Motion sickness (unfinished) Flashcards

1
Q

Cause of motion sickness and main organ for maintaining balance

A

Caused by the body’s balance, namely by the ears, eyes and brain. The inner ear is the main organ responsible for maintaining balance. When brain is unable to process conflicting inputs from this, nausea and vomiting are the result.

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2
Q

Symptoms of motion sickness

A
nausea
vomiting
pale skin/pallor 
cold sweating
abdominal discomfort
sighing, yawning, hyperventilation, headache
swallowing/salivation
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3
Q

Referral criteria for motion sickness

double check with book

A
Pregnant patients
Breastfeeding patients
Children under 8 years 
Those taking other medications
Those that drive and suffer from motion sickness and the length of their journey
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4
Q

Describe the susceptibility of motion sickness in different patient ages and populations

A

0-2 years generally immune.

2-12 years more susceptible, as well as pregnant and menstruating women,

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5
Q

Lifestyle advice regarding motion sickness

A
  • suffering from fatigue, anxiety or lack of sleep can make you more susceptible
  • avoid foods high in protein or salt and avoid heavy, rich meals
  • avoid alcohol and smoking
  • relax, get plenty of fresh air, try to listen to music and keep calm.
  • avoid reading or watching tv in the car/moving vehicle
  • look ahead in the car and decrease speed (if possible)
  • watch the horizon on a boat and try to stay in the middle at roughly sea leave and keep horizon in view
  • if on a plane, try to sit near the wings
  • keep still - restrict head movements (by use of a travel neck pillow)
  • use booster seats in children as they are less likely to feel sick if they can see out of the car.
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6
Q

Name 3 drugs used for the treatment of motion sickness and their respective drug classes

A

Promethazine (antihistamine with anticholingeric action)
Hyoscine hydrobromide(anticholingeric agent)
Cinnarazine (antihistamine with anticholingeric action)

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7
Q

Promethazine
directions and doses dependent on age
Motion sickness

A
Child 2-4 years
5mg at bedtime, night before travel. Repeat following morning if necessary 
Child 5-9 years
10mg as above
Child 10-17 years
10-25mg as above
Adult 20-25mg as above
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8
Q

Promethazine side effects

Motion sickness

A
Drowsiness 
Dizziness
Tired feeling/fatigue
Ringing in the ears (tinnitus) 
dry mouth
stuffy nose 
insomnia
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9
Q

Promethazine warnings

Motion sickness

A

Not for children aged under 2 years
Caution in epilepsy
Not to be used in pregnant or breastfeeding patients
Not to be used in liver impairment
Check interactions with regular medicines

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10
Q

Promethazine counselling

Motion sickness

A

Drowsiness can affect driving
Lasts longer so good for long journeys
Takes 2 hours to kick in, lasts for 24 hours

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11
Q

Hyoscine hydrobromide instructions

Motion sickness

A

Take 20 mins before leaving
Children 4-9 years: 0.5-1 tablets
75-150mg - dose to be taken up to 30 minutes before the start of the journey, then 75-150mg every 6 hours if required. Maximum 450mg per day

Children 10-17 years and adults
1-2 tablets
150-300mg, dose to be taken up to 30 minutes before the start of the journey, then 150-300mg every 6 hours if needed, maximum 900mg per day

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12
Q

Hyoscine hydrobromide side effects

Motion sickness

A

constipation
dry mouth
blurred vision
drowsiness

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13
Q

Hyoscine hydrobromide for motion sickness

warnings

A

Do not use if you have:
-glaucoma
-high blood pressure
-urinary problems
-heart disease
Caution if used with other antimuscarinics
Not recommended in pregnancy but if benefit outweighs risk it is ok

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14
Q

Hyoscine hydrobromide for motion sickness

counselling

A

short duration of action: up to 4 hours
repeated doses for long journeys
Children 4 years of age or older
can affect driving

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15
Q

Cinnarazine doses

motion sickness

A

5-12 years: 1 tablet to be taken 2 hours before journey and then 0.5 tablet after every 8 hours

Adults: 2 tablets before journey and 1 tablet after every 8 hours

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16
Q

Cinnarazine side effects

motion sickness use

A

drowsiness
dry mouth
headache
stomach upset

17
Q

Cinnarazine warnings and counselling

A

Should NOT be used in pregnancy or breastfeeding
Not for those under 5 years of age
Avoid alcohol as it will increase drowsiness