Nausea, Vomiting, Vertigo
Conditions
Keywords
Metoclopramide, Dimenhydrinate, emergency medicine
Brief summary
* Vertigo complaint is one of the common cause of patients who applied to emergency services. * Patients who have applied to emergency services with vertigo complaint mostly have nausea as an additionally symptom to this complaint and anti-emetic agents can be used in their treatments very often. * The investigators purpose is to investigate the advantages of Dimenhydrinate and metoclopramide to each other in the treatment of vertigo and the vertigo accompanied by nausea
Detailed description
* Vertigo describes the illusion of being subject to an involuntary movement, usually rotational, of the patient or the patient's surroundings which is caused by sudden tonic neural activity. * The management and episodic treatment of patients with spontaneous vertigo related nausea-vomiting symptoms are somewhat controversial in the emergency department setting. * Patients admitted to the emergency department with complaints of vertigo in addition to a large portion of the symptoms are accompanied by nausea and antiemetic agents are frequently used in the treatment. * An ideal treatment should be rapid in onset and effective, and lack debilitating side effects. * Although a wide variety of classes of pharmacologic agents and modalities are used, the emergency department treatment of acute spontaneous vertigo and associated with nausea- vomiting has not been well studied. * It has been reported that the most commonly used medications for parenteral treatment of vertigo and nausea-vomiting in emergency department are dimenhydrinate (DMT) and metoclopramide (MTP). * It has a depressant action on hyper-stimulated labyrinthine function and antiemetic effects, believed to be due to the antihistamine. * Dimenhydrinate inhibits vomiting by affecting the histaminic receptor and cholinergic receptor function center of vestibular nucleus in the central vestibular system. * Dimenhydrinate reduces the symptoms of vertigo with depressant effects on the labyrinth function by this means.
Interventions
DRUGDimenhydrinate
50 mg Dramamine with 5 cc syringe in 150 ml normal saline given as a slow intravenous infusion over 15 minutes
DRUGMetoclopramide
10 mg Metoclopramide with 5 cc syringe in 150 ml normal saline given as a slow intravenous infusion over 15 minutes
Sponsors
Pamukkale University
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* between 18 to 65 years old patients, * had vertigo and accompanied nausea or vomiting \[VAS (visual analog scale) score \>5\] during their emergency department episode of care for which the attending physician recommended intravenous antiemetic medication.
Exclusion criteria
* abnormal vital signs, * women who were pregnant or lactation, * those with a history of epilepsy, * acute psychiatric symptoms, * organic brain disease, * parkinson's disease or phaeochromocytoma, * or any known allergy to the study drugs, * uncooperative individuals, * use of any antiemetic drug in the previous 8 hours or previous delivery of intravenous fluids during the emergency department episode of care, * currently undergoing chemotherapy or radiotherapy, * mechanical obstruction or perforation, * gastrointestinal bleeding, * inability to understand study explanation or outcome measures (any reason), * known allergy or previous adverse reaction to metoclopramide or dimenhydrinate, * and patients who refused to participate study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| compare the effects of intravenous dimenhydrinate and metoclopramide in the treatment of nausea due to vertigo in emergency setting. (nausea and vertigo scores as measured by Visual Analogue Scale.) | Change from Baseline in nausea and vertigo scores at 30 minutes. | \- participants will be followed for the duration of hospital stay, an expected average of 30 minutes. |
Outcome results
None listed