Looking Forward to Summer Vacation?

Contributed by: Tammy Stack, Pharm.D.

Community Pharmacy Resident

Text Box: Are you driving, flying, taking a cruise, or visiting your favorite amusement park this summer? Be prepared, and don't let a little thing called motion sickness ruin your fun. Motion sickness (also known as car sickness, air sickness, or sea sickness) usually occurs during travel, when the brain receives conflicting sensory messages. Parts of your nervous system have different jobs to do: your inner ears monitor your direction of motions, your eyes monitor your position in space, skin pressure receptors throughout your body tell which part of your body is down and touching the ground, muscle and joint sensory receptors tell which parts of your body are moving, and the central nervous system (CNS) processes all the incoming information. If the information doesn't agree, the CNS can't make sense of it, and you experience the nausea and vomiting commonly known as motion sickness. Planning ahead can help you avoid motion sickness. If you are traveling: By ship, request a cabin in the middle of the ship, near the water line. By plane, ask for a seat over the front edge of a wing. Once aboard, direct the air vent toward your face. By train, take a seat near a window and face forward. By automobile, drive or sit in the front passenger's seat. (For more information on dealing with motion sickness visit www.mayoclinic.com/invoke.cfm?objectid=EB924B35-0184-4E7D-AA976672941E9934&MOTT=HQ01099 or visit www.mayoclinic.com, typing "motion sickness" in the search box, and following the links.) Motion sickness can also be prevented

Text Box: with the use of non-prescription and prescription medications. These work best if taken 1 to 4 hours before travel or activity. Medications available include: Over the Counter Products: Dimenhydrinate (Calm-X®, Dramamine®, or Marmine®) Adult dose: 50-100 mg up to 4 times a day Child's dose (> 2 years old): 1.25 mg/kg up to 25 mg, can be repeated every 6 hours **Should be used with caution in persons with asthma, cardiac arrhythmias, pyloric or bladder-neck obstruction (i.e. prostatic hypertrophy, BPH), or narrow-angle glaucoma. Diphenhydramine (Benadryl®, Nordryl®) Adult dose: 25-50 mg up to 4 times a day Child's dose (> 2 years old): 1 mg/kg up to 25 mg 3 - 4 times a day **Same cautions as dimenhydrinate. Meclizine (Dramamine II®, Bonine®) Adult dose: 25-50 mg a day Not recommended for children < 12 years old **Meclizine should not be used by people who have asthma, narrow-angle glaucoma, or bladder-neck obstruction. Prescription Products Promethazine (Phenergan®, Pentazine® Phenazine®) Adult dose: 25 mg up to 4 times a day Not recommended for children **Same cautions as for dimenhydrinate. Scopolamine (Transderm Scōp®, Hyoscine®, Murocoll®) Adult dose: patch - change every 72 hours,

Text Box: apply to hairless area behind ear oral - 0.4 - 0.8 mg every 6-8 hours Contraindicated in children **You should not use scopolamine if you have gastrointestinal or bladder neck obstruction, liver or kidney disease, or at risk for acute-angle glaucoma. These medications are classified as either antihistamines or anticholinergics. They often make a person drowsy and less alert. Anyone driving or doing something that requires paying attention should not use these products. They should not be taken with alcohol, sleep aids, or tranquilizers because the adverse effects may intensify more than expected. Some less common side effects of these medications include blurred vision, confusion, headache, stomach ache, constipation, palpitations, or difficulty with urination. These effects are more common in the senior patients. Talk to your physician or pharmacist about using any of these products. You can find more information about motion sickness at www.entnet.org/healthinfo/balance/dizziness.cfm. Bon voyage!