Nausea-producing agents

Nausea-producing agents (eg, DM) may have substantial effectiveness but they can be toxic. Highly potent relatives of apomorphine (a well-known emetic) are known but they have rather low safety margins. (For further discussion of CN, CS, and DM, see Chapter 12, Riot Control Agents.) Psychochemical Agents... 

Dronabinol is indicated for the treatment of the nausea and vomiting produced by cancer chemotherapy in patients who have failed to respond adequately to other conventional treatments. This agent may be habit forming and can be expected to produce disturbing psychomimetic reactions. It should only be used under close supervision. 

Lenalidomide is an immunomodulating agent related to thalidomide that was recently approved for the treatment of patients with multiple myeloma and myelodysplastic syndrome (MDS). Lenalidomide lacks the common side effects of thalidomide, such as constipation and peripheral neuropathy. Interim analyses of two phase III trials show that lenalidomide in combination with dexamethasone produces higher response rates than dexamethasone alone in relapsed and refractory myeloma. Adverse effects of lenalidomide include diarrhea, nausea, muscle cramps, hematologic side effects and deep vein thrombosis.42... 

Clear liquid with an odor that is a mixture of alcohol and ammonia. This material is hazardous through inhalation and ingestion, and produces local skin/eye impacts. Inhalation of the agent may cause irritation of the lower respiratory tract, coughing, difficulty in breathing and, in high concentration, loss of consciousness. It causes severe irritation in contact with the skin and eyes. If ingested it causes nausea, salivation, and severe irritation of the mouth and stomach. 

Yellow Rain A lethal yellow substance thought to have been dispersed aerially as a warfare agent in Southeast Asia and Afghanistan the lethal component is though to have been a trichothecene mycotoxin that was reported to produce severe nausea and vomiting, disturbances in the central nervous system. Fever, chills, and abnormally low blood pressure with a case mortality of approximately 50 percent. 

The human intravenous bolus dose of oximes in nerve agent treatment ranges between 250 and 500 mg ". Side effects of oxime treatment in humans were monitored in 750 volunteers, and the main adverse effects reported were changes in blood pressure, pulse rate, dizziness, nausea and blurred vision . Oral administration of oximes produces gastrointestinal distress. ... 

Other approaches to induce gastrointestinal discomfort have far more serious toxic effects. The chemical colchicine stops cell division (an antimitotic), producing severe nausea, vomiting, and dehydration, which can lead to delirium, neuropathy, and kidney failure. On the other hand, colchicine is used in the treatment of gout and has been studied as an anticancer agent because it stops cell division. Most toxic of all are plants that produce lectins, and the most toxic of these is the chemical ricin produced by castor beans. Only 5 to 6 seeds are necessary to kill a small child. Fortunately, following oral consumption much of the ricin is destroyed in the stomach. Ricin is extremely effective at stopping protein synthesis, so much so that direct exposure to only 0.1 pg/kg can be fatal. 

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