This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Pathophysiology of chemotherapy induced nausea and vomiting

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Chemotherapy-induced nausea and vomiting is classified in three stages:

  • acute - within first 24 hours of administration of chemotherapy
    • believed that the chemotherapy causes enterochromaffin cells in the upper gastrointestinal tract to release serotonin, which acts locally on serotonin type 3 (5HT3) - receptors, triggering afferent impulses to the vomiting centre in the medulla. Selective 5HT3-receptor antagonists (such as ondansetron) appear to work by blocking this pathway
  • delayed - occurring more than 24 hours after administration and lasting for up to 5-7 days
    • no evidence that it is associated with release of serotonin and the underlying mechanism is not known
    • there is however evidence to suggest that release of a neuropeptide, substance P (which acts by binding to a specific neuroreceptor, neurokinin 1), may be important in the genesis of chemotherapy-induced emesis, particularly in the delayed phase
  • anticipatory
    • believed to represent a conditioned response


  1. Drug and Therapeutics Bulletin 2005; 43 (8):57-61.

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.


Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.