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Vomiting


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Vomiting — reflex eruption of contents of a stomach (sometimes and a duodenum) through a mouth (sometimes and through a nose). Vomiting is generally caused by reduction of muscles of an abdominal press; at the same time an output part of a stomach is densely closed, the body of a stomach relaxes, opens an entrance to a stomach, the gullet, an oral cavity extend. All this reflex act is regulated by the emetic center located a vprodolgovaty brain. Vomiting is usually preceded by nausea, involuntary deglutitory movements, rapid breathing, the strengthened discharge of saliva and tears. Emetic masses consists usually of the remains of food, gastric juice, slime; may contain bile and other impurity (bloodpus).

Types of vomiting

 Depending on the origins of vomiting distinguish its main pathogenetic options:

1) central vomiting (nervous, brain);

2) hematogenic and toxic (in uraemia, a liver failure, etc.);

3) visceral, or actually reflex (esophageal, gastric and intestinal).

Each option of vomiting characterizes a certain type of pathology and has the clinical features.

The central vomiting is often observed in diseases of nervous system. It usually develops outside the context of food, it is not preceded by nausea. Emetic masses poor, flavourless. Vomiting does not improve a condition of the patient at which in a clinical picture headaches, disorders of vision and consciousnesses prevail. Signs of the desease of digestive tract, as a rule, are absent.

Esophageal vomiting is a late symptom of considerable esophagectasia at diverticulums, an achalasia and narrowing of his lower parts. Vomiting arises right after food. Emetic masses not volume, consists of undigested food, have no acid taste and a smell.

Gastric vomiting arises most often against the background of a stomach disease (gastritis, a peptic ulcer, a carcinoma of the stomach). It can be usually connected with food, gives temporary relief to the patient. In emetic masses the remains of undigested food, slime, bile, blood (color of "a coffee thick") are found.

 Hematemesis - a symptom of acute bleeding from upper parts of digestive tract. Developing of a hematemesis is always connected with hit of blood in a gastric cavity. Most often stomach helcomenias, from varicose expanded veins of a gullet and a stomach are the reason of a hematemesis at increase in pressure in an upper mesenteric vein at patients with cirrhosis or from stomach polyps. More rare duodenum ulcers, trophic erosion and stomach ulcers at patients to heart failure and oxygen insufficiency (including in a myocardial infarction), erosion and ulcers of a gullet caused by intake of medicines (in particular, aspirin) happen a source of bleedings. The hematemesis is observed in diapedetic bleedings from a stomach wall at a syndrome of its acute expansion and also in the hemorrhagic vasculites and diseases which are followed by disturbances of blood clotting (hemophilia, leukoses, uraemia, sepsis, hemorrhagic diathesis). Wounds and burns of a gullet and stomach belong to very rare causes of a hematemesis.

Intestinal vomiting arises at impassability of intestines. It is caused by the antiperistaltic movement of intestines at which its contents get into a stomach and is a part of emetic masses. Repeated vomiting, persistent, with a fecal smell (intestinal contents). It is preceded by colicy pains in a stomach. The delay of a chair and gases accompany intestinal vomiting.

Vomiting symptoms

Most often vomiting the nausea period precedes any given duration; in certain cases there can be a strengthened salivation.

Causes of vomiting

1. Digestive tract diseases:

  • Acute surgical diseases: appendicitis, peritonitis, acute intestinal impassability, acute pancreatitis, acute cholecystitis, bleedings in digestive tract;
  • Chronic diseases: peptic ulcer of a stomach and duodenum, gastritis, duodenitis, coloenteritis, cholelithiasis;
  • Anomalies of development of bodies of digestive tract: stenosis (narrowing) of the gatekeeper, atresia (fusion of the site of a GIT), defects of development of a pancreas;
  • Digestive tract infections: food toxicoinfections, virus defeats, helminthoses;
  • Foreign bodys of a gullet, stomach, intestines;
  • Functional disorders which are followed by disturbance of motive function of a stomach, intestines
  • Oncological processes

2. Diseases of the central nervous system: injuries and tumors of a brain, the increased intracranial pressure, brain infections (meningitis, encephalitis)

3. Diseases of a cardiovascular system: heart failure, hypertension, myocardial infarction.

4. Diseases of an inner ear: labyrinthitis, Menyer's disease

5. Diseases of an endocrine system: a thyrotoxicosis, ketoacidosis in diabetes, phenylketonuria, insufficiency of function of adrenal glands.

6. Hit in an organism of toxic substances and side effects of medicines

7. Psychogenic reactions: alarm and fear, hysterics, usual vomiting as expression of some emotions.

Nausea and vomiting can be result of "motion desease". Vomiting quite often arises in the first trimester of pregnancy in toxicosis (gestosis).

Nausea and vomiting meet in many diseases. Most often nausea precedes vomiting, and vomiting gives to the patient relief. However it happens not in all cases, and existence or absence of nausea serves as important diagnostic criterion.

Vomiting and vomiting at children

Vomiting at children is observed more often than at adults, and arises that easier, than less child. Newborns and children of chest age have vomiting. Vomiting differs from vomiting in the fact that at the same time the eaten food is allocated without efforts and the significant reductions of muscles of an abdominal wall. The general state is not broken, emissions of gastric contents are less vigorous, the child kind of belches milk from a mouth at once or in a short period of time after feeding. Vomiting is not followed by vegetative symptoms, does not affect behavior, appetite, mood of the child. Tendency to vomiting - one of characteristic features of newborns and children of the first months of life. It is caused by certain features of the structure of upper parts of a digestive tract at this age: weakness of a cardial sphincter at well developed peloric, horizontal arrangement of a stomach and its form in the form of a bag, high pressure in an abdominal cavity, at last, horizontal position of the child and in large volume of food which he begins to receive already to two-week age (1/5 body weights a day). Vomiting at this age is usually promoted by overfeeding and swallowing air.

 Vomiting and vomiting at children can be important symptoms of a number of diseases. Vomiting at children can be divided into two big groups:

  •  primary when the reason is in digestive tract;
  •  secondary when the reason is out of a digestive tract.

In terms of treatment the gastrointestinal forms of vomiting are in turn subdivided into functional and organic. The last at newborns come down to congenital malformations of digestive tract. Secondary (symptomatic) vomiting can be divided conditionally into infectious, connected with cerebral pathology and with disbolism. Primary (gastrointestinal) forms of vomiting, in particular functional vomiting, result from various disturbances of regulation. The most frequent functional pathology is the incompetence of cardia (cardia halaziya, insufficiency of the lower esophageal sphincter). The incompetence of cardia can be a consequence of disturbance of an innervation of the lower part of a gullet (in perinatal encephalopathy), an imbalance of gastrointestinal hormones (gastrin, secretin, cholecystokinin, a motilin) and also increase in intra belly and intragastric pressure in a number of diseases. At a nesmykaniye of the lower esophageal sphincter the gastroesophagal barrier in addition to a pathological reflux and an esophagitis is broken.

Vomiting in an incompetence of cardia arises right after feeding in horizontal position, they are frequent and not plentiful. The reflux esophagitis in this pathology can cause an attack of cardiovascular insufficiency in newborns. At newborns the vomiting can be shown by concern, refusal of food, protrusion of a tip of language, pushing out of a nipple, pallor of integuments.

 

Treatment of vomiting

Symptomatic medicamentous therapy for stopping of vomiting includes use of spasmolysants (Nospanum of 2 ml of 2% of solution), m-holinoblokatorov (atropine of 0.5 — 1 ml of 0.1% of solution) or Metoclopramidum digestive tract (raglan, cerucal, 2 ml) normalizing motility. The specified drugs are administered intravenously or intramusculary. In pernicious vomiting and inefficiency of the above treatment, appoint neuroleptics (for example, etaperazin 4 — 8 mg in 3 — 4 times a day). At emergence of symptoms of intoxication the disintoxication therapy is shown, at the expressed hypovolemia — intravenous administration of liquids and electrolytes, at fluctuations of the ABP — the therapy directed to his normalization. Need of hospitalization is defined by the nature of a basic disease: The patient with a hematemesis is subject to immediate hospitalization in surgical department where the ezofagogastroduodenoskopiya with diagnostic, and sometimes and the medical purpose is urgently carried out. To the direction in hospital the high bed rest, hunger, holding available haemo static actions are necessary.

Treatment of nausea and vomiting at children is always directed to elimination of the reason. In poisonings carry out desintoxication of an organism and gastric lavage. In the presence of tumors, a pyloric stenosis, intestinal impassability the surgery is necessary. It is symptomatic possible to give antiemetics (Metoclopramidum, cerucal), to appoint hunger or a diet. In severe dehydration carry out intravenous administration of liquids, solutions of electrolytes.

First aid to the child in vomiting

First-aid treatment in vomiting: put the child on a stomach or sideways and turn his head aside. If at the child the vomiting when he lay on spin, then urgently turn his face down began, clean with a scarf or fingers from emetic masses his mouth and restore breath. Call a doctor.

Folk remedies from vomiting

1. Ordinary and all the known green tea – one of the best means against plentiful vomiting.

2. Also against vomiting the good effect renders melissa infusion which can be made independently, drawing it within 4 hours. To accept three times a day before reception of food on a half-glass.

3. The trilistny watch which is filled in with two glasses of water and left for the night will have beneficial influence on digestive processes and will promote the termination of vomiting. To accept as usual tea, and even several (4-5) once a day are better.

4. Broth from mint leaves known for the curative force will also help if to accept twice day. It promotes digestion improvement in general.

5. In the small portions collecting from a peppermint, a camomile, roots of a valerian and an everlastings uliginose will help to stop vomiting. One tablespoon of this collecting it is necessary to insist in the boiling water, and then to accept in two hours to food 3-4 times a day.

6. It is possible to use three shaken-up proteins of eggs in poisoning.

7. If vomiting – a consequence alcoholic poisoning, then good means is broth from inula roots. Thanks to the curative properties, it saves from poison in an organism.

8. Infusion from blackberry branches will help to liquidate vomiting. It is simple to prepare it: it is enough to take the main ingredient – 1 tablespoon, to boil in water about 5 minutes, to remove and leave for 40 minutes. To accept the received broth within an hour. This way is considered one of the simplest and effective.

9. From urticaceous a seed and honey it is possible to accept mix on 1 tablespoon twice within 3 hours. Eliminates emetic desires.

10. Also saves from desires to vomiting and a leaf of an ivy which can be used with honey.

Folk remedies from vomiting are most often effective, however anyway the delay can threaten with danger. This protective process in itself exhausts an organism, leads to exhaustion of vital forces. You should not risk and self-medicate.

The drugs used at treatment of this disease:

Azaleptinum
Alimemazinum
Alprazolam
Amizylum
Aminazinum
Anaesthesinum
Apomorphinum
Benperidolum
Bromcamphora
Bromopride
Validolum
Valocordin
Valocormidum
Valosedan
Haloperidolum
Gidazepamum
Grandaxinum
Dimedrolum
Dimenhydrinatum
Dimethpramidum
Domperidone
Droperidolum
Carbidinum
Clobazam
Corvalolum
Rhizomes with roots of a valerian (Rhizomata cum radicibus Valerianae)
Levomepromazinum
Lorazepam
Mebicarum
Mezapamum
Mentholum
Meprotanum
Metherazinum
Metoclopramidum
Sodium bromide (Natrii bromidum)
Nozepamum
Oxylidinum
Penfluridolum
Periciazinum
Pimozidum
Pipotiazine
Propazinum
Sibazonum
Scopolaminum
Sulpiride
Tiapride
Thioproperazinum
Thioridazinum
Thiethylperazinum
Grass of a passionflower (Herba Passiflorae)
Grass of a motherwort (Herba Leonuri)
Trioxazin
Trifluperidolum
Triftazinum
Tropisetron
Phenazepamum
Fluspirilenum
Frenolon
Phthorphenazinum
Phthorphenazinum decanoate
Chlozepidum
Chlorprothixenum
Aethaperazinum

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