CAUSES OF NAUSEA/VOMITING
Early pregnancy
Psychogenic vomiting
Bulemia
Pyloric channel ulcer
Acute gastritis
Gastric retention
Viral gastroenteritis
Acute gastroenteritis
Myocardial infarction
Peritonitis
Acute obstruction
Neurologic emergency
Drug toxicity
Cancer therapy
Drug withdrawal

HISTORY
Timing of symptoms
Relation to meals
Associated symptoms
Last menstrual period
Comorbid conditions
Epidemiologic data
Drug history

PHYSICAL EXAM
Vital signs
Skin
HEENT
Abdomen
Neurologic

LABORATORY
Rule out obstruction and peritonitis
HCG
Urinalysis
Electrolytes, BUN, creatinine, glucose
Transaminases, amylase
EKG, head CT, upper GI &/or endoscopy

MANAGEMENT
Phenothiazines
Compazine & Phenergan
Centrally acting non-phenothiazines
Tigan
Vestibular disturbances
Antivert
Motion sickness
Dramamine & Scopolamine
Pregnancy
No approved
Others
Marinol, Zofran, Kytril