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

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

3. PHYSICAL EXAM n Vital signs n Skin n HEENT n Abdomen n Neurologic

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

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