General

Causes of nausea and vomiting

Nausea and vomiting are symptoms of several conditions, including, gastrointestinal disorders, dysmobility (slowing down of food through the GI tract), food poisoning, migraine, chemotherapy and radiotherapy for cancer treatment, reaction to surgical anaesthetic.
The vomiting reflex originates in the chemoreceptor trigger zone (CTZ) of the area postrema of the brain. The CTZ is triggered by nerve messages sent from the small intestines stimulated by the neurotransmitters dopamine or serotonin. When triggered the CTZ sends nerve messages to the vomiting centre of the brain, causing nausea and vomiting.

Medications for nausea and vomiting

Medications used to relieve nausea and vomiting include two types of antiemetic:

• Serotonin receptor-antagonists like ondansetron work by binding to specific 5HT3 receptors in the intestine and in the CTZ and block the transmission of nerve messages from the intestines and from the CTZ to the vomiting centre in the brain, which prevents the vomiting reflex from being triggered.


• Dopamine antagonist like domperidone and metoclopramide work by binding to dopamine receptors in the CTZ blocking the transmission of nerve messages to vomiting centre in the brain, which prevents the vomiting reflex from being triggered. They also have gastrokinetic action by interacting with nervous control of muscle contraction in the stomach and upper intestine, which helps relieve symptoms of dysmobility and this also helps prevent vomiting.

What are Haemorrhoids?

Haemorrhoids are swollen veins in the lining of the lower part of the rectum and anus. They are caused by an increase in pressure within the rectum and anus such as during pregnancy, due to pressure of the enlarged uterus, and straining due to constipation.
This causes the swollen veins to become permanently dilated, swollen and inflamed. Haemorrhoids can be internal within the lining of the lower rectum and anal canal, or external, which surround the anus. Internal haemorrhoids are made up of blood vessels, supporting connective tissue and smooth muscle. They are usually pain free but can cause bleeding and may also become prolapsed when protrude into the anal canal and can cause problems. External haemorrhoids may also bleed if they become thrombosed, which is when there is bleeding within the haemorrhoid and the blood clots. External haemorrhoids may cause itching due to irritation of the surrounding skin, but this may also be due to rectal or anal fissures, which are small tears or cuts in the anal or rectal canal through which stools are passed. Muscle spasm is also a symptom of haemorrhoids, which can be painful.

Treatment for haemorrhoids

Treatments for haemorrhoids are available as an ointment applied to the anal area or as a suppository that is inserted into the rectum. Haemorrhoid treatments usually combine a corticosteroid anti-inflammatory with a local anaesthetic to treat the inflammation and pain associated with haemorrhoids. The corticosteroid inhibits the formation of inflammatory chemicals like interleukins that stimulate the formation of other inflammatory chemicals like prostaglandins. This reduces pain and swelling, associated with inflammation. The anaesthetic component acts locally to reduce pain, discomfort and itching.

What is influenza?

Influenza is a viral infection that is transmitted from one person to another in droplets produced when someone who is infected by the virus coughs or sneezes.  The flu virus gets into the upper airways of the nose and throat, where it multiplies and spreads.  After a few days, you start to feel unwell as your body fights the infection, with symptoms including fever, headache, muscle aches, sore throat, cough, and extreme tiredness.  If the flu virus gets into your lungs, it can cause severe health problems like pneumonia. 

How is influenza treated?

Treating flu symptoms is best started during the early stages of infection before symptoms become too severe.  Some people have a higher risk of developing complications from influenza, such as older people, pregnant women, and if you have a chronic lung condition like asthma.  If the infection is treated early, it may be possible to reduce the risk of developing health complications like pneumonia. 

Oseltamivir is an antiviral medication that is used to treat influenza.  It works by inhibiting a viral enzyme called neuraminidase.  This enzyme is essential for the influenza virus to be able to get into the cells of the respiratory tract and replicate, then to allow the virus to be released from infected cells and spread the infection.  

What causes travel / motion sickness?

The inner ear contains the vestibular system, which comprises fluid filled canals that detect motion or changes in the body’s position and send information to the brain to be interpreted.  This process helps maintain balance. 

Motion sickness is thought to have originated as a defence mechanism against toxins.  It is caused by conflicting information being received by the brain from the eyes and from the vestibular system.  The messages sent by the ear suggest motion, whereas the messages sent by the eye suggest that the body is still and this conflict causes the brain to interpret that a neurotoxin is responsible for this “hallucination” and induces the vomiting reflex to clear the toxin from the system.   Symptoms of motion sickness include nausea, vomiting and vertigo (sense of loss of balance and dizziness).  

Medications for travel sickness

Medications are available that block the transmission of nerve impulses from the inner ear to the vomiting center in the brain, which blocks the vomiting reflux so preventing symptoms.  A Skin patch is available containing the antiemetic anticholinergic scopolamine that works by binding to and blocking acetylcholine receptors in the vestibular system of the inner ear and in the central nervous system.

General conditions

The range of conditions treated under the General class of medications includes:

• Skin conditions like solar (actinic) keratoses and basal cell carcinoma caused by sun damage.


• Genital/perianal warts, which are warts on the surface of the genitals and around the anus caused by infection with human papillomavirus (HPV).


• Gout, which is painful swelling of the joints and loss of joint mobility, caused by deposition of uric acid crystals in the joints.


• Inflammatory conditions associated with an overactive immune system like severe eczema, asthma, rheumatoid arthritis, systemic lupus erythematosus and Crohn's disease.


• Vascular headaches like migraine and menopausal hot flushes, caused by dilation of blood vessels in the brain and skin respectively.


• Infertility in women due to lack of ovulation.


• Breast cancers that are estrogen-dependent.


• Nausea and vomiting due to several conditions, including gastrointestinal disorders, dysmobility (slowing down of food through the GI tract), food poisoning, migraine, chemotherapy and radiotherapy for cancer treatment, reaction to surgical anaesthetic.


• Incontinence, which is loss of bladder control.


• Thrombosis, which is blood clot formation that can cause a heart attack or stroke in people who have cardiovascular disease.


• Malaria, a parasitic disease.


• Vascular problems, including peripheral artery disease, when large arteries in the arms and legs become obstructed or partially blocked; also circulatory disorders in the eyes and ears, where the blood vessels have degenerated and can lead to impairment of sight and hearing

Meniere's syndrome

Meniere's syndrome is a disorder of the inner ear and is caused by too much fluid (endolymph) in the fluid-filled canals of the inner ear, a condition called endolymphatic hydrops. This puts pressure on the sensory cells in the canals and disturbs the transmission of nerve impulses relating to balance, causing the brain to trigger the vomiting reflex. This induces symptoms including vertigo, a spinning sensation that can cause nausea and vomiting, and affects hearing and balance.

Medications that are used to help relieve symptoms of Meniere's syndrome block the transmission of nerve impulses from the inner ear to the vomiting center in the brain. The histamine agonist betahistine works by binding to histamine receptors in the capillaries (small blood vessels) of the inner ear, which increases their permeability allowing the excess fluid to drain away from the inner ear and relieving the pressure on the sensory cells. Betahistine also binds to histamine receptors on nerve cells, blocking transmission of nerve signals that are interpreted by the brain as disruptive to hearing and balance.

class="editor">Range of general medications

• The immunomodifier and antiviral imiquimod activates immune cells to produce chemicals involved in fighting invasion by pathogens like viruses and killing tumour cells; a property used to treat genital/perianal warts caused by infection with HPV and basal cell carcinoma; also to produce inflammatory reactions a property used to treat skin conditions like solar (actinic) keratoses.


• Allopurinol reduces uric acid productions and thereby reduces levels of uric acid in the blood, and is used for the treatment of gout and prevention of kidney stone formation.


• Colchicine tha blocks the action of inflammatory cells and is used to treat gout to help reduce inflammation associated with uric acid crystals in the joints.


• The anti-inflammatory corticosteroids prednisone and hydrocortisone reduce inflammatory reactions in several conditions, by inhibiting the production of inflammatory chemicals like prostaglandins.


• The anti-inflammatory prednisone a synthetic glucocorticoid, similar to the naturally occurring cortisol that is used for hormone replacement therapy to replace a lack natural corticosteroid in conditions such as underactive adrenal glands.


• The alpha-agonist clonidine acts on alpha adrenergic receptors in the brain and inhibits the release of the neurotransmitter noradrenaline, which inhibits peripheral vasodilation (small blood vessel to widen) and is used to treat vascular headaches like migraine; also menopausal hot flushes.


• Clomiphene a selective oestrogen receptor modulator that binds to the oestrogen receptor in the hypothalamus of the brain to induce ovulation and is used in the treatment of infertility.


• The anti-oestrogen tamoxifen blocks the oestrogen receptor on breast cancer cells and is used to treat breast cancers that are dependent on estrogen to grow.


• The antiemetics and dopamine antagonists domperidone and metoclopramide bind to dopamine receptors and block transmission of nerve signals to the vomiting centre in the brain, thereby blocking the vomiting reflex to prevent nausea and vomiting.


• The antispasmodic and anticholinergic oxybutynin acts directly on the smooth muscle of the bladder, to prevent spasmodic contraction and uncontrolled urination and is used to treat loss of bladder control leading to incontinence.


• The anti-platelet drug clopidogrel inhibits platelet aggregation and is used to reduce risk of a blood clot forming in people who have cardiovascular disease and who are at risk of heart attack or stroke.


• The anti-parasitic and schizontocide quinine that is to treat malaria by killing the infective stage of the plasmodium parasite that transmitted by a mosquito bite and causes malaria.


• The vasodilator oxpentifylline that causes blood vessels to widen and is used to increase blood flow in vascular several conditions.

Pill cutter

A Pill Cutter is available to enable you to cut your pills or tablets into half, to reduce the dose of the medication.