Vertigo Pharm

Question 1

When are the medications for symptomatic vertigo used?

Answer 1

• Only for acute vertigo that lasts a few hours to days

NOT FOR:
- Benign paroxysmal positional vertigo (only lasts <1 min)
- Vertigo that lasts > few days
~ Suggestive of permanent vestibular injury
~ Medications to be stopped to allow brain to adapt to new vestibular input

Question 2

What medications are used to treat vertigo?

Answer 2

Symptomatic relief only

1) Antihistamines
- MECLIZINE
- DIMENHYDRINATE
- DIMENHYDRAMINE

2) Anticholinergics
- SCOPOLAMINE

3) Benzodiazepines
- DIAZEPAM
- LORAZEPAM

Question 3

What are the indications for antihistamines and its MOA?

Answer 3

• Acute motion sickness
• Some vertigo
• Reduces conflicting signals happening in the H1 receptors in brain by blocking histamine
  ~ Connects the mismatch b/w sensory inputs in the part of the brain that controls nausea

Question 4

What are the adverse effects of antihistamines?

Answer 4

• Drowsiness
• Sedation
  ~ Meclizine is the least sedating

Question 5

Why are non-sedating 2nd-gen antihistamines no effective in treating vertigo?

Answer 5

• Does not cross the BBB
  ~ So vestibular function remains intact

Question 6

What are the indications for anticholinergics and its MOA?

Answer 6

• Acute motion sickness
• Vertigo
• Block acetylcholine neurotransmission to reduce neural signals that induce nausea

Question 7

What are the side effects of anticholinergics?

Answer 7

• Drowsiness
• Sedation
• Dry mouth
• Dilated pupils

Question 8

What are the indications for benzodiazepines and its MOA?

Answer 8

• Acute motion sickness
• Vertigo
• Anxiety related to vertigo
• Enhances the activity of GABA-A receptors
  ~ Reduces the brain activity in pathways responsible for neural imbalance

Question 9

What are the side effects of BZP?

Answer 9

• Ataxia
• Euphoria
• Incoordination
• Somnolence
• Hypotension
• Headache
• Dizziness
• Blurred vision