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22. Air sickness

The frequency of air sickness accompanied by nausea and vomiting among airline passengers is under 1%. This increases during turbulence. Air sickness is a cascade of symptoms that develops when the balance system is influenced by stimuli to which it is not accustomed. Psychological factors – for example, fear of flying – have an important influence upon motion sickness.

 

The early symptoms of air sickness are headaches, drowsiness, and a general indisposition, all of which are not always readily connected with the phenomenon of motion sickness. If the motion sickness stimulus is powerful enough and the circumstances allow symptoms to develop, the patient will first become flushed, will experience dryness of the throat as well as an awareness that something is occurring in his or her throat and later in the stomach, gradually succeeded by paleness, perspiration, increased sputum secretion and nausea, culminating in vomiting. In patients recently having had surgery in the larynx or pharynx (e.g. tonsillectomy), intense vomiting can cause bleeding or rupture in the given areas. Throughout the whole process, the sick person experiences a general malaise and is often very sleepy and depressed.

 

The symptoms can be eased (especially in the initial phases) if the person’s attention is distracted. It helps to lie down. The symptoms are often repressed if sleep is possible.

 

Symptoms can be prevented by ingesting certain (but not all) antihistamine preparations.

 

The drugs appear in the following table along with their latency periods and rough estimates of their sedative effects. One should not consume alcohol or drive a motorcar while using these medicaments. It should further be noted that a tablet cannot be expected to take effect when ingested by a person who is already suffering from nausea and vomiting. In situations where motion sickness is accompanied by vomiting, it can be a good idea to use a transdermal Hyoscine patch.

 

Medicine Latency period Duration of effectiveness Sedative effect

in hours in hours

Cycklizine 1-2 4-8 +

Cinnarizine 1-2 6-8 +

Diphenhydramine 1-2 6-12 +++

Meclizine 1-2 6-12 ++

Promethazine 1-2 8-24 +++

Hyoscin

(transdermal patch) 1-6 72 + (+ accomodation difficulties)