A 32-year-old man with acute severe vertigo and vomiting is prescribed meclizine. Which instruction regarding its use is correct?
- A It should be used for no more than 2 to 3 days, since prolonged use delays central vestibular compensation ✓
- B It should be continued for 6 weeks until all vertigo resolves
- C It should be taken continuously as prophylaxis against further attacks
- D It accelerates recovery by enhancing cerebellar inhibition of the vestibular nuclei
Correct answer: A. It should be used for no more than 2 to 3 days, since prolonged use delays central vestibular compensation
Explanation
Vestibular suppressants such as meclizine, dimenhydrinate, and promethazine relieve acute nausea and vertigo but should be restricted to 2 to 3 days. Prolonged sedative use retards the central compensation process by which the brain recalibrates the asymmetric vestibular tone. Vestibular rehabilitation exercises, not continued medication, promote compensation. The drugs act on histaminergic and cholinergic vestibular pathways rather than enhancing cerebellar inhibition.
Reference: Cummings Otolaryngology: Head and Neck Surgery, 7th ed.
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