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Anti-emetic and antihistamine medication
Dimenhydrinate , sold under the brand name Dramamine , among others, is an over-the-counter drug used to treat motion sickness and nausea . Dimenhydrinate is a theoclate salt composed of diphenhydramine , an ethanolamine derivative, and 8-chlorotheophylline , a chlorinated theophylline derivative, in a 1:1 ratio.[1]
Medical uses
Nausea
Dimenhydrinate is an over-the-counter (OTC) antihistamine indicated for the prevention and relief of nausea and vomiting from a number of causes. It is an H1 receptor antagonist that demonstrates anticholinergic activity.[2]
Medicinal chemistry
Diphenhydramine is the primary constituent of dimenhydrinate and dictates the primary effect. The main difference relative to pure diphenhydramine is a lower potency due to being combined with 8-chlorotheophylline. By weight, dimenhydrinate is between 53% to 55.5% diphenhydramine.[3]
Side effects
Common side effects may include:[4]
Drowsiness
Dry mouth, nose, or throat
Constipation
Blurred vision
Feeling restless or excited (especially in children)
Recreational use
Dimenhydrinate is recreationally used as a deliriant .[5] [6] [7] Slang terms for Dramamine used this way include "drama", "dime", "dime tabs", "D-Q", "substance D", "d-house", and "drams".[8] Abusing Dramamine is sometimes referred to as Dramatizing or "going a dime a dozen", a reference to the amount of Dramamine tablets generally necessary for a trip.[9]
Many users report a side-effect profile consistent with tropane alkaloid (e.g. atropine ) poisoning as both show antagonism of muscarinic acetylcholine receptors in both the central and autonomic nervous system, which inhibits various signal transduction pathways.[6]
Other CNS effects occur within the limbic system and hippocampus , causing confusion and temporary amnesia due to decreased acetylcholine signaling. Toxicology also manifests in the autonomic nervous system, primarily at the neuromuscular junction , resulting in ataxia and extrapyramidal side effects and the feeling of heaviness in the legs, and at sympathetic post-ganglionic junctions, causing urinary retention, pupil dilation, tachycardia , irregular urination, and dry red skin caused by decreased exocrine gland secretions, and mucous membranes. Considerable overdosage can lead to myocardial infarction (heart attack), serious ventricular arrhythmias , coma, and death.[10] Such a side effect profile is thought to give ethanolamine -class antihistamines a relatively low abuse liability.[citation needed ] An antidote that can be used for dimenhydrinate poisoning is physostigmine .[11]
Brand names
Dimenhydrinate is marketed under many brand names: in the US, Mexico, Turkey and Serbia as Dramamine; in Ukraine as Driminate; in Canada, Costa Rica, and India as Gravol; in Iceland as Gravamin; in Russia and Croatia as Dramina; in South Africa and Germany as Vomex; in Australia and Austria as Vertirosan; in Brazil as Dramin; in Colombia as Mareol; in Ecuador as Anautin; in Hungary as Daedalon; in Indonesia as Antimo; in Italy as Xamamina or Valontan; in Peru as Gravicoll; in Poland and Slovakia as Aviomarin;[12] in Portugal as Viabom, Vomidrine, and Enjomin; in Spain as Biodramina; in Thailand as Daimenin; in Israel as Travamin; in Pakistan as Gravinate; and in Ethiopia as dimenhydrinate.[13]
Popular culture
Modest Mouse produced a song titled "Dramamine" on their 1996 debut album This Is a Long Drive for Someone with Nothing to Think About . The song uses side effects of the drug as a metaphor for the deteriorating state of a personal relationship.[14]
References
^ Hemmings, Hugh C. Jr.; Talmage, Egan D., eds. (2019). "34 - Pharmacology of Postoperative Nausea and Vomiting" . Pharmacology and Physiology for Anesthesia (Second Edition) (2nd ed.). Elsevier Inc. pp. 671–692. doi :10.1016/B978-0-323-48110-6.00034-X . ISBN 978-0-323-48110-6 . S2CID 81387334 . Retrieved 2 August 2022 .
^ "Abuse and Misuse Potential of Dimenhydrinate: A Review of the Clinical Evidence [Internet]". CADTH Rapid Response Reports . 2015. PMID 26985532 .
^ "Dimenhydrinate injection, solution" . Daily Med . U.S. National Library of Medicine. Archived from the original on 13 October 2014. Retrieved 19 July 2014 . }}
^ "Dimenhydrinate" . Drugs.com . Archived from the original on 28 May 2004.
^ "The Health Risks of Abusing Motion sickness pills" . Narconon International . Retrieved 13 September 2016 .
^ a b Lessenger JE, Feinberg SD (2008). "Abuse of prescription and over-the-counter medications" . Journal of the American Board of Family Medicine . 21 (1): 45–54. doi :10.3122/jabfm.2008.01.070071 . PMID 18178702 .
^ Gardner DM, Kutcher S (March 1993). "Dimenhydrinate abuse among adolescents". Canadian Journal of Psychiatry . 38 (2): 113–6. doi :10.1177/070674379303800208 . PMID 8467436 . S2CID 30190588 .
^ "The Dangers of Dimenhydrinate Abuse" . Bright Hub . 6 October 2009. Retrieved 13 September 2016 .
^ "Dramamine" . Budderbongs forums . Retrieved 13 September 2016 .
^ "Are Teens Abusing Motion Sickness Pills? - Muir Wood Adolescent and Family Services" . Archived from the original on 18 September 2016. Retrieved 13 September 2016 .
^ Scharman, Elizabeth (19 January 2006). "Diphenhydramine and Dimenhydrinate Poisoning: an Evidence-Based Consensus Guideline for Out-of-Hospital Management" . Clinical Toxicology . 44 (3): 205–223. doi :10.1080/15563650600585920 . PMID 16749537 . S2CID 702353 .
^ "Aviomarin, tabletki, 50 mg, 5 szt" . Dox.pl (in Polish).
^ "Gravinate [Dimenhydrinate]" . Karachi Pakistan: The Searle Company. Archived from the original on 5 May 2013.
^ "Modest Mouse: 'This is a long drive...' " . Portland. Retrieved 26 March 2019: Glacial Pace Recordings.{{cite web }}
: CS1 maint: location (link )
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