Pharmaceutisch weekblad

, Volume 1, Issue 1, pp 1235–1247 | Cite as

Braken en anti-emetica

  • G. J. Klein Nulent
Overzichtsartikelen

Samenvatting

In dit literatuuroverzicht wordt de huidige kennis van zaken weergegeven omtrent het braakproces: net neurale mechanisme, de farmaca en syndromen die braken veroorzaken, en omtrent farmaca die anti-emetisch werkzaam zijn.

Innemen van toxisch materiaal, ioniserende straling, schommelende bewegingen van het hoofd, anesthesie, zwangerschap en vele ziektebeelden veroorzaken contracties van de buikmusculatuur en een neerwaartse beweging van het middenrif, waardoor de maaginhoud gedwongen wordt om via de mond naar buiten te gaan.

De mogelijke werkingsmechanismen van de hierboven genoemde oorzaken worden afzonderlijk besproken; allen veroorzaken uiteindelijk een prikkeling van het braakcentrum dat is gelegen in de medullaire reticulaire formatie. In enkele gevallen vindt prikkeling, van het braakcentrum plaats door voorafgaande prikkeling van de chemoreceptor trigger zone (ctz), gelegen op de bodem van het vierde hersenventrikel.

Het overzicht van de anti-emetica omvat de anticholinergica, de antihistaminica, de fenothiazinen, trimethobenzamide, metoclopramide, domperidone en haloperidol.

Vomiting and antiemetics

Abstract The actual knowledge regarding vomiting, the neural mechanism of vomiting, the drugs and syndromes which cause vomiting and the anti-emetic drugs are reviewed. Intake of drugs or toxic materials, ionising irradiation, certain movements of the head, anaesthesia, pregnancy and many other syndromes may cause contractions of the abdominal muscles accompanied bij descent of the diaphragm, by which the gastric contents are forcefully brought up to and out of the mouth.

The possible work-mechanisms of the causes mentioned before, are discussed one by one. They all finely produce a stimulation of the vomiting-centre in the medullar reticular formation. In some cases the stimulation of the vomiting-centre is preceded by stimulation of the chemoreceptor trigger zone on the floor of the fourth ventricle.

The review of the anti-emetics encloses the anticholinergics, the antihistaminics, the phenothiazines, trimethobenzamide, metoclopramide, domperidone and haloperidol.

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Copyright information

© Bohn, Scheltema & Holkema 1979

Authors and Affiliations

  • G. J. Klein Nulent
    • 1
  1. 1.Apeldoorn

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