Future of the management of emesis.

Development of effective antiemesis has depended upon identification of critical neurotransmitter receptors within the emetic reflex arc. Investigations of cholinergic, histaminergic, dopaminergic, and serotonergic receptors led to our present generation of antiemetics. Opiate and adrenergic receptors are the likely targets of the next generation of antiemetics. The recently identified critical neurotransmitter receptors (opiate, adrenergic, and serotonergic) also provide a link to cancer pain, anticipatory vomiting, and cancer anorexia respectively. Future collaborations are likely to include investigators from various areas of supportive care working together on these common problems.