Chemoreceptor trigger zone

The chemoreceptor trigger zone (CTZ) is an area of the medulla oblongata that receives inputs from blood-borne drugs or hormones, and communicates with other structures in the vomiting center to initiate vomiting. The CTZ is located within the area postrema, which is on the floor of the fourth ventricle and is outside of the blood–brain barrier.[1] It is also part of the vomiting center itself.[2] The neurotransmitters implicated in the control of nausea and vomiting include acetylcholine, dopamine, histamine (H1 receptor), substance P (NK-1 receptor), and serotonin (5-HT3 receptor). There are also opioid receptors present, which may be involved in the mechanism by which opiates cause nausea and vomiting. The blood–brain barrier is not as developed here; therefore, drugs such as dopamine which cannot normally enter the CNS may still stimulate the CTZ.[3]

  1. ^ editors, Ansgar M. Brambrink, Jeffrey R. Kirsch (2012). Essentials of neurosurgical anesthesia & critical care : strategies for prevention, early detection, and successful management of perioperative complications (2012 ed.). New York: Springer. p. 716. ISBN 978-0387095615. Retrieved 16 August 2014. {{cite book}}: |last1= has generic name (help)CS1 maint: multiple names: authors list (link)
  2. ^ Pierre, S.; Whelan, R. (11 August 2012). "Nausea and vomiting after surgery". Continuing Education in Anaesthesia, Critical Care & Pain. 13 (1): 28–32. doi:10.1093/bjaceaccp/mks046.
  3. ^ Miller AD, Leslie RA (Dec 1994). "The area postrema and vomiting". Frontiers in Neuroendocrinology. 15 (4): 301–20. doi:10.1006/frne.1994.1012. PMID 7895890. S2CID 28944289.