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รหัสคำถามที่ 2528 : ยาmerislon ที่มีตัวยาBetahistine mesilate 6mg และยาStugeronที่มีตัวยาCinnarizine 25mg สองตัวนี้สามารถกินได้เรื่อยๆเป่าคะ ควรมีระยาเวลาเว้นกินยารึเปล่าเช่น กินไปหกเดือนหยุดหนึ่งเดือนแล้วค่อยกินต่อ และยาพวกนี้มีผลต่อตับไตมากไหมคะ
http://www.pharmacy.mahidol.ac.th/dic/QA_full.php?id=2528
#VERTIGO #บ้านหมุน #BPPV #Betahistine #SERC #MERISLON
http://www.pharmacy.mahidol.ac.th/dic/QA_full.php?id=2528
#VERTIGO #บ้านหมุน #BPPV #Betahistine #SERC #MERISLON
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Betahistine, sold under the brand name Serc among others, is an anti-vertigo medication. It is commonly prescribed for balance disorders or to alleviate vertigo symptoms associated with Ménière's disease. It was first registered in Europe in 1970 for the treatment of Ménière's disease.
>> Low quality evidence suggests that patients suffering from vertigo from different causes may have some benefit from betahistine in terms of reduction in vertigo symptoms. <<
Betahistine is a strong antagonist of the histamine H3 receptor and a weak agonist of the histamine H1 receptor. located on blood vessels in the inner ear. This gives rise to local vasodilation and increased permeability, which helps to reverse the underlying problem of endolymphatic hydrops.
Betahistine is contraindicated for people with pheochromocytoma. People with bronchial asthma and history of peptic ulcer need to be closely monitored.
betahistine may cause several allergic and skin-related side effects. These include rash in several areas of the body; itching and hives; and swelling of the face, tongue and mouth. Other hypersensitivity reactions reported include tingling, numbness, burning sensations, shortness of breath and laboured breathing.
มีรายงานการเกิดอาการไม่พึงประสงค์ต่อตับ คือ มีการเพิ่มระดับของ alkaline phosphatase, gamma-glutamyltransferase, alanine and aspartate aminotransferase แต่ไม่มีรายงานของการพัฒนาไปเป็นตับวายหรือเสียชีวิต
นอกจากนี้ควรระวังการใช้ในผู้ป่วยที่เป็นหอบหืด (bronchial asthma) และ pheochromocytoma
The mean plasma elimination half-life is 3 to 4 hours, and excretion is virtually complete in the urine within 24 hours. Plasma protein binding is very low.
It comes in doses of 6, 16 and 24 mg.The usual dose is 16 mg 3-4 times per day although greater effect is obtained for doses as high as 48 mg at a time
betahistine does not cause drowsiness and has no effect on driving, reaction time or visual acuity. Betahistine can be used in children.
>>>>>>>>>>>>>>>
Betahistine for symptoms of vertigo
http://www.cochrane.org/CD010696/ENT_betahistine-symptoms-vertigo
Serc (betahistine) modified: February 5, 2017
https://www.dizziness-and-balance.com/treatment/drug/serc.html
อยากทราบว่าถ้าเรากินยา merislon นานๆเพื่อใช้ในการรักษาอาการวิงเวียและมีเสียงดังในหูตลอดเวลาแล้วถ้ากินนานๆจะมีอาการข้างเคียงบ้างหรือเปล่าคะ เช่น เป็นอันตรายต่อไตค่ะ
http://drug.pharmacy.psu.ac.th/Question.asp?ID=6626&gid=1
#VERTIGO #บ้านหมุน #BPPV #SERC #Betahistine #MERISLON
>> Low quality evidence suggests that patients suffering from vertigo from different causes may have some benefit from betahistine in terms of reduction in vertigo symptoms. <<
Betahistine is a strong antagonist of the histamine H3 receptor and a weak agonist of the histamine H1 receptor. located on blood vessels in the inner ear. This gives rise to local vasodilation and increased permeability, which helps to reverse the underlying problem of endolymphatic hydrops.
Betahistine is contraindicated for people with pheochromocytoma. People with bronchial asthma and history of peptic ulcer need to be closely monitored.
betahistine may cause several allergic and skin-related side effects. These include rash in several areas of the body; itching and hives; and swelling of the face, tongue and mouth. Other hypersensitivity reactions reported include tingling, numbness, burning sensations, shortness of breath and laboured breathing.
มีรายงานการเกิดอาการไม่พึงประสงค์ต่อตับ คือ มีการเพิ่มระดับของ alkaline phosphatase, gamma-glutamyltransferase, alanine and aspartate aminotransferase แต่ไม่มีรายงานของการพัฒนาไปเป็นตับวายหรือเสียชีวิต
นอกจากนี้ควรระวังการใช้ในผู้ป่วยที่เป็นหอบหืด (bronchial asthma) และ pheochromocytoma
The mean plasma elimination half-life is 3 to 4 hours, and excretion is virtually complete in the urine within 24 hours. Plasma protein binding is very low.
It comes in doses of 6, 16 and 24 mg.The usual dose is 16 mg 3-4 times per day although greater effect is obtained for doses as high as 48 mg at a time
betahistine does not cause drowsiness and has no effect on driving, reaction time or visual acuity. Betahistine can be used in children.
>>>>>>>>>>>>>>>
Betahistine for symptoms of vertigo
http://www.cochrane.org/CD010696/ENT_betahistine-symptoms-vertigo
Serc (betahistine) modified: February 5, 2017
https://www.dizziness-and-balance.com/treatment/drug/serc.html
อยากทราบว่าถ้าเรากินยา merislon นานๆเพื่อใช้ในการรักษาอาการวิงเวียและมีเสียงดังในหูตลอดเวลาแล้วถ้ากินนานๆจะมีอาการข้างเคียงบ้างหรือเปล่าคะ เช่น เป็นอันตรายต่อไตค่ะ
http://drug.pharmacy.psu.ac.th/Question.asp?ID=6626&gid=1
#VERTIGO #บ้านหมุน #BPPV #SERC #Betahistine #MERISLON
This is life with MdDS
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#VERTIGO #บ้านหมุน #BPPV
benign paroxysmal positional vertigo (BPPV) – where specific head movements cause vertigo
labyrinthitis – an inner ear infection caused by a cold or flu virus
Ménière's disease – a rare inner ear condition, which sometimes involves ringing in the ear (tinnitus) or loss of hearing
vestibular neuronitis – inflammation of the vestibular nerve
migraine
Vertigo isn’t the only reason you might feel dizzy, so if symptoms seem to keep coming back, it’s a good idea to get a blood test done and speak with your doctor. Vitamin B12 deficiency, low blood pressure, anemic symptoms, heart complications and even anxiety can all contribute to dizziness,
>>>>>>>>>>>>>>
แยกระหว่าง PERIPHERAL & CENTRAL VERTIGO
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853661/table/T1/
PERIPHERAL
เฉียบพลัน รุนแรง นานเป็นนาที / ชั่วโมง
มีเสียงจิ้งหรีดร้อง เสียงลมออกหู
CENTRAL VERTIGO
เกิดค่อยเป็นค่อยไป พอทนได้ นานเป็นวันหรือสัปดาห์
ตากระตุก ไม่มีเสียงลมออกหู
>>>>>>>>>>>>>>
BPPV can be mistaken for a stroke.
BPPV – nausea, dizziness, light-headedness and loss of balance – are also signs of stroke
"BPPV tends to come and go, and symptoms last only about 30 seconds, whereas stroke symptoms are continuous."
>>>>>>>>>>>>>>
Classification of drugs that may cause vertigo or dizziness as an ADR
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853661/table/T2/
QUINOLONES
MACROLIDES
aminoglycoside
ITRACONAZOLE
Quinine CHLOROQUINE
Loop diuretics FUROSEMIDE HCTZ
ACEi AMLOPINE
SIMVAS
CARBOCYSTEINE
Salicylates NSAID ASA PARA
SERTRALNE AMITRYP
CHLORPROMAZINE
LEVODOPA
Antineoplastic drugs such as cisplatin
ARSENIC MERCURY
>>>>>>>>>>>>>>
TREATMENT
ACUTE VERTIGO
Antihistamines prevent motion sickness and reduce the severity of symptoms
Dimenhydrinate - 25 to 100 mg orally
diphenhydramine
Anticholinergics are vestibular suppressants that inhibit firing in vestibular nucleus neurons6 as well as reduce the velocity of vestibular nystagmus
viral infection causing the labyrinthitis or neuritis, antiviral medications like acyclovir (Zovirax) or valacyclovir (Valtrex)
Vestibular Migraine - triptans
Prophylactic treatment protocols are based on the ones from migraine headache.
Pharmacotherapy used in prevention of migraine attacks includes: as first line-β-blockers: metoprolol (50- 100 mg/day), flunarizine (5-10 mg/day), anticonvulsants: valproic acid (Depakine Chrono 500-800 mg 2 times a day) and topiramate (50- 100 mg/day, starts from 12.5 mg), and as second-line-amitriptyline, venlafaxine, naproxen, bisoprolol [
Ménière’s Disease
stop vertigo attacks, abolish tinnitus and reverse or preserve the hearing loss.
prevention of new attacks and the treatment of audio-vestibular dysfunction.
dietary salt restriction (1-2 gram salt diet) and adequate hydration (35 ml/kg of liquids). Patients should also avoid caffeine and stop smoking.
betahistine regimen is widespread worldwide, with a survey in England reporting that 94% of ENT surgeons prescribe betahistine to their Ménière's patients. The underlying mode of action is believed to be through increased inner-ear blood flow, with local vasodilation and increased permeability, thereby relieving pressure from the inner ear. A long-term high-dose treatment with betahistine (at least 48 mg three times daily), has shown a significant effect on the frequency of the attacks
central causes of vertigo need further investigation and treatment
>>>>>>>>>>>>>>
BT-SEMINAR VERTIGO
https://www.youtube.com/watch?v=LAgP0Sq9roI
บ้านหมุน
https://www.pobpad.com/บ้านหมุน
Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update March 1, 2017)
http://journals.sagepub.com/doi/pdf/10.1177/0194599816689667
Treatment of Vertigo
https://www.aafp.org/afp/2005/0315/p1115.html
Vertigo Treatment - How To Treat Vertigo
https://www.youtube.com/watch?v=1VWyPgfMuvM
How to Get Rid of Vertigo
https://draxe.com/how-to-get-rid-of-vertigo/
Vertigo/dizziness as a Drugs’ adverse reaction
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853661/
This is life with MdDS
https://youtu.be/yuKE4wdhkT8
Medicine-induced Vertigo
http://www.medsafe.govt.nz/profs/PUArticles/March2017/MedicineInducedVertigo.htm
Vertigo Caused by Medication
http://www.fpnotebook.com/ENT/Pharm/VrtgCsdByMdctn.htm
Can medications actually cause vertigo?
http://www.dizzyfix.com/2011/10/can-medications-actually-cause-vertigo.html
Vestibular Disorders > Treatment
http://vestibular.org/understanding-vestibular-disorders/treatment/vestibular-medication
Current Views on Treatment of Vertigo and Dizziness
https://www.omicsonline.org/open-access/current-views-on-treatment-of-vertigo-and-dizziness-2168-9784.1000150.php
Misunderstood and often misdiagnosed, the mystery of vertigo
http://www.cbc.ca/news/health/misunderstood-and-often-misdiagnosed-the-mystery-of-vertigo-1.2748513
benign paroxysmal positional vertigo (BPPV) – where specific head movements cause vertigo
labyrinthitis – an inner ear infection caused by a cold or flu virus
Ménière's disease – a rare inner ear condition, which sometimes involves ringing in the ear (tinnitus) or loss of hearing
vestibular neuronitis – inflammation of the vestibular nerve
migraine
Vertigo isn’t the only reason you might feel dizzy, so if symptoms seem to keep coming back, it’s a good idea to get a blood test done and speak with your doctor. Vitamin B12 deficiency, low blood pressure, anemic symptoms, heart complications and even anxiety can all contribute to dizziness,
>>>>>>>>>>>>>>
แยกระหว่าง PERIPHERAL & CENTRAL VERTIGO
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853661/table/T1/
PERIPHERAL
เฉียบพลัน รุนแรง นานเป็นนาที / ชั่วโมง
มีเสียงจิ้งหรีดร้อง เสียงลมออกหู
CENTRAL VERTIGO
เกิดค่อยเป็นค่อยไป พอทนได้ นานเป็นวันหรือสัปดาห์
ตากระตุก ไม่มีเสียงลมออกหู
>>>>>>>>>>>>>>
BPPV can be mistaken for a stroke.
BPPV – nausea, dizziness, light-headedness and loss of balance – are also signs of stroke
"BPPV tends to come and go, and symptoms last only about 30 seconds, whereas stroke symptoms are continuous."
>>>>>>>>>>>>>>
Classification of drugs that may cause vertigo or dizziness as an ADR
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853661/table/T2/
QUINOLONES
MACROLIDES
aminoglycoside
ITRACONAZOLE
Quinine CHLOROQUINE
Loop diuretics FUROSEMIDE HCTZ
ACEi AMLOPINE
SIMVAS
CARBOCYSTEINE
Salicylates NSAID ASA PARA
SERTRALNE AMITRYP
CHLORPROMAZINE
LEVODOPA
Antineoplastic drugs such as cisplatin
ARSENIC MERCURY
>>>>>>>>>>>>>>
TREATMENT
ACUTE VERTIGO
Antihistamines prevent motion sickness and reduce the severity of symptoms
Dimenhydrinate - 25 to 100 mg orally
diphenhydramine
Anticholinergics are vestibular suppressants that inhibit firing in vestibular nucleus neurons6 as well as reduce the velocity of vestibular nystagmus
viral infection causing the labyrinthitis or neuritis, antiviral medications like acyclovir (Zovirax) or valacyclovir (Valtrex)
Vestibular Migraine - triptans
Prophylactic treatment protocols are based on the ones from migraine headache.
Pharmacotherapy used in prevention of migraine attacks includes: as first line-β-blockers: metoprolol (50- 100 mg/day), flunarizine (5-10 mg/day), anticonvulsants: valproic acid (Depakine Chrono 500-800 mg 2 times a day) and topiramate (50- 100 mg/day, starts from 12.5 mg), and as second-line-amitriptyline, venlafaxine, naproxen, bisoprolol [
Ménière’s Disease
stop vertigo attacks, abolish tinnitus and reverse or preserve the hearing loss.
prevention of new attacks and the treatment of audio-vestibular dysfunction.
dietary salt restriction (1-2 gram salt diet) and adequate hydration (35 ml/kg of liquids). Patients should also avoid caffeine and stop smoking.
betahistine regimen is widespread worldwide, with a survey in England reporting that 94% of ENT surgeons prescribe betahistine to their Ménière's patients. The underlying mode of action is believed to be through increased inner-ear blood flow, with local vasodilation and increased permeability, thereby relieving pressure from the inner ear. A long-term high-dose treatment with betahistine (at least 48 mg three times daily), has shown a significant effect on the frequency of the attacks
central causes of vertigo need further investigation and treatment
>>>>>>>>>>>>>>
BT-SEMINAR VERTIGO
https://www.youtube.com/watch?v=LAgP0Sq9roI
บ้านหมุน
https://www.pobpad.com/บ้านหมุน
Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update March 1, 2017)
http://journals.sagepub.com/doi/pdf/10.1177/0194599816689667
Treatment of Vertigo
https://www.aafp.org/afp/2005/0315/p1115.html
Vertigo Treatment - How To Treat Vertigo
https://www.youtube.com/watch?v=1VWyPgfMuvM
How to Get Rid of Vertigo
https://draxe.com/how-to-get-rid-of-vertigo/
Vertigo/dizziness as a Drugs’ adverse reaction
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853661/
This is life with MdDS
https://youtu.be/yuKE4wdhkT8
Medicine-induced Vertigo
http://www.medsafe.govt.nz/profs/PUArticles/March2017/MedicineInducedVertigo.htm
Vertigo Caused by Medication
http://www.fpnotebook.com/ENT/Pharm/VrtgCsdByMdctn.htm
Can medications actually cause vertigo?
http://www.dizzyfix.com/2011/10/can-medications-actually-cause-vertigo.html
Vestibular Disorders > Treatment
http://vestibular.org/understanding-vestibular-disorders/treatment/vestibular-medication
Current Views on Treatment of Vertigo and Dizziness
https://www.omicsonline.org/open-access/current-views-on-treatment-of-vertigo-and-dizziness-2168-9784.1000150.php
Misunderstood and often misdiagnosed, the mystery of vertigo
http://www.cbc.ca/news/health/misunderstood-and-often-misdiagnosed-the-mystery-of-vertigo-1.2748513
Vertigo Treatment - How To Treat Vertigo
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