Oral, IM or IV. <ref name="pmid18321441">{{cite journal |vauthors=Chepyala P, Olden KW |title=Nausea and vomiting |journal=Curr Treat Options Gastroenterol |volume=11 |issue=2 |pages=135–44 |date=April 2008 |pmid=18321441 |doi=10.1007/s11938-008-0026-6 |url=}}</ref> <ref name="pmid15190136">{{cite journal |vauthors=Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N |title=A factorial trial of six interventions for the prevention of postoperative nausea and vomiting |journal=N Engl J Med |volume=350 |issue=24 |pages=2441–51 |date=June 2004 |pmid=15190136 |pmc=1307533 |doi=10.1056/NEJMoa032196 |url=}}</ref>
* NK-1 Receptor Antagonist is used in acute as well as delayed chemotherapy-induced nausea and vomiting. It has also been used in gastroparesis-associated nausea and vomiting. Eg., Aprepitant 80–125 mg every 24 hours oral. <ref name="pmid18208572">{{cite journal |vauthors=Madsen JL, Fuglsang S |title=A randomized, placebo-controlled, crossover, double-blind trial of the NK1 receptor antagonist aprepitant on gastrointestinal motor function in healthy humans |journal=Aliment Pharmacol Ther |volume=27 |issue=7 |pages=609–15 |date=April 2008 |pmid=18208572 |doi=10.1111/j.1365-2036.2008.03618.x |url=}}</ref> <ref name="pmid19719336">{{cite journal |vauthors=Curran MP, Robinson DM |title=Aprepitant: a review of its use in the prevention of nausea and vomiting |journal=Drugs |volume=69 |issue=13 |pages=1853–78 |date=2009 |pmid=19719336 |doi=10.2165/11203680-000000000-00000 |url=}}</ref> <ref name="pmid19444262">{{cite journal |vauthors=Chong K, Dhatariya K |title=A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant |journal=Nat Rev Endocrinol |volume=5 |issue=5 |pages=285–8 |date=May 2009 |pmid=19444262 |doi=10.1038/nrendo.2009.50 |url=}}</ref>

===Prokinetics===
*Prokinetic agents are used for only prokinetic activity (such as Erythromycin) or both prokinetic and antiemetic activity (such as Metoclopramide and Domperidone which are Benzamides). Metoclopramide 10–20 mg every 6–8 hours Oral, IM or IV, Domperidone 10mg every 8–24 hours oral, Erythromycin 250–500mg every 8 hours oral or IV. <ref name="pmid23201066">{{cite journal |vauthors=Javid FA, Bulmer DC, Broad J, Aziz Q, Dukes GE, Sanger GJ |title=Anti-emetic and emetic effects of erythromycin in Suncus murinus: role of vagal nerve activation, gastric motility stimulation and motilin receptors |journal=Eur J Pharmacol |volume=699 |issue=1-3 |pages=48–54 |date=January 2013 |pmid=23201066 |doi=10.1016/j.ejphar.2012.11.035 |url=}}</ref>
===Miscellaneous therapy===
* Novel and non-traditional therapies for nausea and vomiting include Tricyclic antidepressants (TCAs), Gabapentin and Olanzapine. Tricyclic antidepressants (Amitriptyline, Nortriptyline, Doxepin, Desipramine, Imipramine) 10–100 mg/day oral, Gabapentin 300–900 mg three times daily oral, Olanzapine 5–10 mg/day oral. <ref name="pmid9753257">{{cite journal |vauthors=Prakash C, Lustman PJ, Freedland KE, Clouse RE |title=Tricyclic antidepressants for functional nausea and vomiting: clinical outcome in 37 patients |journal=Dig Dis Sci |volume=43 |issue=9 |pages=1951–6 |date=September 1998 |pmid=9753257 |doi=10.1023/a:1018878324327 |url=}}</ref> <ref name="pmid15796394">{{cite journal |vauthors=Guttuso T, Vitticore P, Holloway RG |title=Responsiveness of life-threatening refractory emesis to gabapentin-scopolamine therapy following posterior fossa surgery. Case report |journal=J Neurosurg |volume=102 |issue=3 |pages=547–9 |date=March 2005 |pmid=15796394 |doi=10.3171/jns.2005.102.3.0547 |url=}}</ref> <ref name="pmid15700131">{{cite journal |vauthors=Navari RM, Einhorn LH, Passik SD, Loehrer PJ, Johnson C, Mayer ML, McClean J, Vinson J, Pletcher W |title=A phase II trial of olanzapine for the prevention of chemotherapy-induced nausea and vomiting: a Hoosier Oncology Group study |journal=Support Care Cancer |volume=13 |issue=7 |pages=529–34 |date=July 2005 |pmid=15700131 |doi=10.1007/s00520-004-0755-6 |url=}}</ref> <ref name="pmid15493359">{{cite journal |vauthors=Passik SD, Navari RM, Jung SH, Nagy C, Vinson J, Kirsh KL, Loehrer P |title=A phase I trial of olanzapine (Zyprexa) for the prevention of delayed emesis in cancer patients: a Hoosier Oncology Group study |journal=Cancer Invest |volume=22 |issue=3 |pages=383–8 |date=2004 |pmid=15493359 |doi=10.1081/cnv-200029066 |url=}}</ref>
* Ginger has some efficacy to reduce post-operative nausea and vomiting, morning sickness and motion sickness. <ref name="pmid10793599">{{cite journal |vauthors=Ernst E, Pittler MH |title=Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials |journal=Br J Anaesth |volume=84 |issue=3 |pages=367–71 |date=March 2000 |pmid=10793599 |doi=10.1093/oxfordjournals.bja.a013442 |url=}}</ref> <ref name="pmid12233808">{{cite journal |vauthors=Keating A, Chez RA |title=Ginger syrup as an antiemetic in early pregnancy |journal=Altern Ther Health Med |volume=8 |issue=5 |pages=89–91 |date=2002 |pmid=12233808 |doi= |url=}}</ref>
* Gastric electric stimulation is a surgical procedure used in refractory gastroparesis. <ref name="pmid19719511">{{cite journal |vauthors=McCallum RW, Dusing RW, Sarosiek I, Cocjin J, Forster J, Lin Z |title=Mechanisms of symptomatic improvement after gastric electrical stimulation in gastroparetic patients |journal=Neurogastroenterol Motil |volume=22 |issue=2 |pages=161–7, e50–1 |date=February 2010 |pmid=19719511 |doi=10.1111/j.1365-2982.2009.01389.x |url=}}</ref>
* Alternative approaches include hypnosis, acupressure and acupuncture. <ref name="pmid10971166">{{cite journal |vauthors=Marchioro G, Azzarello G, Viviani F, Barbato F, Pavanetto M, Rosetti F, Pappagallo GL, Vinante O |title=Hypnosis in the treatment of anticipatory nausea and vomiting in patients receiving cancer chemotherapy |journal=Oncology |volume=59 |issue=2 |pages=100–4 |date=August 2000 |pmid=10971166 |doi=10.1159/000012144 |url=}}</ref> <ref name="pmid19370583">{{cite journal |vauthors=Lee A, Fan LT |title=Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD003281 |date=April 2009 |pmid=19370583 |pmc=3113464 |doi=10.1002/14651858.CD003281.pub3 |url=}}</ref>

==References==
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[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Obstetrics]]
[[Category:Needs overview]]