Neurology Case No 7. Motion Sickness

Hello I'm Raiyyan Tahsan

Brand Model and Executive

Neurology Case No 7. Motion Sickness

মোশন সিকনেস এ বমি হওয়ার কারণ ও চিকিৎসা –

মোশন সিকনেস: গাড়িতে উঠলে বমি হওয়া/অস্বস্তি লাগা-

(Motion Sickness) হয় যখন মস্তিষ্কের বিভিন্ন অংশ থেকে পরস্পরবিরোধী তথ্য পায়। শরীরের Balance and movement এর সেন্স মস্তিষ্কে আসে তিনটি প্রধান উৎস থেকে:

1. ভেসটিবুলার সিস্টেম: (কানের ভেতরের অংশ): এটি শরীরের ভারসাম্য ও গতির ধারণা প্রদান করে।

2. চোখ:

আমাদের চোখ আমাদের পারিপার্শ্বিক পরিবেশে কোন দিকে যাচ্ছি তা দেখে।

3. পেশী ও জয়েন্ট:

এগুলো শরীরের অবস্থান সম্পর্কে তথ্য দেয়।

যখন এই তিনটি সূত্র থেকে আসা তথ্যগুলির মধ্যে সমন্বয় থাকে না, তখন মস্তিষ্ক বিভ্রান্ত হয়। vomiting center stimulate হয়, এবং বমি হয়-

মেকানিজম

মোশন সিকনেসের ক্ষেত্রে, উদাহরণস্বরূপ যদি কেউ একটি গাড়িতে বসে থাকে এবং বাইরের দৃশ্য না দেখে, তবে শরীর মনে করতে পারে যে এটি স্থির অবস্থায় আছে, কিন্তু কানের ভেতরের ভেসটিবুলার সিস্টেম জানাচ্ছে যে শরীরটি গতিশীল। এই ধরনের পারস্পরিকবিরোধী তথ্য মস্তিষ্কের মধ্যে সংকেত তৈরি করে যা বমির অনুভূতি সৃষ্টি করে।

চিকিৎসা:

hyoscine – Joytrip নামে পাওয়া যায়-

এইটা Anti muscarinic drug, Vomiting center কে inhibit করে দেয়, সাথে Gastro intestinal motility কমায়- যার মাধমে মোশন সিকনেসে এইটা অনেক কার্যকরী

ডোজ–

12 বছরের অধিক হলে-

Tab- Joytrip 300 mcg

ট্রাভেলের ৩০ মিনিট আগে খেয়ে নিবে-

বাচ্চাদের ডোজ- 6 mcg/kg (সাধারণত ৪-১২ বছরে)

Joytrip 150 mcg একটা ট্যাবলেট দেওয়া হয়, চুষে খেয়ে নিবে-

৪ বছরের কম হলে Joytrip 150 এর অর্ধেক দেওয়া হয়-

Tablet 1:-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

Indications of Tablet :-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

Joytrip is indicated in the prevention and control of nausea and vomiting associated with motion sickness/travel sickness.

Pharmacology Tablet :-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

Hyoscine Hydrobromide is a type of medicine called an antimuscarinic (or anticholinergic). Hyoscine hydrobromide is sometimes known as scopolamine. It is thought to prevent motion sickness by stopping the messages sent from the vestibular system to reach an area of the brain called the vomiting centre. This area of the brain coordinates the vomiting reflex.

Dosage Tablet :-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

Adults and children over 13 years: 2 tablets (Maximum 4 tablets in 24 hours).
Children age 7-12 years: 1-2 tablets (Maximum 2 tablets in 24 hours).
Children age 4-7 years: 1 tablet (Maximum 2 tablets in 24 hours).
Children age 3-4 years: half a tablet (Maximum 1 tablet in 24 hours).
Children under 3 years: Not recommended under 3 years or as directed by the physician.

Administration Tablet :-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

Ideally, take tablets 30 minutes before the journey.

Interaction Tablet :-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

Additive sedative effects with alcohol or other CNS depressants. Reduced effects with acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine, tacrine).

Contraindications Tablet :-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

Hyoscine Hydrobromide is contraindicated in Glaucoma/Blindness.

Side Effects Tablet :-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

Dry mouth, dizziness, blurred vision, difficulty with micturition.

Pregnancy & Lactation Tablet :-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

Not recommended during pregnancy and lactation.

Precautions & Warnings Tablet :-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

May cause drowsiness, if affected do not drive or operate machinery. May be potentiated by concurrent phenothiazines, tricyclic antidepressants or alcohol. Absorption may be reduced by aluminium hydroxide preparations.

Use in Special Populations Tablet :-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

Children: Joytrip only be given to children over 3 years old

Therapeutic Class Tablet :-Joytrip 300mg (AS A Hyoscine Hydrobromide AS A Anti-emetic drugs).

Anti-emetic drugs

২.. Meclizine (Aclliz 50 mg)

এইটা ১২ বছরের উপরে হলে দেওয়া যায়-

এইটা ট্রাভেলের এক ঘন্টা আগে খেতে হয়-

Tablet 2:-Acliz 50 mg (AS A Meclizine Hydrochloride AS A Anti-emetic drugs)

Indications of Tablet :-Acliz 50 mg (AS A Meclizine Hydrochloride AS A Anti-emetic drugs)

Acliz tablet is indicated for the management of nausea and vomiting, and dizziness associated with motion sickness, vertigo associated with diseases affecting the vestibular system.

Pharmacology of Tablet :-Acliz 50 mg (AS A Meclizine Hydrochloride AS A Anti-emetic drugs)

Meclizine has antiemetic, anticholinergic and antihistaminic properties. It reduces the sensitivity of the labyrinthine apparatus. The action may be mediated through nerve pathways to the vomiting center (VC) from the chemoreceptor trigger zone (CTZ), peripheral nerve pathways, the VC, or other CNS centers. Meclizine has an onset of action of 30 to 60 minutes, depending on dosage; their duration of action is 12 to 24 hours.

Dosage & Administration of Tablet :-Acliz 50 mg (AS A Meclizine Hydrochloride AS A Anti-emetic drugs)

For the prevention and treatment of nausea, vomiting and vertigo associated with motion sickness, the usual oral dosage of meclizine hydrochloride in adults and children 12 years of age or older is 25-50 mg once daily.

Vertigo: for the control of vertigo associated with diseases affecting the vestibular system, the recommended dose is 25 to 100mg daily, in divided doses, depending upon clinical response.

Motion Sickness: The initial dose of 25 to 50mg should be taken one hour prior to embarkation for protection against motion sickness. Thereafter, the dose may be repeated every 24 hours for the duration of the journey.

Interaction of Tablet :-Acliz 50 mg (AS A Meclizine Hydrochloride AS A Anti-emetic drugs)

Additive CNS depression may occur where Acliz are administered concomitantly with other CNS depressants including barbiturates, tranquilizers and alcohol.

Contraindications of Tablet :-Acliz 50 mg (AS A Meclizine Hydrochloride AS A Anti-emetic drugs)

Meclizine hydrochloride is contraindicated in individuals who have shown a previous hypersensitivity to it.

Side Effects of Tablet :-Acliz 50 mg (AS A Meclizine Hydrochloride AS A Anti-emetic drugs)

Drowsiness, dry mouth and, on rare occasions, blurred vision have been reported.

Pregnancy & Lactation of Tablet :-Acliz 50 mg (AS A Meclizine Hydrochloride AS A Anti-emetic drugs)

Pregnancy Category B by FDA. Safety for use in the nursing mother has not been established.

Precautions & Warnings of Tablet :-Acliz 50 mg (AS A Meclizine Hydrochloride AS A Anti-emetic drugs)

Due to its potential anticholinergic action, Acliz should be used with caution in patients with asthma, glaucoma, or enlargement of the prostate gland.

Therapeutic Class of Tablet :-Acliz 50 mg (AS A Meclizine Hydrochloride AS A Anti-emetic drugs)

Anti-emetic drugs

৩.. Cinarizine+ dyminhydrinate

Cinaron plus নামে পাওয়া যায়-

এইটা ট্রাভেলের ২ ঘন্টা আগে খেতে হয়–

এইটা শুধু adult দের জন্য

Tablet 3:-Cinaron Plus ((20mg+40mg) AS A (Cinnarizine+Dimenhydrinate) AS A Anti vertigo drugs ).

Indications of Tablet :-Cinaron Plus ((20mg+40mg) AS A (Cinnarizine+Dimenhydrinate) AS A Anti vertigo drugs ).

Cerebral circulatory disorders:

Prophylaxis and maintenance therapy for symptoms of cerebral vascular spasms and arteriosclerosis such as: dizziness, ear buzzing (tinnitus), vascular headache, unsociability and irritability, fatigue, sleep rhythm disorders such as premature awakening, involutional depressions, loss of memory and lack of concentration, incontinence and other disorders due to aging.
Sequelae of cerebral and cranial trauma.
Postapoplectic disorders.
Migraine.

Peripheral circulatory disorders: Prophylaxis and maintenance therapy for symptoms of vascular spasms and arteriosclerosis (obliterating arteritis, thromboangitis obliterans, Raynaud’s disease, diabetes, acrocyanosis pernio, etc.) such as intermittent claudication, trophic disturbances, pregangrene, trophic and varicose ulcers, paraesthesia, nocturnal cramps, cold extremities.

Disorders of balance:

Prophylaxis and maintenance therapy for symptoms of labyrinthine arteriosclerosis; vestibular irritability; Meniere’s syndrome such as vertigo, dizziness, giddiness, syncopal attacks, tinnitus, nystagmus, nausea and vomiting.
Prophylaxis of motion sickness.

Pharmacology Tablet :-Cinaron Plus ((20mg+40mg) AS A (Cinnarizine+Dimenhydrinate) AS A Anti vertigo drugs ).

This contains two active ingredients Cinnarizine and Dimenhydrinate. The two substances belong to different groups of medicines. Cinnarizine is part of a group called calcium antagonists. Dimenhydrinate belongs to a group called antihistamines. Both substances work by reducing symptoms of vertigo (a feeling of dizziness or spinning) and nausea (feeling sick). The combination product is more effective than the individual compounds.

Dosage & Administration Tablet :-Cinaron Plus ((20mg+40mg) AS A (Cinnarizine+Dimenhydrinate) AS A Anti vertigo drugs ).

Adults: 1 tablet three times daily, to be taken after meals. Children and
adolescents under the age of 18 years: Not recommended
Elderly: Dosage as for adults.

Interaction Tablet :-Cinaron Plus ((20mg+40mg) AS A (Cinnarizine+Dimenhydrinate) AS A Anti vertigo drugs ).

Concurrent use of alcohol, CNS depressants or tricyclic antidepressants may potentiate the sedative effects of either these drugs or of Cinnarizine and Dimenhydrinate. Therefore, it is advisable to avoid these drugs while taking Cinnarizine and Dimenhydrinate.

Contraindications

Cinnarizine and Dimenhydrinate should not be used by patients with severe hepatic impairment. Cinnarizine and Dimenhydrinate is contra-indicated in patients with known hypersensitivity to the active substances or to any of the excipients. Cinnarizine and Dimenhydrinate should not be used in patients with angle-closure glaucoma, convulsions, suspicion of raised intracranial pressure, and alcohol abuse or urine retention due to urethroprostatic disorders.

Side Effects Tablet :-Cinaron Plus ((20mg+40mg) AS A (Cinnarizine+Dimenhydrinate) AS A Anti vertigo drugs ).

Drowsiness, dry mouth, headache, and stomach pain may occur. Rare side effects are impaired vision, allergic reactions, light sensitivity, and difficulty in urinating. Other possible reactions which may occur: weight gain, constipation, tightness of the chest, jaundice, worsening of angle-closure glaucoma, uncontrollable movements, unusual excitement and restlessness, severe skin reactions.

Pregnancy & Lactation Tablet :-Cinaron Plus ((20mg+40mg) AS A (Cinnarizine+Dimenhydrinate) AS A Anti vertigo drugs ).

Dimenhydrinate and cinnarizine should not be used during pregnancy and lactation.

Precautions & Warnings Tablet :-Cinaron Plus ((20mg+40mg) AS A (Cinnarizine+Dimenhydrinate) AS A Anti vertigo drugs ).

Cinnarizine and Dimenhydrinate do not reduce blood pressure significantly; however, it should be used with caution in hypotensive patients. Cinnarizine and Dimenhydrinate should be taken after meals to minimize any gastric irritation. Caution should be exercised when administering Cinnarizine and Dimenhydrinate to patients with Parkinson’s disease.

Overdose Effects Tablet :-Cinaron Plus ((20mg+40mg) AS A (Cinnarizine+Dimenhydrinate) AS A Anti vertigo drugs ).

Drowsiness, dizziness and ataxia with anticholinergic effects such as dry mouth, flushing of the face, dilated pupils, tachycardia, pyrexia, headache and urinary retention. General supportive measures should be used to treat respiratory insufficiency or circulatory failure. Gastric lavage with isotonic sodium chloride solution is recommended.

Therapeutic Class Tablet :-Cinaron Plus ((20mg+40mg) AS A (Cinnarizine+Dimenhydrinate) AS A Anti vertigo drugs ).

Anti vertigo drugs

OR Most effective Medicine :-

Tablet 4:-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

Indications of Tablet :-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

Meniere’s disease and Meniere-like syndromes are characterized by attacks of vertigo, tinnitus and/or progressive loss of hearing, usually accompanied by nausea and vomiting.

Description of Tablet :-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

Menaril is a histamine analog that was developed following successful parenteral use of histamine in patients with Meniere’s Syndrome. Menaril relieves vertigo symptoms by improving circulation in the microvasculature of the inner ear which leads to a pressure reduction on the membranous labyrinth and relieves the symptoms of Meniere’s disease.

Pharmacology of Tablet :-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

The mechanism of action of betahistine is multifactorial. Meniere’s disease is thought to result from a disruption of endolymphatic fluid homeostasis in the ear. Betahistine mainly acts as a histamine H1-receptor agonist. The stimulation of H1-receptors in the inner ear causes a vasodilatory effect leading to increased permeability of blood vessels and a reduction in endolymphatic pressure; this action prevents the rupture of the labyrinth, which can contribute to the hearing loss associated with Ménière’s disease. Betahistine is also purported to act by reducing the asymmetrical functioning of sensory vestibular organs and increasing vestibulocochlear blood flow, relieving symptoms of vertigo.

In addition to the above mechanisms, betahistine also acts as a histamine H3-receptor antagonist, increasing the turnover of histamine from postsynaptic histaminergic nerve receptors, subsequently leading to an increase in H1-agonist activity. H3-receptor antagonism elevates levels of neurotransmitters including serotonin in the brainstem, inhibiting the activity of vestibular nuclei, thus restoring proper balance and decreasing vertigo symptoms.

Dosage & Administration of Tablet :-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

Adults: Initial oral treatment is 8 to 16mg three times daily, taken preferably with meals. Maintenance doses are generally in the range 24-48 mg daily. Daily dose should not exceed 48mg. Dosage can be adjusted to suit individual patient needs. Sometimes improvement could be observed only after a couple of weeks of treatment. There is no data available for patients with hepatic impairment. There is no data available for patients with renal impairment. There is limited data in the elderly, betahistine should be used with caution in this population.

Children and adolescents: Betahistine tablets are not recommended for use in children and adolescents below age 18 due to lack of data on safety and efficacy.

Interaction of Tablet :-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

There are no proven cases of hazardous interactions. There is a case report of an interaction with ethanol and a compound containing pyrimethamine with dapsone and another of potentiation of betahistine with salbutamol. Menaril is a histamine analogue, concurrent administration of H1 antagonists may cause a mutual attenuation of effect of the active agents.

Contraindications of Tablet :-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

Betahistine is contraindicated in patients with phaeochromocytoma. As betahistine is a synthetic analogue of histamine it may induce the release of catecholamines from the tumour resulting in severe hypertension. Hypersensitivity to the active substance.

Side Effects of Tablet :-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

Menaril is generally well tolerated and there is no known serious adverse effects. In some circumstances gastrointestinal disturbances, headache, rashes and pruritus have been reported.

Pregnancy & Lactation of Tablet :-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

In Pregnancy: The safety of Betahistine in human pregnancy has not been completely established, although there is no known teratogenic effect in animals. A careful assessment of potential benefits should be made before prescribing Betahistine in pregnancy.

In Lactation: Betahistine is excreted in the breast milk of nursing mothers in concentrations similar to those found in plasma. Toxicity to the neonate at these concentrations is not known.

Precautions & Warnings of Tablet :-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

Caution is advised in the treatment of patients with peptic ulcer or a history of peptic ulceration, because of the occasional dyspepsia encountered in patients on betahistine. Caution should be exercised in patients with bronchial asthma. Caution is advised in prescribing betahistine to patients with either urticaria, rashes or allergic rhinitis, because of the possibility of aggravating these symptoms. Caution is advised in patients with severe hypotension. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Effects on ability to drive and use machines: Rare reports of drowsiness associated with betahistine have been made. Patients should be advised that they are affected in this way they should avoid activities requiring concentration, such as driving and operating machinery.

Overdose Effects of Tablet :-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

The symptoms of betahistine overdose are nausea, vomiting, dyspepsia, ataxia and seizures. More serious complications (convulsion, pulmonary or cardiac complications) were observed in cases of intentional overdose of betahistine especially in combination with other overdosed drugs. No specific antidote. Gastric lavage and symptomatic treatment are recommended.

Therapeutic Class of Tablet :-Menaril 8mg (AS A Betahistine Dihydrochloride Drugs used in meniere’s diseases).

Drugs used in meniere’s diseases

OR Most effective medicine can be used :-

Tablet 5:-Promtil 5mg (AS A Prochlorperazine Maleate AS A Anti vertigo drugs, Anti-emetic drugs).

Indications of Tablet :-Promtil 5mg (AS A Prochlorperazine Maleate AS A Anti vertigo drugs, Anti-emetic drugs).

Promtil is indicated-

To control severe nausea and vomiting caused by radiation therapy, cancer chemotherapy, surgery, and other conditions.
Relieving nausea, vomiting, and attacks of dizziness or spinning sensations (vertigo) associated with Meniere’s disease and other inner ear disorders.
For the treatment of psychotic illness such as schizophrenia (hallucinations and hostility).
Acute mania.
For the short-term treatment of generalized non-psychotic anxiety.

Pharmacology of Tablet :-Promtil 5mg (AS A Prochlorperazine Maleate AS A Anti vertigo drugs, Anti-emetic drugs).

Prochlorperazine is a dopamine & histamine antagonist. The mechanism of antiemetic activity is due to the blockade of histamine H, & dopamine D2 neurotransmitter receptors in the chemoreceptor trigger zone and vomiting centre. It also has a weak anticholinergic effect and prevents acid reflux by increasing the tone of the lower oesophageal sphincter.

Dosage & Administration of Tablet :-Promtil 5mg (AS A Prochlorperazine Maleate AS A Anti vertigo drugs, Anti-emetic drugs).

Antiemetic–
Children (not recommended in children <10 kg or <2 years):

10-14 kg: 2.5 mg every 12-24 hours as needed;maximum: 7.5 mg/day
15-18 kg: 2.5 mg every 8-12 hours as needed;maximum:10 mg/day
19-39 kg: 2.5 mg every 8 hours or 5 mg every 12 hours as needed; maximum: 15 mg/day.

Adults: 5-10 mg 3-4 times/day;usual maximum:40 mg/day

Antipsychotic–
Children (not recommended in children <10 kg or <2 years):

2-12 years: 2.5 mg 2-3 times/day
Increase dosage as needed to a maximum daily dose of 20 mg for 2-5 years and 25 mg for 6-12 years

Adults: 5-10 mg 3-4 times/day; doses up to 150 mg/day may be required in some patients for treatment of severe disturbances

Nonpsychotic anxiety–

Adults: Usual dose: 15-20 mg/day in divided doses; do not give doses >20 mg/day or for longer than 12 weeks
Elderly: Initial: 2.5-5 mg 1-2 times/day; increase dose at 4 to 7 day intervals by 2.5-5 mg/day; increase dosing intervals (twice daily, thrice daily, etc) as necessary to control response or side effects; maximum daily dose should probably not exceed 75 mg in elderly; gradual increases (titration) may prevent some side effects or decrease their severity.

Prochlorperazine may be administered without regard to the meal.

Interaction of Tablet :-Promtil 5mg (AS A Prochlorperazine Maleate AS A Anti vertigo drugs, Anti-emetic drugs).

Alcohol, barbiturate & other sedatives may increase the CNS depressant action. Some drugs like Antacids, antiparkinson’s drug, lithium may interfere the absorption of Promtil. Promtil may interfere with the plasma concentration of Propanolol and Phenobarbital.

Contraindications of Tablet :-Promtil 5mg (AS A Prochlorperazine Maleate AS A Anti vertigo drugs, Anti-emetic drugs).

Hypersensitivity to prochlorperazine or any component of the formulation, severe CNS
depression; coma; should not be used in children <2 years of age or <10 kg.

Side Effects of Tablet :-Promtil 5mg (AS A Prochlorperazine Maleate AS A Anti vertigo drugs, Anti-emetic drugs).

Drowsiness; jaw, neck, and back muscle spasms; fine worm-like tongue movements; rhythmic face, mouth, or jaw movements; slow or difficult speech; difficulty swallowing; restlessness and pacing; tremors; shuffling walk; skin rash; yellowing of the skin or eyes.

Pregnancy & Lactation of Tablet :-Promtil 5mg (AS A Prochlorperazine Maleate AS A Anti vertigo drugs, Anti-emetic drugs).

No evidence of adverse effects of this drug has been reported during pregnancy & lactation.

Precautions & Warnings of Tablet :-Promtil 5mg (AS A Prochlorperazine Maleate AS A Anti vertigo drugs, Anti-emetic drugs).

Caution should be taken while performing tasks that require alertness, such as driving or using machinery. The use of alcohol can cause extreme drowsiness. This medication may increase sensitivity to sunlight. Prolonged sun exposure should be avoided and sunscreen and protective clothing should be taken when anybody is exposed to the sun. This medication can reduce sweating making it more susceptible to heatstroke.

Overdose Effects of Tablet :-Promtil 5mg (AS A Prochlorperazine Maleate AS A Anti vertigo drugs, Anti-emetic drugs).

Symptoms of overdose include deep sleep, coma, extrapyramidal symptoms, abnormal involuntary muscle movements, and hypotension.

Therapeutic Class of Tablet :-Promtil 5mg (AS A Prochlorperazine Maleate AS A Anti vertigo drugs, Anti-emetic drugs).

Anti vertigo drugs, Anti-emetic drugs

বাচ্চাদের জন্য Joytrip পাওয়া না গেলে

Pheniramine সিরাপ দিবেন- অথবা ডমপেরিডন দিতে পারেন –

সিরাপ Avil

১০ কেজিতে আধা চামচ

২০ কেজিতে ১ চামচ

যাদের মোশন সিকনেস আছে, তারা কিছু বিহেভিয়ারেল অ্যাপ্রোচ নিতে পারেন–

বিহেভিয়োরাল_অ্যাপ্রোচ

– গাড়িতে সামনে বসে দৃশ্যের দিকে মনোযোগ দেওয়া।

– মাথা স্থির রাখা।

– ছোট, হালকা খাবার খাওয়া।

– তাজা বাতাসে থাকা।

Raiyyan Tahsan Date:-24-01-2025 Friday Time:-11-15-45 PM

Raiyyan Tahsan

Raiyyan Tahsan