Vertigo

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A presentation on Vertigo and its treatment

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Vertigo

  1. 1. Vertigo and its treatment with Betahistine
  2. 2. Index <ul><li>What is vertigo. </li></ul><ul><li>Symptoms of vertigo. </li></ul><ul><li>Causes of vertigo. </li></ul><ul><li>Complications of vertigo. </li></ul><ul><li>Current therapies of Vertigo. </li></ul><ul><li>Betahistine. </li></ul><ul><li>Indications of Betahistine in details </li></ul><ul><li>Mode of action of Betahistine. </li></ul><ul><li>Your words . </li></ul>
  3. 3. INTRODUCTION <ul><li>25 % of population will experience dizziness , with or without vertigo at some point of their life. </li></ul><ul><li>Older people experience more frequently that younger one. </li></ul><ul><li>All vertigo comes with dizziness , but reverse is not true. </li></ul>
  4. 4. What is Dizziness <ul><li>Feeling of light-headedness due to </li></ul><ul><li>Anxiety / Panic disorder / Mood disorder </li></ul><ul><li>Cardiovascular problem </li></ul><ul><li>Medications like sedative , hypnotics etc. </li></ul><ul><li>Problems with the chemical changes within the body like hypoglycemia </li></ul>
  5. 5. Symptoms of dizziness <ul><li>Light-headedness. </li></ul><ul><li>Motion sickness or nausea. </li></ul><ul><li>Faintness or weakness </li></ul>
  6. 6. What is vertigo <ul><li>> Vertigo is a strong feeling of movement or spinning when you are actually still. </li></ul><ul><li>>It may also worsen and make you vomit . </li></ul><ul><li>>These episodes of vertigo are not constant . </li></ul>
  7. 7. Symptoms of vertigo <ul><li>Sense of movement of yourself and objects around you . </li></ul><ul><li>An illusion of spinning and circling . </li></ul><ul><li>Worsened with head movements. </li></ul><ul><li>Episodes come and go . </li></ul><ul><li>Nausea and vomiting . </li></ul><ul><li>Ringing in the ears . </li></ul>
  8. 8. CAUSES <ul><li>Motion sickness . </li></ul><ul><li>Abnormality in the inner ear . </li></ul><ul><li>Central &peripheral vestibular disorders . </li></ul><ul><li>Menieres disease. </li></ul><ul><li>Labrinthitis </li></ul>
  9. 9. Current Therapies for Vertigo <ul><li>Life style changes (low salt ). </li></ul><ul><li>Anticolinergics (does not cross BBB) </li></ul><ul><li>Antihistamines </li></ul><ul><li>Benzodiazepines (addiction) </li></ul><ul><li>Antiemetics (side effects like restless ness ,EPS prostrate enlargement, drowsiness.) </li></ul><ul><li>Diphenhydramine (Benadryl)  </li></ul><ul><li>Anti emetics and Anti vertigo agent-Betahistine </li></ul>
  10. 10. Description <ul><li>Betahistine dihydrochloride is a white crystalline powder and very hygroscopic in nature . </li></ul><ul><li>Composition : 16mg &24mg tablets contain 16mg and 24mg Betahistine dihydrochloride respectively . </li></ul>
  11. 11. <ul><li>A histamine H 1 -agonist with an intrinsic activity equal to that of histamine and an H 1 -agonistic activity of about 0.07 times that of histamine – Not affect wakefulness </li></ul><ul><li>A potent H 3 -receptor antagonist – Effective in central and peripheral vestibular disorders </li></ul>
  12. 12. <ul><ul><li>Histavert exhibits H1 Agonistic and H3 Receptor antagonistic action . </li></ul></ul><ul><ul><li>H1receptor activation stimulates the release histamine </li></ul></ul><ul><ul><li>Betahistine when acts as agonist at H1receptor it increases the release of histamine . (histamine release causes vasodilatation in the blood vessels .) </li></ul></ul>Mode of Action
  13. 13. Betahistine <ul><ul><li>Betahistine when acts as H3antagonist(H3 receptors controls histamine release . </li></ul></ul><ul><ul><li>Antagonist activity causes histamine release . </li></ul></ul><ul><ul><li>That means because of H1 Agonistic activity&H3 antagonist activity there is vasodialation . </li></ul></ul>
  14. 14. <ul><li>Histamine is an amine. </li></ul><ul><li>It regulates physiological functions and also acts as neurotransmitter. </li></ul><ul><li>Histamine is stored in mast cells . </li></ul><ul><li>Mast cells are present all internal body surfaces and blood vessels . </li></ul>
  15. 15. <ul><li>Histamine exerts its action by combining with specific receptors . </li></ul><ul><li>There are four histamine receptors . </li></ul><ul><li>H1 Receptors – present in smooth muscle .endothelium ,CNS . </li></ul><ul><li>H2 Receptors – present in parietal cells , </li></ul><ul><li>H3 Receptors – present in brain and peripheral regions . </li></ul>
  16. 16. <ul><li>Agonist – It is substance that binds to the receptor and triggers the response . </li></ul><ul><li>Antagonist- it is substance that inhibits the normal function of the receptors . </li></ul>
  17. 17. PHARMACOKINETICS <ul><li>Rapidly and completely absorbed from the GI tract </li></ul><ul><li>Metabolized to primary metabolite-2-pyridylacetic acid </li></ul><ul><li>Plasma half life : 3.4 hours </li></ul><ul><li>90 % of the orally administered excreted within 24 hours through urine </li></ul>
  18. 18. INDICATIONS <ul><li>Menieres Disease </li></ul><ul><li>Benign Paroxysmal Positional Vertigo </li></ul><ul><li>Peripheral Vestibular Vertigo </li></ul><ul><li>Labrynthitis </li></ul><ul><li>Tinnitus </li></ul>
  19. 19. Inner ear <ul><li>  </li></ul> 
  20. 20. Ménière’s disease <ul><li>Ménière’s disease is one of the most common causes of dizziness originating in the inner ear due to abnormality in the fluids in the inner ear . </li></ul>
  21. 21. Benign Paroxysmal Positional Vertigo <ul><li>Benign Paroxysmal Positional Vertigo (BPPV) is an inner ear problem that results in short lasting, but severe, room-spinning vertigo. </li></ul>
  22. 22. Peripheral Vestibular Vertigo <ul><li>If vertigo results from a disorder in the peripheral vestibular system (i.e., structures of the inner ear). </li></ul><ul><li>It also may occur due a disorder in the central vestibular system (i.e., vestibular nerve, brainstem, and cerebellum). In some cases, cause is unknown. </li></ul>
  23. 23. Labyrinthitis <ul><li>Labyrinthitis is an inflammation of labyrinth (a system of intercommunicating cavities and canals in the inner ear). </li></ul><ul><li>The syndrome is defined by the acute onset of vertigo, commonly associated with head or body movement. </li></ul>
  24. 24. Tinnitus <ul><li>It is the perception of sound in the ear when no external source is present . </li></ul>
  25. 25. Dosage and Administration <ul><li>> 24 - 48 mg administered orally in divided doses. </li></ul>
  26. 26. CONTRAINDICATION <ul><li>Patients hypersensitive to Betahistidine </li></ul><ul><li>Patients with Peptic Ulcer </li></ul><ul><li>Patients with pheochromocytoma`(tumor in the adrenal medulla ,increased secretions of neurotransmitters ) </li></ul>

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