Nausea and vomiting are common gastrointestinal symptoms following opioid administration, for either chronic or acute pain
management. As a consequence, patients’ dissatisfaction has a negative impact on treatment efficacy. A number of mechanisms have
been identified, involving both central and peripheral sites. This article will review the pathophysiology of opioid-induced nausea and
vomiting and the various pharmacological treatments currently available for its management. Preventive strategies and therapeutic approaches
are evaluated in the perioperative setting and in chronic pain. Newer drugs include second generation serotonin receptor antagonists
(palonosetron) and neurokinin-1 (NK-1) antagonists (aprepitant).
Keywords: Opioid, nausea, vomiting, postoperative, chemotherapy, neurokinin, serotonin, chemoreceptor trigger zone, pain, aprepitant.
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