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Evidence-based medicine, rational drug use
Betahistine, one of the most commonly used drugs in neurology, has the reputation of “evergreen tree in the gods”. The rational and effective clinical use of the drug is crucial to improving the therapeutic effect and promoting the recovery of patients, and it is also one of the keys to the diagnosis and treatment of vertigo diseases.
Rational use of betahistine requires at least the following:
Available for
What causes vertigo[1-7]?
Betahistine is primarily used for:
1. Dizziness, tinnitus, hearing loss associated with Meniere’s disease;
2. Dizziness, tinnitus and hearing loss caused by cerebral arteriosclerosis;
3. Orthostatic vertigo and tinnitus due to hypertension;
4. Postural vertigo and tinnitus due to ischemic cerebrovascular disease;
5. Vertigo.
Anti-dizziness pharmacological effects[2-7]
The anti-vertigo effect of betahistine mainly increases the turnover and release of histamine by blocking presynaptic H3 receptors and inducing down-regulation of H3 receptors, thereby exerting pharmacological effects from the following aspects :
1. Increases blood flow to the cochlear region and the entire brain, eliminating inner ear vertigo, tinnitus, and closed ears;
2. Promote vestibular compensation to accelerate the recovery of patients after vestibular neurectomy;
3. Alter neuronal firing in the vestibular nucleus to improve the severity and frequency of vertigo attacks;
4. Betahistine is a diamine oxidase inhibitor, which can significantly increase blood flow in the heart, brain and peripheral circulation, and improve blood circulation.
Be careful when prescribing these 3 patients[1,3,6,7]
Betahistine acts as a partial agonist of histamine H1 receptor, binds to H1 receptor of bronchial smooth muscle and can cause bronchoconstriction; betahistine binds to H2 receptor of gastric parietal cells , may increase gastric acid secretion; betahistine, a synthetic analogue of histamine, may also induce the release of catecholamines in tumors, leading to severe hypertension. Therefore, patients with related diseases need special attention:
1. Use with caution in patients with bronchial asthma or a history of bronchial asthma!
2. Use with caution in patients with active peptic ulcer or with a history of peptic ulcer!
3. Patients with pheochromocytoma are prohibited!
References:
[3] Drug Information: Betahistine Mesylate Tablets, Eisai (China) Pharmaceutical Co., Ltd., approved by Chinese medicine H20040130; 2007/11/14.
[5]Drug information: Betahistine Hydrochloride Oral Liquid, Harbin Renhuang Pharmaceutical Co., Ltd., approved by Chinese medicine H20066114.
[6]Drug information: Betahistine Hydrochloride Oral Liquid, Daqing No. 3 Pharmaceutical Factory, approved by Chinese medicine H20056604.
Source: Medicine
Proofreading: Zang Hengjia
Editor in charge: Tian Dongliang
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