Motion Sickness

• Most meds are anticholinergic and may cause drowsiness

 

Scopolamine patch (Transderm)

• 1 patch(1.5mg) Q3days, apply 4-hrs before activity
• SE: dry mouth, dizziness, stinging eyes, pupil dilation (mydriasis)
• Washing hands after application as touching the eye may result in blurred vision due to its dilation effect

 

Meclizine (Antivert)

• 1^st-generation antihistamine, highly sedating and causes anticholinergic SE

 

Diclegis

• Approved for morning sickness in pregnancy
• A combo of V-B6 & doxylamine

 

Non-pharmacological treatment

• Ginger
• Wrist band
• V-B6

Altitude Illness

Background

• High altitude exposes body to: low humidity, increased UV light, decreased air pressure, low oxygen level, cold temperatures.
• It causes illness such as headache, nausea, fatigue, in rare cases lead to cerebral or pulmonary edema, or even death.
• Pharmacist in CA state can now furnish travel meds for altitude illness.
• Encourage gradual ascent, stay hydrated, limit alcohol, avoid overexertion in the first few days.

 

Meds

• Save meds for higher risk situations, such as severe cases of altitude illness or rapid ascent of 9000 ft in one day.
• Meds not needed for a short day trip, travelling up to a high altitude and down in the same day.
• Acetazolamide is the first line. 125mg BID.
  • Start a day before ascent and continue 2 days after reaching the destination.
  • Caution about tingling of fingers/toes, numbness, and altered taste. Do not use in severe sulfa allergy, mild rash or hives with other sulfa drugs (TMP/SMX) is ok.
• Use dexamethasone if severe acetazolamide allergy. Only helps with symptoms, but not acclimatization.
  • 2mg q6 hr, or 4mg q12 hr.

 

Quiz

Which of the following are used in morning sickness in pregnancy?

1. Benadryl
2. Diclegis
3. Vitamin B6
4. Pyridoxine
5. Doxylamine

 

Answer: BCDE. Pyridoxine (B6) and doxylamine are commonly used in pregnancy for morning sickness, the prescription drug is Diclegis.

 

 

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