Motion sickness

19 important questions on Motion sickness

Dizziness, with the sensation that the environment is moving or spinning. Typically due to inner ear condition that affects balance.

Vertigo

Why are 5-HT3 receptor antagonists not helpful for vertigo?

They do not affect the inner ear

Dizziness, with a sensation of being off-balance and woozy due to repetitive motions, such as boat moving over waves or airplane flying in turbulent weather

Motion sickness
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Uncomfortable queasy feeling that one may vomit

Nausea

In general, what is the treatment for motion sickness?

Anticholinergics and antihistamines

How is Scopolamine (Transderm Scop) applied?

Behind the ear and lasts 3 days

Antihistamines for motion sickness

Dimenhydrinate and meclizine

When should the PO meds for motion sickness be taken?

30-60 minutes before needed effect

All of the antihistamines for motion sickness have what effects similar to scopolamine?

Anticholinergic effects

Even though dimenhydrinate and meclizine are long acting and are a little less sedating than other antihistamines, what do all meds for motion sickness cause?

Drowsiness and impair judgement

Main warnings of dimenhydrinate and meclizine

CNS depression (may impair physical or mental abilities, caution in elderly), worsen BPH, increase IOP (glaucoma)

Main side effects of dimenhydrinate and meclizine

Dizziness, drowsiness, dry mouth, blurry vision, tachycardia

Which anticholinergic is commonly used for vertigo?

Meclizine

Scopolamine patch counseling

Remove patch before MRI
Avoid alcohol

When should Rx promethazine be used for motion sickness?

In patients that do not respond to antihistamines

Is Promethazine safe to use in children, especially less than 2 years?

No, avoid due to risk of respiratory depression

Directions to apply scopolamine patch

-apply at least 4 hours before needed or the night before surgery
-press firmly to skin behind ear for 30 seconds
-avoid placing over hair
-if continued treatment is needed after first 3 days, remove original patch and place new patch behind other ear
-wash hands after applying    

Is it okay to drive while using scopolamine patch?

No, due to high level of drowsiness, dizziness and confusion

Specifically, what drugs are NOT effective for motion sickness?

Reglan (metoclopramide) and 5-HT3 receptor antagonists

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