Motion Sickness

 

Definition

 

Motion sickness consists of a group of signs & symptoms that develop in response to real or perceived motion.

 

Causes

 

Artificial means of transportation

Mechanical vehicule , sailing, skiing, horseback riding, camel riding, flying and space flight.

 

Incidence

 

Greater in women

 

Predisposing factors

 

Past hx of motion sickness

Alcohol

Fatigue- sleep deprivation

Drugs

Emotional state

 

 

Symptoms

 

Pallor

Cold sweating

Hyperventilation

Hypersalivation

Nausea-vomiting

Abdominal disconfort

Dehydration  

Some drowsiness

Lethargy

 

Non medicinal prevention

 

Small piece of cotton plugged in one external ear in the nondominant side

Eye fixation at the horizon

Avoiding room with an outside view aboard ship

Select a position in the most stable part of the vehicule

Ensure a seat with good visibility

Use restraints across the upper body  and lean against a headrest (minimizing head motion)

Sitting in a semireclining position

Focus visually on a distant point or take over the driving vehicule

Avoid reading & other task requiring focusing up close

Ensure good ventilation 

Metal strip fixed on a car

Eat only small & low fat meals

Avoid alcohol beverages & smoking

 

 

Prevention or Treatment-Pharmacotherapy

 

Medications are most effective when taken prior onset of symptoms.

 

Generic Name

Brand Names*

Dosage Form

Adult Dose

Onset

 Duration

Dimenhydrinate

Dramamine Gravol

25 mg, 50 mg tablet and capsule; 12.5 mg/4ml, 15.62 mg/5ml liquid

50-100 mg

 30 min.

4-6 hours

Diphenhydramine

Benadryl

12.5 mg, 25 mg, 50 mg tablets & capsule; 6.25 mg/5ml and 12.5 mg/5 ml liquid; 50 mg/ml injectable

25-50 mg

30 min.

4-8 hours

Promethazine

Phenergan

12.5 mg, 25 mg, 50 mg tablets & capsule; 6.25 mg/5ml and 25 mg/5 ml liquid; 12.5 mg, 25 mg, and 50 mg suppository; 25 mg/ml and 50 mg/ml injectable

25 mg

30 min.

8-12 hours

Meclizine

Antivert Bonine Bonamine Dramamine II

& others

12.5 mg, 25 mg, and 50 mg tablets and capsule

25-50 mg

60 min.

24 hours

Cinnarazine =

(Sturgeon)

25 mg tablet

25 mg

2 hours

8 hours

Cyclizine

Marezine

50 mg tablet; 50 mg/ml injectable

50 mg

30 min.

4-6 hours

Scopolamine

Transderm-Scop; Transderm-V; Scopace

1.5 mg patch; 0.4 mg tablet

1 patch; 0.4-0.8 mg (oral)

8 hours (patch)

1 hour (oral)

72 hours (patch)

6-8 hours (oral)

 

* Used in the US and/or Canada

=  Not available in North America

 

 

Travellers should be advised that nearly all anti-motion sickness drugs can produce drowsiness as side effects. They should avoid driving or operating machinery when taking these drugs and avoid concomitant use of alcohol or other CNS depressant to prevent potentially life threatening additive effects.

 

The drugs have varying degrees of other anti-cholinergic effects including dry mouth, blurred vision, tachycardia , headache, vertigo, restlessness, euphoria, hallucination, constipation, urinary retention and rash.

 

 

 

References

 

1.                  DuPont HL, Steffen R.  Textbook of Travel Medicine and Health.  First Edition.  BC Decker Inc, Hamilton, London.  1997

 

2.                  Jong EC, McMullen R. The Travel and Tropical Medicine Manual .Third  Edition.  Saunders, Philadelphia, Pensylvania. 2003

 

3.                  Website: www.travax.com

 

 

 

 

Nicole Denommé

Ottawa Hospital-General Campus

Fax: (613) 737-8009

e-mail: ndenomme@ottawahospital.on.ca