Motion-Induced Nausea and Vomiting
John Kucharczyk, David J. Stewart, Alan D. Miller in Nausea and Vomiting: Recent Research and Clinical Advances, 2017
Large individual differences in response to antimotion sickness drugs have been observed, demonstrating the need for individual assessment with respect to the choice of drug and the amount administered.195,196,209,210 In addition, there are well-known side effects associated with the use of antimotion sickness drugs. Scopolamine can produce deficits in some measures of anterograde memory.210,211 Blurred vision210,212 and dizziness212 occur frequently with elevated or prolonged doses of scopolamine, while drowsiness and fatigue are reported with standard doses of either scopolamine or promethazine.193,207,210,212,213 Scopolamine also commonly causes dry mouth.193,207,210,212 Dimenhydrinate (Dramamine®) often produces drowsiness and sometimes dizziness.212 In spite of these side effects, standard doses of many of the most effective drugs have no significant effect on many aspects of human performance.193,203,207,210,212–215 Examples include symbol-digit substitution, simple reaction time, pattern recognition, digit span and pattern memory,215 pursuit tracking,212 vision,207,212 and a battery of professional (naval-related) and cognitive tests.207 Higher drug doses produce a greater impact on operational efficiency.212,214 The combination of d-amphetamine with various doses of scopolamine or promethazine results in performance scores at placebo level or better and reduces side effects.193,212–214
Antihistamines, Decongestants, and Expectorants during Pregnancy
“Bert” Bertis Britt Little in Drugs and Pregnancy, 2022
Antihistamines for treatment of pruritus during pregnancy include chlorpheniramine and diphenhydramine. Loratadine is the first choice and cetirizine the second choice among second-generation antihistamines (Bechtel, 2018). Diphenhydramine is well studied during pregnancy and is a safe agent to use (Table 11.3). Its oxytocic effects do not appear to be as pronounced as dimenhydrinate (Hara et al., 1980), and studies support its safety. Other medications found to be safe and effective in the treatment of pruritus are hydroxyzine or dexchlorpheniramine (Drugs and Pregnancy Study Group, 1994) (Table 11.3).
Medical Consequences of Over-the-Counter (OTC) Substance Abuse
John Brick in Handbook of the Medical Consequences of Alcohol and Drug Abuse, 2012
Patients abusing up from 1,250 up to 3,750 mg of dimenhydrinate daily developed anorexia, nausea, vomiting, diarrhea, dehydration, weight loss, depersonalization, hallucinations, shakiness, and weakness. Symptoms resolve in seven to ten days (Craig and Mellor, 1990).
Adjuvant Hypnotherapy for Hyperemesis Gravidarum: A Randomized Pilot Study
Published in International Journal of Clinical and Experimental Hypnosis, 2022
Seyda Efsun Ozgunay, Burcu Dincgez, Derya Karasu, Gulten Ozgen, Ibrahim Taymur, Sermin Eminoglu, Ilkay Ceylan
The principal aim of HG treatment is to minimize symptoms in order to reduce the adverse effects of HG on mothers and their fetuses. In the current study, the conventional treatment was organized according to symptom severity, clinical findings, and response to treatment. The basic protocol for the first 24 hours included intravenous hydration with NaCl (0.9% x2500 cc) supplemented with vitamin B1 and vitamin B6. Oral intake of food was restricted during this time. The second step of treatment consisted of 50 mg dimenhydrinate and a H1 receptor blocker (dramamin®, Ali-Raif ilac, Istanbul, Turkey) administered intravenously four times per day as an antiemetic. When the nausea VAS was 4 or greater, the serotonin antagonist ondansetron 4 mg, i.v.;(Ondaren®, Vem ilac, Istanbul, Turkey) was added to the treatment as the rescue medication. The daily severity of nausea, frequency of vomiting were queried on a daily basis. Patients who vommitted less than twice per day, tolerated oral nutrition, or reported urine cleared of ketonuria met the conditions for being discharge. The duration of hospital stay and treatment procedures were followed and recorded.
Isoflurane not at the expense of postoperative nausea and vomiting in cardiac anesthesia – an observational study
Published in Current Medical Research and Opinion, 2021
Christine H. Meyer-Frießem, Sabeth Hüsken, Miriam Kaisler, Nathalie M. Malewicz, Peter K. Zahn, Andreas Baumann
After arrival on ICU, patients remained sedated with propofol until an intensive care specialist deemed them stable for weaning. After administration of 0.1–0.2 mg*kg–¹ piritramide patients were deemed suitable for extubation once the patient showed protective reflexes (extubation within eight hours after surgery was targeted). All patients were allowed to drink directly after extubation; the first meal after surgery was a light breakfast at the first postoperative morning. The standard treatment of postoperative pain consisted of prolonged-release oral oxycodone/naloxone (0.25–0.5 mg*kg–¹) every 12 h, and additional oral oxycodone and/or i.v. paracetamol, with a target pain intensity of NRS <4 on the numerical rating scale (0–10; 0 = no pain, 10 =worst imaginable pain). In the case of PONV, it was treated with ondansetron (0.05–0.1 mg*kg–¹), and, in cases where this was insufficient, dimenhydrinate (1 mg*kg–¹) was administered intravenously.
Intratympanal administration of lidocaine in the management of Ménière’s Disease
Published in Acta Oto-Laryngologica, 2021
Mattis Bertlich, Friedrich Ihler, Jennifer Lee Spiegel, Martin Canis, Bernhard G. Weiss
Intratympanic injections were performed in local anesthesia. Therefore, cotton wads soaked with Lidocaine 2% were placed in the ear canal with direct contact to the tympanic membrane. To assure sufficient anesthesia, wads were placed under microscopic control to avoid getting air bubbles between the wad and the ear drum. After 10 min, wads were removed and the eardrum was carefully perforated with a 22-gauge needle (0.7 × 32 mm) in the anterosuperior quadrant. 0.5 to 1.0 ml lidocaine 2% at approximate body temperature was injected with the same needle through a secondary puncture in the anteroinferior quadrant, so as not to endanger the ossicles. Lidocaine was injected into the ear drum until microscopy showed that the eardrum was filled. Patients were then told to remain steady (despite the vertigo they felt) and to avoid speaking or swallowing for as long as possible. Routinely, patients stayed one night in the hospital and received dimenhydrinate before and/or after intratympanic injection to attenuate the anticipated vertigo.
Related Knowledge Centers
- Anticholinergic
- Diphenhydramine
- Ethanolamine
- Motion Sickness
- Theophylline
- Nausea
- Over-The-Counter Drug
- 8-Chlorotheophylline
- Antihistamine
- Potency