Comparison of Efficacy Dimenhydrinate and Metoclopramide in the Treatment of Nausea Due to Vertigo
Comparison of Efficacy Dimenhydrinate and Metoclopramide in the Treatment of Nausea Due to Vertigo
-  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
-  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.
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.