Vomiting, Act

Actions and Uses.—Internally —In excessive doses, irritant poison in small doses, it promotes the secretion of mucous membranes, skin, liver, pancreas, and kidneys, likewise stimulates the activity of the absorbent system in larger doses, it causes nausea, relaxes muscular fibres, depresses the nervous system, and, in animals capable of vomition, acts as an emetic. Used internally as an alterative, antiphlogistic, nauseant, sedative, and emetic. Given in the early stages of infiammatory diseases, in pneumonia, bronchitis, articular rheumatism, Ac. also employed as a vermifuge. Externally —Vesicant, counter-irritant. Sometimes added to ordinary blistering ointments to increase their activity. 

Ipecac is prepared from the dried roots and rhizomes of Cephaelis ipecacuanha (Brot.) A. Rich, and contains the alkaloids emetine [483-18-1] (17) and cephaeJine [483-17-0] (18) in a ratio between 2 1 and 4 1. It has been used extensively in cough preparations and is beheved to act by gastric reflex stimulation. Toxic effects include vomiting, irritation of the gastrointestinal tract, and cardiac arrhythmias (19). Ipecac symp is available over-the-counter in the United States only in 30-mL containers for use as an emetic in treating poisonings. 

Opioids act on the area postrema and/or the NTS via p or 8 receptors to produce emesis. Also, ambulatory patients receiving opioids are more affected than those confined to bed, suggesting a vestibular component in the effect. The emetic action of opioids is complicated by an antiemetic action, possibly involving two receptors at the NTS or the vomiting centre. 

The act of vomiting is a complex process accompanied by several events apart from activation of the motor nerves and various voluntary muscles involved in the increase of intragastric pressure and evacuation of the stomach contents. Vomiting is preceded by a deep inspiration, closure of the glottis and raising of the soft palate to prevent vomitus entering the trachea and nasopharynx, respectively. There is also increased heart rate, pallor, salivation, sweating and lacrimation. 

The nurse immediately reportsany signs of acetaminophen toxicity, such as nausea, vomiting, anorexia, malaise, diaphoresis abdominal pain, confusion, liver tenderness hypotension, arrhythmias jaundice, and acute hepatic and renal failure. Early diagnoss is important because liver failure may be reversible. Toxicity is treated with gastric lavage, preferably within 4 hours of ingestion of the acetaminophen. Liver function studiesare perform ed frequently. Acetylcysteine (Mucomyst) is an antidote to acetaminophen toxicity and acts by protect-... 

The large numbers of opioid receptors in areas of the brainstem such as the solitary tract and adjacent areas are probably related to respiratory effects of opiates, cough suppression and nausea and vomiting. Opiates acting in the brainstem reduce the sensitivity of the respiratory centres to pC02 and this is the most common cause of death from overdose with street use of opiates. 

The safety and efficacy of orlistat have not been determined beyond 4 years of use. Minimal systemic effects exist because orlistat acts locally in the GI tract. Thus, common side effects reported include oily spotting, flatus with discharge, fecal urgency, fatty/oily stools, oily evacuation, increased defecation, and fecal incontinence.31 Other adverse events include bloating, abdominal pain, dyspepsia, nausea, vomiting, diarrhea, and headache.37... 

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