Motion sickness is more easily prevented than cured. It is due chiefly to overstimulation of the vestibular apparatus (and does not occur if the labyrinth is destroyed). Other factors also contribute. Visually, a moving horizon can be most disturbing, as can the sensations induced by the gravitational inertia of a full stomach when the body is in vertical movement. That the environment, whether close and smelly or open and vivifying, is important, is a matter of common experience amongst all who have been on a rough sea. Psychological factors, including observation of the fate of one's companions, are also important. Tolerance to the motion occurs, generally over a period of days.
Drugs that are used for motion sickness include the antimuscarinic agents cinnarizine, cyclizine, dimenhydrinate, hyoscine and promethazine.
For prophylaxis an antiemetic is best taken 1 h before exposure to the motion. About 70% protection may be expected by the right dose given at the right time. Once motion sickness has started, oral administration of drugs may fail, and the i.m., s.c.
or rectal routes are required. Alternatively, hyoscine may be administered as a dermal patch, so avoiding the enteral route. Prevention of symptoms may therefore be possible only at the expense of troublesome unwanted effects: sleepiness, dry mouth, blurred vision.
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