Motion sickness.

Motion sickness or kinetosis, also known as travel sickness, is a condition

in which a disagreement exists between visually perceived movement and
the vestibular system's sense of movement. Depending on the cause, it can
also be referred to as seasickness, car sickness, simulation sickness
or airsickness.

Dizziness, fatigue, and nausea are the most common symptoms of motion
sickness. Sopite syndrome in which a person feels fatigue or tiredness is also
associated with motion sickness.Nausea in Greek means seasickness
(naus means ship).] If the motion causing nausea is not resolved, the sufferer
will usually vomit. Unlike ordinary sickness, vomiting in motion sickness tends
not to relieve the nause
a.
 Causes.
• M.S. is thought to be caused by conflect of
massage to the brain ;where the vomiting
center receives information from eye ,GIT,and
vestibular system in the ear .
 SYMPTOMS.
• Nausea
• Some times vomiting
• Pallor and cold sweat.
• Commonly accure to children.
• Can be prophylacticaly treated be the OTC.
and can be selected to match the patient
needs.
 AGE.
• Commenly accure in young children(over 2
years old )

• Incidance decreased with age .

• Different dosage forms can be used for

management according to the age variance
 Previous History.

• Asking about family member whom have

pervious experience of M.S. and then
management used .
 Mode of Ttravel –Length of Journey.
• Length of journy is important for drug election(length
of action of drug is varies ).
• Drug should recomanded by pharmacist in good time
brfore journey (once vomiting stated there is little
that can be done ).
• For long journey repeating the dose during travel is
indicated ,that been effective in practice .
 Mode of Ttravel –Length of Journey.
• Pharmaceutical advice ,that been effective in
practice (sit of seat).

• For any method of travel ,children are less

likely to experience symptoms if kept accupied
by playing games (brain concentration).

• Reading exacerbates the feeling of nausea .

 Management.
• Prophylacticaly treatment by OTC. medication

• The basis of treatment depend the

anticholenergic activity of drug used and
antihistamin which have anticholenergic
property
 Antihistamines.
• Cinnarizine,Meclozine,and Promethazine.are the are
the effective for the mamagement of M.S.
• All have potential to cause drowsness and
promethazine have sedation .
• Meclazine and promethzine theoclats have long
duration of action (long journey).
• Cinnarizine and promethzine not recomanded for
children younger than5 year
• Meclozine can be given to those over 2 years.
• Should avoided during pregnancy(eccept meclozin).
 Anticholinergic agents
*The only anticholinergic used widely in the prevention of
motion sickness in hyoscine hydrobromide (prototype).
*Anticholinergic drugs can cause drowsiness,blurred
vision,dry mouth,constipation and urinary retention.
*children could be given sweets to suck to counteract any
drying of the mouth.
*Hyoscine has a short duration of action(1-3)hr.so its useful
for shorter journeys and should be given 20 min. before
the start of a journey.
*Anticholinergic drugs and antihistamines with
anticholinergic effects are best avoided in patients with
Prostatic hyperatrophy because of the possibility of urinary
retention and in glaucoma because the intraocular
pressure might be increased.
*Pharmacists should remember that side-effects from
anticholinergic agents are additive and may be increase
in patients already taking drugs with anticholinergic
effects ,such as amantidine ,TCA(e.g
amitriptyline),butyrophenones(e.g haloperidol) and
phenothiazines (e.g chlorpromazine).
 Alternative approaches to motion sickness
*Ginger ,it was found that ginger powder (Zingiber
officinale) could be effectively reduce motion
sickness .
*No mechanism of action has been suggested that
ginger acts on the GI tract itself rather than on the
vomiting centre in the brain or on the vestibular
system .
*Ginger would be woth trying for a driver who
suffered from motion sickness,since it does not
cause drowsiness,and might be worth considering
for use in pregnant women ,for whom other
antiemetics such as anticholinergic and
antihistamines are not recommended .
 Acupressure wristbands

*Elasticated wristbands that apply pressure to a

defined point on the inside of the wrists are
now readily available
*Such wristbands might be worh trying for
drivers or pregnant women