Motion sickness Flashcards
Diphenhydramine
Benadryl
dimenhydrinate
Dramamine
Meclizine
Dramamine All Day Less Drowsy
Scopolamine
Transderm Scop
Metoclopramide and the SHT-3receptor antagonists (e.g., ondansetron) in motion sickness
are generally not effective for motion sickness.
Only one antiemetic works well for motion sickness. What is it?
PROMETHAZINE
is prescription only and should not be used in children due to the risk of respiratory depression. All promethazine products carry a boxed warning to avoid use in children less than 2 years old and strongly caution against use in children age 2 and older
Scopolamine patch frequency
one patch every 3 days PRN
CI of scopolamine patch
Hypersensitivity to belladonna alkaloids, closed-angle glaucoma
SE of scopolamine
Dry mouth, CNS effects [drowsiness, dizziness, confusion (can be significant in elderly, frail), hallucinations (rare)], stinging of the eyes and pupil dilation (if eyes are touched after handling), risk of increased IOP,tachycardia (rare)
Should we remove Scopolamine patch before MRI ?
Yes
can you use scopolamine in children?
No do not use in children.
Counsel on scopolamine patch for N/V due to motion sickness or anaesthesia/surgery
- Apply at least 4 hours before needed or the night before surgery
- Press firmly to skin behind ear for 30 seconds
- Try to avoid placing the patch over hair, or when the patch is removed, the hair may be removed, too
-Lasts 3 days; if continued treatment needed, remove the first patch and place a new patch behind the other ear.
-Wash hands after applying
-Do not drive: high level of sedation, dizziness,confusion - these anticholinergic side effects are worse, and not well-tolerated, in elderly patients (avoid use when possible)
scopolamine uses
motion sickness
pre-op C section
Dimenhydrinate (Dramamine) class and uses
First Generation Antihistamine H1
Motion sickness
N/V
Warning with Dramamine
CNS DEPRESSION (may impair physical or mental abilities, caution in elderly), worsening of BPH symptoms, INCREASE IOP (GLAUCOMA)