Abstract
Peripheral vestibular disease can be treated with several approaches (e.g., maneuvers, surgery, or medical approach). Comorbidity is common in elderly patients, so polytherapy is used, but it can generate the development of drug–drug interactions (DDIs) that play a role in both adverse drug reactions and reduced adherence. For this reason, they need a complex kind of approach, considering all their individual characteristics. Physicians must be able to prescribe and deprescribe drugs based on a solid knowledge of pharmacokinetics, pharmacodynamics, and clinical indications. Moreover, full information is required to reach a real therapeutic alliance, to improve the safety of care and reduce possible malpractice claims related to drug–drug interactions. In this review, using PubMed, Embase, and Cochrane library, we searched articles published until 30 August 2021, and described both pharmacokinetic and pharmacodynamic DDIs in patients with vestibular disorders, focusing the interest on their clinical implications and on risk management strategies.
Highlights
drug–drug interactions (DDIs) are potentially harmful to patients, so full information is required to improve the safety of care and to avoid malpractice claims
The management of peripheral vestibular vertigo in elderly requires a deep knowledge of clinical pharmacology and of multidisciplinary issues in the treatment of these patients
The evaluation of the different alleles linked to CYP450 isoforms and transporters may be useful to choose the best therapeutic option [102,115,125,159,327]
Summary
The function of balance is regulated by the vestibular system. The main subdivision of this system, includes a peripheral portion Many pharmacological treatments modulate the activity of neurotransmitters, neuromodulators, and voltage-gated channels involved in the modulation of neuronal excitability. Among all of these drugs, cinnarizine is the first-line therapy for the management of some kind of vertigo. It may act on the peripheral vestibular system with several mechanism [9,10,11,12] able to induce both an anti-vasoconstrictor activity and a decrease in blood viscosity of the inner ear’s circulatory system [11]. In the present review we assessed the possibility of DDIs and ADRs in elderly people with vestibular disease
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
