Clinicians must be cognizant of the common, more benign but often treatable causes of vomiting as well as the less common but life-threatening surgical, metabolic and infectious disorders of which vomiting is a symptom. Practitioners should stay abreast of evolving recommendations on newer, effective anti-emetic therapies for treating chemotherapy patients and others with non-cancerous disorders.
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We will use the following terms as defined by the American Gastroenterological Association (AGA). (1)
Vomiting is a complex process that involves various systems that influence the vomiting center (Fig 1). The vomiting center is located in the lateral medullary reticular formation of the brainstem and is the final pathway for the physiologic processes that result in vomiting. The center has predominantly muscarinic M1 (M1), histamine 1 (H1), neurokinin 1, and serotonin receptors. The vomiting center receives...