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Nausea

German: Nausea, Übelkeit

1 Definition

Nausea is a sensation of feeling sick that usually stems from the gastrointestinal tract. Nausea can entail vomiting.

2 Causes

Nausea can have a variety of causes, e.g.:

3 Pathophysiology

Nausea is a complex sensation of the body that is modulated by the central and autonomous nervous system. Nausea associated with food poisoning can be understood as a self-protection mechanism of the body to prevent further food intake.

4 Therapy

Therapy of nausea depends on the specific cause and should primarily be causal. In addition to that, medication can be used for a symptomatic treatment. Drugs that aim to alleviate nausea are called antiemetics. This group of drugs includes among others:

When choosing the agent, the cause of the nausea should be taken into account.

The most commonly used antiemetics are probably the prokinetic agents Metoclopramide and Domperidone. They are used against nausea with different causes. Those also include nausea caused by pharmaceutical drugs, e.g. Tramadol and other opioids - especially when applied intravenously, some antibiotics (Doxycycline, Clindamycin) or SSRIs in the initial phase.

Nausea that is caused by kinetoses (motion sickness) does not respond to the usual antiemetics, like Metoclopramide. In those cases, first generation antihistamines (Diphenhydramine, Dimenhydrinate) or the anticholinergic agent Hyoscine are used.

Gastroparesis caused by diabetes is preferably treated with Metoclopramide and Domperidone. Those prokinetic agents are also used with food poisoning.

In the case of acute migraine attacks, Metoclopramide is used to suppress nausea and increase intestinal peristalsis that has slowed down due to pain. Metoclopramide can also be applied intravenously in serious cases. There are also suppositories available for migraine attacks.

The most effective drugs against nausea caused by cytotoxic agents in connection with chemotherapy or radiation treatment are setrons that have an antagonistic effect on the 5-HT-receptor. Products like Granisetron or Ondansetron reliably suppress nausea. They are often augmented with the glucocorticoid agent Dexamethasons. In therapy-resistant cases, treatment can include the benzodiazepine Lorazepam. Setrons can also be used for postoperative nausea.

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