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CAUSES OF
NAUSEA/VOMITING
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Early pregnancy
Psychogenic vomiting
Bulemia
Pyloric channel ulcer
Acute gastritis
Gastric retention
Viral gastroenteritis
Acute gastroenteritis
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Myocardial infarction
Peritonitis
Acute obstruction
Neurologic
emergency
Drug toxicity
Cancer therapy
Drug withdrawal
HISTORY
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Timing of symptoms
Relation to meals
Associated symptoms
Last menstrual period
Comorbid conditions
Epidemiologic data
Drug history
PHYSICAL EXAM
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Vital signs
Skin
HEENT
Abdomen
Neurologic
LABORATORY
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Rule out obstruction and peritonitis
HCG
Urinalysis
Electrolytes, BUN, creatinine, glucose
Transaminases, amylase
EKG, head CT, upper GI &/or
endoscopy
MANAGEMENT
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Phenothiazines
– Compazine & Phenergan
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Centrally acting non-phenothiazines
– Tigan
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Vestibular disturbances
– Antivert
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Motion sickness
– Dramamine & Scopolamine
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Pregnancy
– No approved
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Others
– Marinol, Zofran, Kytril