title: Non-analgesic effects of opioids: opioid-induced nausea and vomiting: mechanisms and strategies for their limitation.
abstract: 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).
authors: Unit of Anesthesia, Intensive Care Unit and Pain Medicine, Faculty of Pharmacy and Medicine, Department of Medical and Surgical Sciences and Biotechnologies, SAPIENZA University of Rome, Italy. flaminia.coluzzi@uniroma1.it
authors: Flaminia
authors: F
authors: Coluzzi
authors: Alessandra
authors: A
authors: Rocco
authors: Ilenia
authors: I
authors: Mandatori
authors: Consalvo
authors: C
authors: Mattia
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects*; D000818:Animals; D000932:Antiemetics / Q000627:therapeutic use; D006801:Humans; D009325:Nausea / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D010146:Pain / Q000188:drug therapy*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000517:prevention & control; D014839:Vomiting / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control
chemical_list: D000701:Analgesics, Opioid; D000932:Antiemetics