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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Fainting Spell Due To High Blood Pressure?

Good morning doctor, I m a MBBS student.on 7th january i finished my 2nd MB exam.i want to clear some doubts about a problem which my mother is facing for which doctor prescribed her a medicine VERTIN 24 two times daily.My mother has high blood pressure so she is taking anti hypertensives for many years.2 years before she had urosepsis for which she was admitted in hospital and E.coli was found and it was seen in a test report that her creatinine became 2.4.so doctor thought it to be some problem with the kidney.but when USG was done it was seen that both the kidneys are normal and no hydronephrosis was seen.then within 1 month her creatinine became normal and doctor suggested her to show a nephrologist for further advice.i took her to the nephrologist and he saw the USG and told no problem with the kidneys but there may be some slight problem which cant be seen in the USG and its not at all serious so he gave my mother a medicine TELMA 20.my mother continued it for 4 months then again went to doctor and doctor told her to test creatinine which was normal.then he again prescribed my mother TELMA 40 which was adviced to continue for 2 months after which she was adviced to go the doctor but due to some work she went out of station and couldnt meet the doctor and she remained without medicine for 2 months.there she became sick as she had tremendous headache,nausea and she sometimes felt that she would faint but she didnt faint.after she returned the problem was gone and due to my MB exams she couldnt meet doctor and the problem again started.so after my exams i took her to a medicine doctor and he told her BP is very high and all these was only due to her not taking antihypertensives.so he prescribed her TELMA 40 two times daily along with VERTIN 24 which is for VERTIGO as she feels like that everything is moving around her and she cant see properly when she had headache.my mother is now ok but i want to know whether this medicine was given for that purpose only or not because after taking TELMA 40 she is not facing that problem.so should she take VERTIN 24 as she is not facing the problem anymore?
Tue, 29 Nov 2016
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Cardiologist 's  Response
hi dear
vertin contains betahistine salt which is meant to treat chronic labrinthine disorder

i am briefing you the mechanism of action of beta histine

Betahistine has two modes of action. Primarily, it has a direct stimulating (agonistic) effect on H1 receptors located on blood vessels in the inner ear. This gives rise to local vasodilation and increased permeability, which helps to reverse the underlying problem of endolymphatic hydrops.

More importantly, betahistine has a powerful antagonistic effects at H3 receptors, thereby increasing the levels of neurotransmitters histamine, acetylcholine, norepinephrine, serotonin, and GABA released from the nerve endings. The increased amounts of histamine released from histaminergic nerve endings can stimulate receptors. This stimulation explains the potent vasodilatory effects of betahistine in the inner ear, that are well documented.

Betahistine seems to dilate the blood vessels within the inner ear which can relieve pressure from excess fluid and act on the smooth muscle.

It is postulated that betahistine's increase in the level of serotonin in the brainstem inhibits the activity of vestibular nuclei.

so for acute phase of dizziness vertin was ok but now as primary problem of your mother was hypertension ,not labyrinthine disorder betahistine should be stoppped and she should be maintained on a dose of telmisartan on which her b.p is normal

thanks
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Is Fainting Spell Due To High Blood Pressure?

hi dear vertin contains betahistine salt which is meant to treat chronic labrinthine disorder i am briefing you the mechanism of action of beta histine Betahistine has two modes of action. Primarily, it has a direct stimulating (agonistic) effect on H1 receptors located on blood vessels in the inner ear. This gives rise to local vasodilation and increased permeability, which helps to reverse the underlying problem of endolymphatic hydrops. More importantly, betahistine has a powerful antagonistic effects at H3 receptors, thereby increasing the levels of neurotransmitters histamine, acetylcholine, norepinephrine, serotonin, and GABA released from the nerve endings. The increased amounts of histamine released from histaminergic nerve endings can stimulate receptors. This stimulation explains the potent vasodilatory effects of betahistine in the inner ear, that are well documented. Betahistine seems to dilate the blood vessels within the inner ear which can relieve pressure from excess fluid and act on the smooth muscle. It is postulated that betahistine s increase in the level of serotonin in the brainstem inhibits the activity of vestibular nuclei. so for acute phase of dizziness vertin was ok but now as primary problem of your mother was hypertension ,not labyrinthine disorder betahistine should be stoppped and she should be maintained on a dose of telmisartan on which her b.p is normal thanks