Vomiting cyclic

Bulimia and anorexia nervosa Cyclic vomiting syndrome... 

Cannabinoid hyperemesis. Nineteen patients were identified with chronic cannabis abuse and a cyclical vomiting illness. Pol-low-up was provided with serial urine drug... 

While the 5-HT3 receptor is the most important in control of nausea and vomiting, others are also involved. 5-HT4 agonists have prokinetic properties in nauseated patients with gastroparesis and functional dyspepsia. The 5-HTlD-receptor agonists, such as sumatripan, are used in treatment of migraine and reduce emesis both in this condition and also in the cyclic vomiting syndrome, most likely via action on CNS sites. 

In a randomized, controlled study of cyclic iloprost or nifedipine in 46 patients with systemic sclerosis, the predictable adverse effects of iloprost (headache, nausea and vomiting, and diarrhea) were common but quickly resolved after the end of the infusion (5). They rarely required a temporary dose reduction. Hypotension occurred less often than with nifedipine. 

Evaluate for urea cycle disorders, as hyperammonemic encephalopathy, sometimes fatal, has been associated with valproate administration in these uncommon disorders urea cycle disorders, such as ormithine transcarbamylase deficiency, are associated with unexplained encephalopathy, mental retardation, elevated plasma ammonia, cyclical vomiting, and lethargy... 

Cyclical vomiting (self-limiting episodic condition)... 

Papaverine is an inhibitor of cyclic nucleotide phosphodiesterase, producing vasodilatory effect. The acute toxic effects relative to phenanthrene-type opium alkaloids (e.g., morphine, heroin) are low and the symptoms are not the same. Papaverine is neither a narcotic nor an addictive substance. Excessive doses may produce drowsiness, headache, facial flushing, constipation, nausea, vomiting, and liver toxicity. 

Lithium carbonate is used in the treatment of manic depressive illnesses. The exact mechanism of its action is not known but it may interfere with cyclic-AMP mediated processes. The level of the drug in the blood must be monitored periodically as toxic reactions (tremors, diarrhoea, vomitting and drowsiness) can result from overdosage. Recently it has been found that lithium inhibits thyroxine biosynthesis and this may lead to hypothyroidism. 

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