OTC - motion sickness

Question 1

Symptoms?

Answer 1

• n+v
• pale skin
• cold sweats
• dizziness

Triggered by travel

Question 2

Referral criteria?

Answer 2

• symptoms continue after stopping travel

- taking other anticholinergic drugs e.g. TCAs, phenothiazines

Question 3

OTC products?

Answer 3

• Choice depends on length of journey ‘
• main difference is the duration of action
• causes drowsiness

ANTIMUSCARINIC DRUGS 
Journey under 4 hours: hyoscine hydrobromide last 6 hours 
- 10+ (kwells)
- 4+ (kwells kids)
- 3+ (joy rides)
(take up to 30 mins before)

Journey over 24 hours: hyoscine hydrobromide lasts 72 hours
- 10+ (scopoderm patches)
(take 5-6 hours or evening before)

*c/i in glaucoma and prostatic enlargement

ANTIHISTAMINES
Journey 4-8 hours
- 5+ cinnarizine (sturgeron) - lasts 8 hours
(take 2 hours before)

• 2+ promethazine (phenergan) lasts 6-8 hours
  (take night before)

Question 4

What is hyoscine hydrobromide c/i in?

Answer 4

glaucoma and prostatic enlargement

Question 5

OTC alternatives?

Answer 5

• acupressure wristbands (sea band)
• ginger herbal supplements

Suitable for: pregnant or breastfeeding women, drivers - avoids drowsiness and those who cannot take anticholinergic drugs e.g. glaucoma patients)

Question 6

Advice?

Answer 6

• keep still: use a pillow or headrest to help keep your head as still as possible
• look at a stable object: e.g. horizon or close eyes. reading or playing games worsens symptoms
• fresh air: open windows
• relax: listen to music, focus on breathing