Our expert says:
• Cinnarizine 25mgs given an hour prior to departure and repeated every 6-8 hours
• Paediatric dose: 5-10 years 15-20mg daily in divided doses.
• Older children: up to 30mg daily. Being a long-acting 75mg formulation, it can be given twice daily. Remember that anti histamines are mildly sedating
• Other medications include:
• Cyclizine 50mgs tabs - syrup 12.,5mgs/5ml –Supp 50mgs and 100mgs –inject 50mgs/ml
• Use 12 hourly.
• Piperazine anti histamine and anticholinergic -sedating
• Promethazine 10 &25mgs tabs- syrup 5mgs/5ml- inject 25mgs/1ml and 50mgs/2ml
• Phenothiazide derivative. The most effective antihistamine to prevent and treat motion sickness, but is the most sedating.
• Phenytoin 200mgs stat dose. Military trials have shown this to be effective and safe and non sedating. Hydantoin anticonvulsant. C/I in cardiac, renal, liver patients as well as porphyrics.
• Granisetron 2mgs stat dose and Ondansetron 8mgs stat dose.. They are specific 5-HT3 antagonists; more expensive but useful were alertness can’t be compromised. C/I in porphyrics.
Accupressure. Applying pressure approximately two finger-widths below the inside of the wrist has been suggested to provide relief. Several elastic wristbands are commercially available that stimulate these points when worn.
Ginger [Zingiber officinalis] and Peppermint have shown effectiveness in alleviating the symptoms of Motion Sickness
Studies have shown that controlled breathing is all that is necessary to treat mild forms of motion sickness.
However once nausea and vomiting has become established intra-muscular promethazine or prochlorperazine 12.5mgs/ml work well. Their suppository formulations are also useful. With prolonged vomiting, IV fluids and electroylytes may be required for replacement and maintenance.
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