motion sickness

Question 1

what are the symptoms of motion sickness?

Answer 1

• Nausea
• Vomiting
• Pallor
• Clammy appearance
• Sweating (and cold sweats)
• Excess saliva

Question 2

what are the red flags for motion sickness?

Answer 2

• Be aware that anticholinergic side effects can be additive, and to exercise caution in patients already taking drugs with anticholinergic side effects such as tricyclic antidepressants, butyrophenones and phenothiazines

Question 3

what are lifestyle advice for motion sickness?

Answer 3

• Look out of the car/bus window frequently and focus on fixed objects in the distance
• Ensure the vehicle travelling in is well-ventilated
• If possible, attempt to sleep
• Taking a break from travel and getting fresh air
• Listening to music
• Avoid large meals, smoking or alcohol prior to travel
• Making sure of adequate rest prior to travel, as lack of sleep can increase the likelihood of
symptoms
• Avoid reading or watching TV whilst travelling
• Decrease the speed of travel where possible
• If in a boat, watch the horizon
• If on a plane, sit near the wings
• Purchasing a neck pillow may aid symptoms by restricting head movements

Question 4

what are some of the drug treatments for motion sickness?

Answer 4

Anticholinergics, Antihistamines,

Question 5

what is an example of an anticholingeric for motion sickness?

Answer 5

hyoscine

Question 6

what are some of the side effects of hyoscine?

Answer 6

o Dry mouth
o Drowsiness
o Blurred vision
o Constipation

Question 7

when should hysocine be taken?

Answer 7

Tablets should be taken ~30 minutes prior to the journey and act for 6-8 hours

Question 8

who should NOT use hyoscine?

Answer 8

• Not suitable for pregnant or breastfeeding women
o Epilepsy
o Glaucoma
o Hypertension
o Heart disease
o Paralytic ileus
o Pyloric stenosis
o Prostatic enlargement o Myasthenia Gravis

Question 9

what are examples of antihistamines used for travel sickness?

Answer 9

Cinnarizine, Meclizine, Promethazine

Question 10

when should antihistamines for travel sickness be used?

Answer 10

• Should be taken 2 hours before the journey begins and act for ~8 hours
• Better for longer journeys

Question 11

what are some of the side effects of antihistamiens?

Answer 11

o Drowsiness
o Tiredness
o Ringing in the ears (tinnitus) o Dry mouth
o Insomnia

Question 12

who should not use antihistamines for motion sickness?

Answer 12

o Children under 2 years
not be used in: o Epilepsy
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o Liver impairment
o Pregnancy and breastfeeding o Parkinson’s disease
o Fructose/galactose intolerance o Porphyria