Rx Note

Introduction Vertigo is an illusion of rotational, liner or tilting movement of self or environment. It could be produced by peripheral (inner ear) or central (brainstem-cerebellum) stimulation. The most common motion illusion is a spinning sensation. Nausea and vomiting are typical with acute vertigo, unless it is mild or very brief, as with benign paroxysmal positional vertigo (BPPV). Vomiting can be severe, causing dehydration and electrolyte imbalance. Postural stability can be affected in patients with vertigo. NOTE: It is important to distinguish vertigo from other potential causes of "dizziness". Evaluation The clinical features of the most common disorders are summarized in the table below. NOTE: The time course of symptoms provides one the best clues to the underlying pathophysiology of vertigo. Symptomatic Treatment Medications to suppress vestibular symptoms are best used for alleviating acute episodes of vertigo that last at least a few hours or days. These dr...

Introduction Nausea (the desire to vomit) and vomiting are common occurrences that can be caused by Simple disease, e.g. after exposure to bacterial toxins Motion sickness More serious underlying pathology Management When vomiting is undesirable, the first approach is to remove any precipitating factor if possible. Medications commonly associated with nausea and vomiting include metformin , GLP-1 receptor agonists , levodopa, donepezil, and oral iron supplements. In cases of infection, food poisoning, or alcohol intoxication, vomiting may be considered an appropriate physiological response to eliminate noxious agents. The site of action determines the circumstances in which an antiemetic is effective. Not all antiemetics are effective for all conditions, e.g. serotonin and dopamine receptor antagonists are ineffective in motion sickness . If a patient does not respond to an antiemetic, trial a different antiemetic. Some antiemetics have multiple mechanism of action, so it may be appro...