Motion Sickness

What is prochlorperazine (Buccastem M?

• dopamine antagonist

• given in N+V associated with migraines

• given for >18

• buccal tablet

• 1-2 tabs daily

Side effects of prochlorperazine ?

• drowsiness

• dizziness

• dry mouth

• skin reactions

Interactions of prochlorperazine?

• increase CNS depression with:

  • alcohol

  • opioids

  • sedatives

Why are antihistamines used in N+V?

• reduce vestibular stimulation of vomiting centre

• 1st generation

  • cyclizine

    • safe in pregnancy

  • cinnarizine

  • promethazine

Side effects of antihistamines?

• sedation

• dry mouth

• constipation

Interactions of antihistamines?

• increased sedation with:

  • alcohol

  • opioids

  • antidepressants

  • hypnotics

What age ranges and duration are licensed for antihistamines?

• cyclizine

  • >6yrs

  • 6hrs

• cinnarizine (Sturgeaon)

  • >5yrs

  • 8hrs

• promethazine (Avomine)

  • >5hrs

  • 12hrs

Why are anticholinergics used in N+V?

• act on inner ear/vomiting centre

• relaxes GI smooth muscle

• hyoscine - Kwells/JoyRides

• scopolamine - scop

Side effects of anticholinergics?

• dry mouth

• sedation

• blurred vision

• urinary retention

Interactions of anticholinergics?

• TCAs

• antipsychotics

What age ranges and duration are licensed for anticholinergics?

• Joy rides

  • >3yrs

  • 4hrs

• Kwells kids

  • >4yrs

  • 4hrs

• Kwells

  • >10yrs

  • 4hrs

• Scopoderm

  • >10yrs

  • lasts upto 3 days

Non-pharmacological options?

• ginger

  • safe in pregnancy

• acupressure bands