Department of Acute Medicine, Chelsea and Westminster Hospital, London, UK.
Department of Acute Medicine, University Hospital Southampton, Southampton, UK.
Br J Hosp Med (Lond). 2020 May 2;81(5):1-8. doi: 10.12968/hmed.2020.0050. Epub 2020 May 11.
Nausea and vomiting are common symptoms in the hospital setting, with numerous causes. Common precipitants leading to or complicating inpatient hospital admissions include nausea and vomiting secondary to drugs, gastrointestinal disturbances, metabolic aberrancies, and vestibular pathologies. Appropriate selection and prescribing of antiemetic drugs is therefore important for healthcare professionals. There are numerous antiemetics available to physicians, ranging from muscarinic, dopaminergic and serotoninergic drugs, each acting on a different part of the nausea-vomiting cascade. This review describes the main pathophysiological processes involved in the development of symptomatic nausea and vomiting, and gives an overview of how common antiemetic drugs function to alleviate symptoms, alongside cautions and contraindications in their usage.
恶心和呕吐是医院环境中的常见症状,有许多原因。导致或使住院复杂化的常见诱因包括药物引起的恶心和呕吐、胃肠道紊乱、代谢异常和前庭病变。因此,对于医疗保健专业人员来说,选择和开处方适当的止吐药物非常重要。医生可使用的止吐药有很多种,包括毒蕈碱、多巴胺能和 5-羟色胺能药物,每种药物都作用于恶心-呕吐级联反应的不同部位。这篇综述描述了导致症状性恶心和呕吐的主要病理生理过程,并概述了常见止吐药物如何发挥作用来缓解症状,以及在使用时的注意事项和禁忌证。