The onset of vertigo is rapid, often accompanied by nausea and vomiting, and patients are often very frightened. How to relieve the symptoms of vertigo, nausea and vomiting as soon as possible is a top priority. Here, two types of drugs are commonly used in clinical practice: vestibular depressants and antiemetics. The following is a brief introduction.
I. The pharmacological effects of vestibular inhibitors are related to their shocking side effects.
For patients with acute vertigo accompanied by nausea and vomiting, the sedative effect is also stronger after applying drugs with stronger vestibular inhibitory effect, which are commonly used in acute vestibular neuritis, acute attack of Ménière’s disease, migrainous vertigo and severe motion sickness; for patients with mild to moderate symptoms, drugs with weaker vestibular inhibitory and sedative effects should be used to reduce the interference with patients’ daily activities.
Drug onset time and route
For oral administration, the onset of action should take at least 30 minutes, and the maximum effect should take one to several hours; intravenous (diazepam, promethazine) or rectal (diazepam, promethazine) administration can shorten the absorption and onset of action of the drug, and can also avoid the stimulation of the stomach and the loss of the drug caused by vomiting.
III. Commonly used drugs
1.Pheniramine H1 receptor antagonist.
Indication: moderate vertigo and nausea, motion sickness.
Adverse effects: moderate sedation, taste. May aggravate glaucoma or develop urinary retention or asthma.
2. Scopolamine Toxic base receptor antagonist (anticholinergic), potent antiemetic.
Indications: Prevention of motion sickness attacks; not effective in acute motion sickness that has already occurred.
Adverse effects: mild sedative effect, taste, memory disturbance, hallucinations, aggravation of glaucoma or development of urinary retention. Withdrawal symptoms (nausea, imbalance, headache) may occur with more than 3 days of continuous use.
3.Diazepam (Valium) Benzodiazepines. Maximum effect 2 hours after oral administration, immediate effect after intravenous injection.
Indications: Acute vertigo with nausea, especially in patients requiring sedation and anxiety at the same time.
Adverse effects: drowsiness, drowsiness, drug dependence, withdrawal symptoms, etc.
4.Isoprostanes Antihistamines, both anticholinergic and antidopaminergic.
Indication: Acute vertigo with severe nausea and vomiting.
Adverse effects: sedation, dry mouth, blurred vision, upright hypotension.
5.Gastrofacial D2 receptor antagonist, both anticholinergic and gastrointestinal pro-motor effects.
Indication: nausea, vomiting. Not effective for vestibular vertigo and motion sickness.
Adverse effects: dystonia, fidgeting, drowsiness, fatigue, etc.
6.Difenidol (vertigo stop) Anticholinergic
Indication: Acute vertigo with nausea and vomiting.
Adverse reactions: taste, drowsiness, blurred vision, etc.
Most of the above drugs are used in the acute attack of vertigo. In principle, vestibular inhibitor application should not exceed three days as far as possible, too long time often affects the patient’s later recovery. After the patient’s symptoms are stabilized, the cause should be identified as soon as possible for treatment or vestibular rehabilitation training.