All right, so welcome back to the Internet Book of Critical Care Podcast. I'm here with

Adam Thomas, and we're going to talk about nausea, emacists, and anti-aimetics. Josh, this is really

exciting because I think a core component for this chapter is how you do your marmectomy every day,

right? How to cut out a bunch of drugs that are useless

and probably not helping the patient whatsoever. So with that, you're going to deep dive

what the differential diagnosis of nausea and vomiting is first. And the reason that is,

is because these drugs are very different pathways. So how you choose what tool to use is

highly dependent on what's causing the nausea and vomiting.

So let's get straight into it.

What is this fever in ICU level differential for nausea and vomiting?

Yeah, so this is pretty broad.

A lot of these things are going to be medications, chemotherapy, of course, analgesics, opioids

or big offenders, insides, aspirin, A couple antibiotics, antirthymic,

beta blockers, calcium channel blockers, diuretics, oral anti-diabetic agents, although we don't

really use those in the ICU, anti-convulsants. Any particular ones stick out in your minds

as far as drugs that we use in the ICU that cause nausea and vomiting? I mean, like, don't miss your dig toxicity and then, of course, opioids. I think

that's a big thing that we lose that are causing delirium and more nausea vomiting and constipation.

Those, I think those are the big offenders for me. Yeah, 100%. And we already talked a lot in the

pain chapter about how to avoid excess opioids. Let's move on to endocrine metabolic. So pregnancy,

of course, and especially

in the first nine weeks, hormone-related, hyperamysis, gravita is a major concern there. Euremia,

fulminant hepatic failure, ketoacidosis, decay is the most common, but starvation, ketoacidosis

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