Which of the following drugs is commonly used to treat vertigo?

Appeared in: DSSSB 13 August 2024

Explanation

Cinnarizine is an H1 antihistamine with anticholinergic and calcium channel blocking properties.
It acts as a labyrinthine suppressant, meaning it reduces the activity of the vestibular system in the inner ear.
By inhibiting calcium influx into vestibular sensory cells, it dampens the signals that cause the sensation of spinning or dizziness (vertigo).
It is commonly prescribed for vertigo of various origins, including Ménière's disease and other vestibular disorders.

Option A: Ivermectin is an antiparasitic medication used to treat infections caused by worms and other parasites.
Option C: Imipramine is a tricyclic antidepressant (TCA) primarily used to treat major depressive disorder and sometimes neuropathic pain or enuresis.
Option D: Ondansetron is a serotonin 5-HT3 receptor antagonist. It is a powerful antiemetic, but it primarily acts on the chemoreceptor trigger zone (CTZ) and the gastrointestinal tract to prevent nausea and vomiting.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological management of vertigo as background academic context rather than a clinical decision trigger.
Nurses must educate patients taking Cinnarizine about its most common side effect: drowsiness. Patients should be advised to avoid driving or operating heavy machinery until they know how the drug affects them.
It is crucial to differentiate between vertigo (a spinning sensation) and lightheadedness or dizziness, as the underlying causes and treatments differ. A thorough patient assessment is key.
What if? If a patient experiences severe nausea and vomiting due to chemotherapy but does not have vertigo, Ondansetron would be the more appropriate medication, as it is a potent antiemetic that targets the pathways involved in chemotherapy-induced nausea.

How to Approach the Question

First, identify the core clinical condition in the question, which is 'vertigo'.
Next, recall the main drug classes used to treat vertigo. These are primarily labyrinthine suppressants, which include certain antihistamines (like Cinnarizine, Meclizine) and anticholinergics.
Evaluate each option based on its drug class and primary indication.
Ivermectin is an antiparasitic. Eliminate it.
Imipramine is an antidepressant. Eliminate it as a primary choice.
Ondansetron is an antiemetic for chemo- or post-op nausea, not a primary vertigo treatment. Eliminate it.

Concept Tested & Keywords

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Practise the full DSSSB 13 August 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.