CVT CVT Pharmacology & Medication Effects on Vestibular Function 1 — Questions and Answers
Question 1: Which class of medication is most commonly used as a vestibular suppressant for acute vertigo?
- Antihistamines (e.g., meclizine) (Correct answer)
- ACE inhibitors
- Beta blockers
- Proton pump inhibitors
Correct answer: Antihistamines (e.g., meclizine)
Antihistamines such as meclizine act on histamine H1 receptors and are first-line vestibular suppressants for acute vertigo.
Question 2: Aminoglycoside antibiotics such as gentamicin cause vestibular damage primarily by:
- Blocking endolymph reabsorption
- Destroying type I and type II hair cells in the labyrinth (Correct answer)
- Increasing intracranial pressure
- Compressing the eighth cranial nerve
Correct answer: Destroying type I and type II hair cells in the labyrinth
Aminoglycosides preferentially accumulate in the inner ear and destroy vestibular hair cells, causing permanent vestibular hypofunction.
Question 3: Which diuretic combination is most commonly prescribed to reduce endolymphatic hydrops in Meniere's disease?
- Furosemide and spironolactone
- Acetazolamide and triamterene
- Hydrochlorothiazide and triamterene (Correct answer)
- Mannitol and furosemide
Correct answer: Hydrochlorothiazide and triamterene
Hydrochlorothiazide combined with triamterene reduces fluid retention and endolymphatic pressure, decreasing Meniere's attack frequency.
Question 4: Long-term use of vestibular suppressants can interfere with vestibular rehabilitation primarily by:
- Increasing the risk of BPPV
- Elevating blood pressure during exercise
- Causing paradoxical vertigo
- Impairing central vestibular compensation (Correct answer)
Correct answer: Impairing central vestibular compensation
Prolonged vestibular suppressant use reduces the sensory mismatch signals needed to drive central nervous system adaptation and compensation.
Question 5: Intratympanic steroid injections are used in Meniere's disease primarily to:
- Ablate vestibular hair cells permanently
- Reduce endolymphatic pressure via anti-inflammatory action (Correct answer)
- Restore normal caloric responses
- Eliminate otoconia from the canals
Correct answer: Reduce endolymphatic pressure via anti-inflammatory action
Corticosteroids delivered intratympanically reduce inner ear inflammation and may decrease the frequency and severity of Meniere's attacks.
Question 6: When a patient on multiple vestibular medications reports worsening dizziness, the vestibular therapist's first action should be:
- Increase exercise frequency to accelerate compensation
- Discontinue all balance exercises immediately
- Perform an emergency Epley maneuver
- Document findings and refer back to the prescribing physician for medication review (Correct answer)
Correct answer: Document findings and refer back to the prescribing physician for medication review
Polypharmacy-related dizziness requires medical evaluation; the therapist documents clinical observations and coordinates with the physician rather than altering the medication independently.
CVT CVT Pharmacology & Medication Effects on Vestibular Function 1
Which class of medication is most commonly used as a vestibular suppressant for acute vertigo?