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Introduction to palliation of nausea and vomiting Introduction to palliation of nausea and vomiting
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Pathways involved in emesis Pathways involved in emesis
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Definitions Definitions
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Central pathways involved in emesis Central pathways involved in emesis
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Afferent pathways involved in emesis Afferent pathways involved in emesis
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Choosing an antiemetic Choosing an antiemetic
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Antiemetic drugs available Antiemetic drugs available
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Drugs with receptor-specification Drugs with receptor-specification
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Dopamine (D2) antagonists Dopamine (D2) antagonists
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Phenothiazines Phenothiazines
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Antihistamines and anticholinergics Antihistamines and anticholinergics
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5-HT3 receptor antagonists 5-HT3 receptor antagonists
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NK1 receptor antagonists NK1 receptor antagonists
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Other antiemetic drugs Other antiemetic drugs
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Corticosteroids Corticosteroids
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Cannabinoids Cannabinoids
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Benzodiazepines Benzodiazepines
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Octreotide Octreotide
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Propofol Propofol
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Opioids Opioids
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Mirtazapine Mirtazapine
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Non-drug measures of palliation of nausea and vomiting Non-drug measures of palliation of nausea and vomiting
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Psychological techniques and massage Psychological techniques and massage
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Transcutaneous electrical nerve stimulation Transcutaneous electrical nerve stimulation
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Acupuncture and acupressure Acupuncture and acupressure
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Dietary modification, ginger, fish oil, and aromatherapy Dietary modification, ginger, fish oil, and aromatherapy
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Clinical syndromes associated with nausea and vomiting Clinical syndromes associated with nausea and vomiting
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Chemical causes of emesis Chemical causes of emesis
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Gastrointestinal causes of emesis Gastrointestinal causes of emesis
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Cranial causes of emesis Cranial causes of emesis
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Other causes of emesis Other causes of emesis
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Intractable nausea Intractable nausea
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Future developments Future developments
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References References
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Online references Online references
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10.2 Palliation of nausea and vomiting
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Published:March 2015
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Abstract
Nausea and vomiting (NV) are unpleasant symptoms reported as highly distressing by sufferers and have a significant impact on activities of daily living. The prevalence of nausea is 6-68% in people with advanced cancer, 17-48% in heart disease, 30-43% in renal disease, and 43-49% in people with AIDS and is not always associated with vomiting. Several multifactorial clinical syndromes can contribute to NV in patients with advanced illness. Two strategies have been proposed for the management of nausea and vomiting: the mechanistic and the empirical approach. Most of the evidence supporting the use of antiemetic drugs in palliative care has been extrapolated from trials of chemotherapy- and radiotherapy-induced NV. An ideal measurement tool for the assessment of NV and retching has yet to be developed. Inherent in the management of NV is to maximize treatment of those symptoms commonly associated with NV.
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