Theories of nausea and vomiting
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23.12.09
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- The main area in the brain responsible for vomiting is the vomiting center
- This area is located in the lateral reticular formation of the medulla
- It receives input from many areas:
- Chemoreceptor trigger zone
- Located in the floor of the 4th ventricle in the area postrema
- It picks up circulating chemical in the blood
- It is important because it lies outside the BBB, therefore, circulating toxins (e.g.bacterial food poisoning toxins, chemotherapy) can cause vomiting, even though they do not pass through the BBB
- Vestibular apparatus
- Tractus solitarius
- vagal afferents from the gut, heart and testes
- Direct input from gut (reflex)
It is important to know the receptors involved in the emetic response
- On the CTZ:
- 5HT3
- D2
- On the vagal afferents:
- 5HT3
- In the vomiting center
- Muscarinic
- H1 receptors
Category: Medical Subject Notes , Pharmacology Notes
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1 comments:
NK 1 (neurokinin 1) - antagonist aprepitant is also used in chemotherapy induced vomiting .
steroids (dexamethasone) also are anti emetics
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