All the Nausea Pathways
Walk down the 4 pathways that lead to vomiting, learn to organize types of nausea, how vomiting reflex and nausea threshold works, and explore how to choose between antiemetics.
Alright let’s get NERDY!! What exactly is nausea?
- Nausea is the same thing as being queasy or state of feeling like vomiting could be soonish
- More than physical = also emotional & psychological
- Can be learned behavior
- Goes away with adrenaline
- Can’t be measured, hard to test & study
- Different process from vomiting
- Simmers below a threshold until setting off vomiting
nausea = parasympathetic vomiting = sympathetic
4 nausea pathways: gut vagal nerve, the vestibular nerve, the glossopharngeal nerve and the area postrema in the brain.
Gut vagal nerve:
- Gastric irritation: reflux, gastroparesis (n damage or sugar), smoke, bacterial toxin, viral infection, obstruction, slow empty, digesting blood, medicaiton side effects (and more!)
- Emotion, espeically anxiety or fear
Go to medication: antihistamines, zofran or reglan
Glossopharyngeal nerve:
- Gag reflex
- Foul smell?
- low BP?
Go to medication: sedation/paralyze
Vestibular nerve:
- motion
- otolith dislodgement
- infection/inflammation
Go to medication: meclizine, scopolamine, valium
Area Postrema:
- emotions
- high intracranial pressure
- toxins
- hormones
Go to medications: zofran, phenergan + steroid
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