Motion Sickness

Question 1

What are the treatments for disorders of motion?

Answer 1

▪ Anticholinergics (e.g., scopolamine) and

▪ antihistamines (e.g., meclizine)

Question 2

Dizziness, with the sensation that the environment is moving or spinning.

Answer 2

Vertigo

Question 3

Vertigo is typically due to an ___________ condition that affects balance.

Answer 3

Inner ear

Question 4

What are the treatments for vertigo?

Answer 4

▪ Vestibular (inner-ear) suppressants
▪ anticholinergics
▪ antihistamines (e.g., meclizine, dimenhydrinate)
▪ benzodiazepines
▪ 5HT-3 receptor antagonists (serotonin receptor antagonists or serotonin blockers) are not useful for vertigo because they do not affect the inner ear

Question 5

kinetosis

Answer 5

Motion Sickness

Question 6

Motion sickness is caused by the _________ sent to the brain by the eyes and the inner ear (semicircular canals).

Answer 6

Mixed signals

Question 7

What are some non pharmacological treatments for motion sickness?

Answer 7

• Wrist band that presses on an acupuncture point located on the inside of the wrist. One popular brand is Sea-Band.
• Ginger in tea or supplements, is used commonly for nausea.
• Peppermint
• Stop the motion –the best way to resolve motion sickness

Question 8

Drug treatments for motion sickness?

Answer 8

• Anticholinergics
• Antihistamines
• Antiemetics
• 5HT-3 Antagonist

Question 9

Dramamine

Answer 9

Dimenhydrinate

Question 10

Dramamine All Day Less Drowsy

Answer 10

Meclizine

Question 11

Bonine

Answer 11

Meclizine

Question 12

Scopolamine

Answer 12

Transderm Scop

Question 13

Promethazine

Answer 13

Phenergan

Question 14

Reglan

Answer 14

Metoclopramide

Question 15

Anzemet

Answer 15

Dolasetron

Question 16

Granisetron

Answer 16

Sancuso

Question 17

Palonosetron

Answer 17

Aloxi

Question 18

TorF: Antihistamines and antiemetics are recommended for motion sickness

Answer 18

False. Antihistamines and anticholinergics are recommended for motion sickness

Question 19

TorF: • 2nd generation antihistamines are highly effective for treating motion sickness

Answer 19

False. 2nd generation antihistamines are ineffective for treating motion sickness (azelastine, cetirizine, fexofenadine, loratadine, etc.)

Question 20

TorF: Transderm Scop is more effective at treating motion sickness than OTC medicines

Answer 20

False. It is not more effective than generically available OTC drugs

Question 21

How long does Transderm Scop lasts?

Answer 21

3 days

Question 22

TorF: Metoclopramide and the 5HT-3 receptor antagonists like ondansetron are generally not effective for motion sickness.

Answer 22

True

Question 23

The long acting piperazine antihistamines are:

Answer 23

Meclizine, dimenhydrinate, Cyclizine

Question 24

TorF: All of the antihistamines have anticholinergic effects similar to scopolamine.

Answer 24

True

Question 25

TorF: oral antihistamines need to be taken 15-30 minutes prior to the needed effect.

Answer 25

False. Oral agents must be taken 30 –60 minutes prior to the needed effect.

Question 26

What is the dosing for Dramamine?

Answer 26

Motion Sickness –
• Adults and Children ≥ 12 years: 50 –100 mg every 4-6 hours (400 mg)

• Children 6 to < 12 years: 25-50 mg every 6-8 hours (150 mg)
• Children 2 to < 6 years: 12.5-25 mg every 6-8 hours (75 mg)
• Nausea and vomiting – IM, IV: 50 –100 mg every 4 hours

Question 27

• Dramamine Original Formula contains only dimenhydrinate.

* Dramamine All Day Less Drowsy contains only meclizine

Answer 27

True

Question 28

Meclizine

Answer 28

Meclizine (Bonine, Dramamine All Day Less Drowsy, Motion-Time, Travel Sickness)

Question 29

Meclizine is commonly used for vertigo; it was previously branded as Antivert

Answer 29

More effective for prevention rather than treatment of motion sickness