An Outpatient Approach to Nausea and Vomiting

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An Outpatient Approach to Nausea and Vomiting

Abstract and Introduction

Abstract


Nausea and vomiting (N/V) is a common complaint among patients across all ages and levels of care. Symptoms of N/V may be self-treated or require referral to another provider for further work-up of possible causes. Selection of appropriate prevention and treatment is reliant upon understanding the precipitating physiological mechanisms from which N/V results. N/V may be caused by the vestibular system, stimulation of receptors at the chemoreceptor trigger zone, or infectious origins. Disease states may exacerbate symptoms or cause secondary N/V. The pharmacist plays an important role in the management of N/V including proper referral, medication selection, review of drug interactions or causes, and patient counseling.

Introduction


Nausea and vomiting (N/V) is a common complaint among patients across all ages and levels of care. Nausea is defined as the feeling of a need to vomit and vomiting as the expulsion of gastric contents via abdominal and chest wall contractions. The clinical presentation of N/V may involve the symptoms described above as well as signs of dehydration and electrolyte imbalance such as hypokalemia or metabolic acidosis. A thorough patient history for onset, timing of symptoms, nature of vomitus, and other signs that referral is appropriate is necessary to accurately assess the correct treatment option. The pharmacist should be able to assess medication efficacy for preventing and treating N/V to help establish a firm recommendation to the patient or provider.

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