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Drug Study: Ranitidine (Zantac)

GENERIC NAME: Ranitidine

BRAND NAME: Zantac

CLASSIFICATION
Therapeutic:
Anti-ulcer agents

Pharmacologic:
Histamine H2 antagonists

DOSAGE

20 mg
IV q8h

MECHANISM OF ACTION
• Inhibits the action of histamine at the H2 receptor site located primarily in gastric parietal cells,
resulting in inhibition of gastric acid secretion.

• In addition, ranitidine bismuth citrate has some antibacterial action against H. pylori.

INDICATION
•Treatment and prevention of heartburn, acid indigestion, and sour stomach.

CONTRA INDICATIONS
Contraindicated in:

•Hypersensitivity, Cross-sensitivity may occur; some oral liquids contain alcohol and should be
avoided in patients with known intolerance.

Use Cautiously in:

• Renal impair- ment

• Geriatric patients (more
susceptible to adverse CNS reactions)
• Pregnancy or Lactation
SIDE EFFECTS/ ADVERSE EFFECTS
• CNS:
Confusion, dizziness, drowsiness, hallucinations, headache

• CV:
Arrhythmias

• GI:
Altered taste, black tongue, constipation, dark stools, diarrhea, drug-induced hepatitis, nausea

• GU:
Decreased sperm count, impotence

• ENDO:
Gynecomastia

• HEMAT:
Agranulocytosis, Aplastic Anemia, neutropenia, thrombocytopenia

• LOCAL:
Pain at IM site

• MISC:
Hypersensitivity reactions, vasculitis

NURSING IMPLICATIONS/RESPONSIBILITIES
• Assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or
gastric aspirate.
• Nurse should know that it may cause false-positive results for urine protein; test with
sulfosalicylic acid.
• Inform patient that it may cause drowsiness or dizziness.
• Inform patient that increased fluid and fiber intake may minimize constipation.
• Advise patient to report onset of black, tarry stools; fever, sore throat; diarrhea; dizziness; rash;
confusion; or hallucinations to health car professional promptly.
• Inform patient that medication may temporarily cause stools and tongue to appear gray black.

http://www.nursing-nurse.com/drug-study-ranitidine-zantac-177/
Mannitol – Drug Study
Posted by: Daisy Jane, RN

October 13, 2010 · 1 Comment  ·   Email This Post ·  Print This Post

Brand Name: Osmitrol, Resectisol

Classification: Osmotic Diuretic

Action Summary

Half-life Onset Peak Duration

100 minutes 30-60 minutes 1 hour 6-8 hours

Indications

1. Acute oliguric renal failure

2. Toxic overdose
3. Edema
4. Increased intracranial pressure (ICP)
5. Intraocular pressure (IOP)
Action

1. In the oliguric phase of acute renal failure, Mannitol increases osmotic pressure (pressure
needed to stop the absorption of something or osmosis) of the glumerular filtrate, thereby,
promoting diuresis (treating the oliguric phase of renal failure) and excretes toxic materials
(management for toxic overdose).
2. It also elevates blood plasma osmolality thus, inhibiting the reabsorption of water and
electrolytes (for relief of edema) and mobilizing fluids in the cerebral and ocular spaces (lowers
intracranial or intraocular pressure).

Contraindications

1. Susceptibility
2. Dehydration

Adverse reactions

1. Dehydration
2. Anuria
3. Intracranial bleeding
4. Headache
5. Blurred vision
6. Nausea and vomiting
7. Volume expansion
8. Chest pain
9. Pulmonary edema
10. Thirst
11. Tachycardia
12. Hypokalemia (increases the risk of digoxin toxicity)
13. Chronic renal failure

Dosage

Adult

Oliguria: 50-100 g as a 5-25% solution.

Intracranial/Intraocular pressure: 0.25-2 g/kg as 15-25% solution administered for 30-60

minutes.

Children

Oliguria: 0.25-2 g/kg as a 15-20% solution for 2-6 hours

Intracranial/Intraocular pressure: 1-2 g/kg as a 15-20% solution administered for 30-60 minutes.
Nursing considerations

Assessment – Monitor the following:

1. 1. Vital signs
2. 2. Intake and output
3. 3. Central venous pressure
4. Pulmonary artery pressure
5. Signs and symptoms of dehydration (e.g. poor skin turgor, dry skin, fever, thirst)
6. Signs of electrolyte imbalance/deficit (e.g. muscular weakness, paresthesia, numbness,
confusion, tingling sensation of extremity and excessive thirst)
7. (for increase ICP) Neurologic status and intracranial pressure readings.
8. (for increase IOP) Elevating eye pain or decreased visual acuity.

Laboratory Tests

1. Renal function (BUN and Creatinine)

2. Serum Electrolyte (Sodium and Potassium)

Precaution

Pregnancy and lactation (safe use during these conditions is not established)

Interventions

1. Observe the IV site regularly for infiltration.

2. Administration rate for oliguria should be titrated to produce a urine output. (about 30-50 ml/hr
in adult and 2-6 hours in children)

http://nursingcrib.com/drug-study/mannitol-drug-study/
ZOCOR
(SIMVASTATIN) Tablets

DRUG DESCRIPTION

What are the possible side effects of simvastatin (Zocor)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives;
difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using simvastatin and call your doctor at once if you have any of these serious side effects:

 muscle pain, tenderness, or weakness with fever or flu symptoms and dark colored urine.

Less serious side effects may include:

 mild stomach pain, gas, bloating, stomach upset, heartburn;

ZOCOR (simvastatin) is a lipid-lowering agent that is derived synthetically from a fermentation

product of Aspergillus terreus. After oral ingestion, simvastatin, which is an inactive lactone, is
hydrolyzed to the corresponding β-hydroxyacid form. This is an inhibitor of 3-hydroxy-3-
methylglutaryl-coenzyme A (HMG-CoA) reductase. This enzyme catalyzes the conversion of
HMG-CoA to mevalonate, which is an early and rate-limiting step in the biosynthesis of
cholesterol.

Simvastatin is butanoic acid, 2,2-dimethyl-,1,2,3,7,8,8a-hexahydro-3,7-dimethyl-8-[2-

(tetrahydro-4-hydroxy-6-oxo-2H-pyran-2-yl)-ethyl]-1-naphthalenyl ester, [1S-
[1α,3α,7β,8β(2S*,4S*),-8aβ]]. The empirical formula of simvastatin is C25H38O5 and its
molecular weight is 418.57. Its structural formula is:

Simvastatin is a white to off-white, nonhygroscopic, crystalline powder that is practically

insoluble in water, and freely soluble in chloroform, methanol and ethanol. Tablets ZOCOR for
oral administration contain either 5 mg, 10 mg, 20 mg, 40 mg or 80 mg of simvastatin and the
following inactive ingredients: ascorbic acid, citric acid, hydroxypropyl cellulose, hypromellose,
iron oxides, lactose, magnesium stearate, microcrystalline cellulose, starch, talc, and titanium
dioxide. Butylated hydroxyanisole is added as a preservative.

http://www.rxlist.com/zocor-drug.htm
Drug Study (Paracetamol)
Posted by: Admin

April 27, 2008 · 14 Comments  ·   Email This Post ·  Print This Post

Paracetamol is a widely used over-the-counter analgesic (pain reliever) and antipyretic (fever
reducer). It is commonly used for the relief of fever, headaches, and other minor aches and pains,
and is a major ingredient in numerous cold and flu remedies. In combination with non-steroidal
anti-inflammatory drugs (NSAIDs) and opioid analgesics, paracetamol is used also in the
management of more severe pain (such as cancer or postoperative pain).

While generally safe for human use at recommended doses, acute overdoses (above 1000 mg per
single dose and above 4000 mg per day for adults, above 2000 mg per day if drinking alcohol) of
paracetamol can cause potentially fatal liver damage and, in rare individuals, a normal dose can
do the same; the risk is heightened by alcohol consumption. Paracetamol toxicity is the foremost
cause of acute liver failure in the Western world, and accounts for most drug overdoses in the
United States, the United Kingdom, Australia and New Zealand.

Paracetamol is derived from coal tar, and is part of the class of drugs known as “aniline
analgesics”; it is the only such drug still in use today. It is the active metabolite of phenacetin,
once popular as an analgesic and antipyretic in its own right, but unlike phenacetin and its
combinations, paracetamol is not considered to be carcinogenic at therapeutic doses. The words
acetaminophen and paracetamol both come from chemical names for the compound: para-
acetylaminophenol and para-acetylaminophenol. In some contexts, it is simply abbreviated as
APAP, for N-acetyl-para-aminophenol.
As pain and fever are common, no home should be without some paracetamol, particularly
homes with children.

http://nursingcrib.com/drug-study/drug-study-paracetamol/
CLOXACILLIN, SODIUM
Posted by: Admin

Classifications: antiinfective;antibiotic,naturalpenicillin;beta-lactam
Prototype: Penicillin G
Pregnancy Category: B

NURSING IMPLICATIONS

Assessment & Drug Effects

 Determine previous exposure and sensitivity to penicillins and cephalosporins and other allergic
reactions of any kind before treatment is initiated.
 Monitor for S&S of anaphylactoid reaction (see Appendix G) or other signs or symptoms of
hypersensitivity reaction (see Appendix F) as with other penicillins.
 Lab tests: Periodic assessments of renal, hepatic, and hematopoietic function are advised in
patients on long-term therapy.

Patient & Family Education

 Take medication around the clock, do not miss a dose, and continue taking the medication until
it is finished.
 Report to physician the onset of hypersensitivity reaction (see Appendix F) and superinfections.
 Check with physician if GI adverse effects (nausea, vomiting, diarrhea) appear.
 Do not breast feed while taking this drug.

http://nursingcrib.com/drug-guides/cloxacillin-sodium/
GENERIC NAME: SALBUTAMOL (ALBUTEROL) - ORAL DISK INHALER (sal-BYOU-tuh-mole)

USES: This drug relaxes the smooth muscle in the lungs and opens airways to improve
breathing. It is used to treat asthma, chronic bronchitis, emphysema and to prevent exercise-
related asthma.

HOW TO USE: Make sure you understand how to correctly use the inhaler device and the
disks, and how this product is used with your other asthma drugs. Consult your pharmacist or
doctor and read all manufacturer instructions carefully. Doses and frequency of use varies
depending on your age and medical condition. Follow all prescription label directions exactly.
When inhaling this product, take a fast, deep breath. Rinse your mouth after using to help
prevent dryness and relieve throat irritation. Use this medication exactly as prescribed. Do not
use it more frequently without your doctor's approval. Excessive use may result in decreased
effectiveness and increased side effects. If symptoms do not improve or worsen after using this
drug or if you find yourself using this more than usual, contact your doctor immediately.

SIDE EFFECTS: Dry mouth, irritated throat, dizziness, headache, lightheadedness, heartburn,
loss of appetite, altered taste sensation, restlessness, anxiety, nervousness, trembling, and
sweating may occur but should subside as your body adjusts to the medication. If these
symptoms persist or worsen, inform your doctor. To relieve dry mouth, suck on (sugarless) hard
candy or ice chips, chew (sugarless) gum, drink water or use saliva substitute. Inform your
doctor if you experience: chest pain, pounding heartbeat, breathing difficulties. In the unlikely
event you have a serious allergic reaction to this drug, seek medical attention immediately.
Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble
breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: Tell your doctor your medical history, especially of: an overactive thyroid,
heart disease, high blood pressure, epilepsy, diabetes, drug allergies. This medication should be
used only when clearly needed during pregnancy. Discuss the risk and benefits with your doctor.
This drug may be excreted into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Tell your doctor of all prescription and nonprescription medications
you use, including: beta-blockers (e.g., propranolol, timolol), all asthma medications, ephedrine,
epinephrine, pseudoephedrine, antidepressants, MAO inhibitors (e.g., furazolidone, linezolid,
phenelzine, selegiline, tranylcypromine), diuretics (e.g., hydrochlorothiazide). It is important to
read the labels carefully on all over-the-counter medications, especially those used for colds,
allergies, asthma or diets as they may contain ingredients mentioned above. Do not start or stop
any medicine without doctor or pharmacist approval.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency
room immediately. US residents can call the US national poison hotline at 1-800-222-1222.
Canadian residents should call their local poison control center directly. Symptoms of overdose
may include chest pain, fast or irregular heartbeat, headache, tremors, nervousness, weakness,
and dizziness.
NOTES: Do not share this medication with others.

MISSED DOSE: Ask your doctor about what action to take if you should miss a dose. Do not
"double-up" the dose.

STORAGE: Store at temperatures below 86 degrees F (30 degrees C) away from moisture and
sunlight. Do not store in the bathroom.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For
enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).

Last Editorial Review: 3/2/2005

http://www.medicinenet.com/salbutamol_albuterol-oral_disk_inhaler/page2.htm
 Citicoline

Systematic (IUPAC) name

5'-O-[hydroxy({hydroxy[2-(trimethylammonio)ethoxy]

phosphoryl}oxy)phosphoryl]cytidine

Identifiers
CAS number 987-78-0 33818-15-4 (sodium salt)
ATC code N06BX06
PubChem CID 13805
ChemSpider 16736209
Chemical data
Formula C14H27N4O11P2+
Mol. mass 489.332 g/mol
SMILES eMolecules & PubChem
Synonyms Cytidine diphosphate choline
Therapeutic considerations
Pregnancy cat.  ?
Legal status  ?
  (what is this?)  (verify)

Citicoline (INN), also known as cytidine diphosphate-choline (CDP-Choline) & cytidine 5'-
diphosphocholine is a psychostimulant/nootropic. It is an intermediate in the generation of
phosphatidylcholine from choline. Sold in over 70 countries under a variety of brand names:
Ceraxon, Cognizin, NeurAxon, Somazina etc. Also found as an ingredient in 5-hour Energy.

Studies suggest that CDP-choline supplements increase dopamine receptor densities,[1] and
suggest that CDP-choline supplementation can ameliorate memory impairment caused by
environmental conditions.[2] Preliminary research at Harvard found that citicoline supplements
help improve focus and mental energy and may possibly be useful in the treatment of attention
deficit disorder.[3][4] Citicoline has also been shown to elevate ACTH independent of CRH levels
and to amplify the release of other HPA axis hormones such as LH, FSH, GH and TSH in
response to hypothalamic releasing factors.[5] These effects on HPA hormone levels may be
beneficial for some individuals but, may have undesirable effects in those with medical
conditions featuring ACTH or cortisol hypersecretion including, but not limited to, PCOS, type
II diabetes and major depressive disorder.[6][7]

http://www.prescriptiondrug-info.com/drug_details.asp?
title=Citicoline&page=1002111&ad=true
Kalium Durules - General Information:
A white crystal or crystalline powder used as an electrolyte replenisher, in the treatment of
hypokalemia, in buffer solutions, and in fertilizers and explosives.

Pharmacology:
The potassium ion is in the principle intracellular cation of most body tissues. Potassium ions participate
in a number of essential physiological processes including the maintenance of intracellular tonicity, the
transmission of nerve impulses, the contraction of cardiac, skeletal and smooth muscle, and the
maintenance of normal renal function. The intracellular concentration of potassium is approximately
150 to 160 mEq per liter. The normal adult plasma concentration is 3.5 to 5 mEq per liter. An active ion
transport system maintains this gradient across the plasma membrane. Potassium is a normal dietary
constituent and under steady-state conditions the amount of potassium absorbed from the
gastrointestinal tract is equal to the amount excreted in the urine. The usual dietary intake of potassium
is 50 to 100 mEq per day. Potassium depletion will occur whenever the rate of potassium loss through
renal excretion and/or loss from the gastrointestinal tract exceeds the rate of potassium intake. Such
depletion usually develops as a consequence of therapy with diuretics, primarily or secondary
hyperaldosteronism, diabetic ketoacidosis, or inadequate replacement of potassium in patients on
prolonged parenteral nutrition. Depletion can develop rapidly with severe diarrhea, especially if
associated with vomiting. Potassium depletion due to these causes is usually accompanied by
concomitant loss of chloride and is manifested by hypokalemia and metabolic alkalosis. Potassium
depletion may produce weakness, fatigue, disturbances of cardiac rhythm (primarily ectopic beats),
prominent U-waves in the electrocardiogram, and, in advanced cases, flaccid paralysis and/or impaired
ability to concentrate urine. If potassium depletion associated with metabolic alkalosis cannot be
managed by correcting the fundamental cause of the deficiency, e.g., where the patient requires long-
term diuretic therapy, supplemental potassium in the form of high potassium food or potassium
chloride may be able to restore normal potassium levels. In rare circumstances (e.g., patients with renal
tubular acidosis) potassium depletion may be associated with metabolic acidosis and hyperchloremia. In
such patients, potassium replacement should be accomplished with potassium salts other than the
chloride, such as potassium bicarbonate, potassium citrate, potassium acetate, or potassium gluconate.

Kalium Durules for patients

Physicians should consider reminding the patient of the following:

1. To take each dose with meals mixed in water or other suitable liquid.
2. To take this medicine following the frequency and amount prescribed by the physician. This is
especially important if the patient is also taking diuretics and/or digitalis preparations.
3. To inform patients that this product contains as a dispersing agent the stool softener, docusate
sodium, which may change stool consistency, or, rarely, produce diarrhea or cramps.
4. To check with the physician at once if tarry stools or other evidence of gastrointestinal bleeding
is noticed.
Kalium Durules Interactions

Kalium Durules Contraindications

Potassium supplements are contraindicated in patients with hyperkalemia since a further increase
in serum potassium concentration in such patients can produce cardiac arrest. Hyperkalemia may
complicate any of the following conditions: chronic renal failure, systemic acidosis such as
diabetic acidosis, acute dehydration, extensive tissue breakdown as in severe burns, adrenal
insufficiency, or the administration of a potassium-sparing diuretic (e.g., spironolactone,
triamterene, amiloride).

Controlled-release formulations of potassium chloride have produced esophageal ulceration in

certain cardiac patients with esophageal compression due to an enlarged left atrium. Potassium
supplementation, when indicated in such patients, should be given as an immediate-release liquid
preparation.

All solid oral dosage forms of potassium chloride are contraindicated in any patient in whom
there is structural, pathological (e.g., diabetic gastroparesis) or pharmacologic (use of
anticholinergic agents or other agents with anticholinergic properties at sufficient doses to exert
anticholinergic effects) cause for arrest or delay in tablet or capsule passage through the
gastrointestinal tract.

Additional information about Kalium Durules

Kalium Durules Indication: For use as an electrolyte replenisher and in the treatment of hypokalemia.
Mechanism Of Action: Supplemental potassium in the form of high potassium food or potassium
chloride may be able to restore normal potassium levels.
Drug Interactions: Not Available
Food Interactions: Take with a full glass of water Take after a full meal.
Generic Name: Potassium Chloride
Synonyms: Chloride of potash; Chlorid draselny [Czech]; ClK; Dipotassium dichloride; Hydrochloric acid
potassium salt (1:1); Monopotassium chloride; Potassium monochloride; Potassium thallium chloride
(KTlCl); Tripotassium trichloride
Drug Category: Not Available
Drug Type: Small Molecule; Approved; Withdrawn

Other Brand Names containing Potassium Chloride: Acronitol; Addi-K; Apo-K; Celeka; Cena-K;
Chloropotassuril; Chloropotassuril diffu-K; Chlorvescent; Clor-K-Zaf; Colyte; Diffu-K; Duffi-K; Durekal;
Durules; Durules-K; Emplets potassium chloride; Enpott; Enseal; Infalyte; K Tab; K-Care; K-Contin; K-
Grad; K-Lease
Absorption: Potassium is a normal dietary constituent and under steady-state conditions the amount of
potassium absorbed from the gastrointestinal tract is equal to the amount excreted in the urine.
Toxicity (Overdose): The administration of oral potassium salts to persons with normal excretory
mechanisms for potassium rarely causes serious hyperkalemia. However, if excretory mechanisms are
impaired, of if potassium is administered too rapidly intravenously, potentially fatal hyperkalemia can
result. It is important to recognize that hyperkalemia is usually asymptomatic and may be manifested
only by an increased serum potassium concentration (6.5-8.0 mEq/L) and characteristic
electrocardiographic changes (peaking of T-waves, loss of P-wave, depression of S-T segment, and
prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular
collapse from cardiac arrest (9-12 mEq/L).
Protein Binding: Not Available
Biotransformation: Not Available
Half Life: Not Available
Dosage Forms of Kalium Durules: Solution Intravenous
Powder, for solution Oral
Tablet, extended release Oral
Liquid Intravenous
Tablet Oral
Capsule, extended release Oral
Solution Oral
Liquid Sublingual
Solution / drops Oral
Liquid Oral
Chemical IUPAC Name: potassium chloride
Chemical Formula: ClK
Potassium Chloride on Wikipedia: http://en.wikipedia.org/wiki/Potassium_Chloride
Organisms Affected: Humans and other mammals

http://www.flexyx.com/K/Kalium%20Durules.html
 How Meniere's Disease is Diagnosed

Because the exact cause of Meniere's Disease is still unknown, it is really important to get a
correct diagnosis. To arrive at a firm and supportive diagnosis and in order to rule out other
problems, a very detailed history and physical examination will be required. Several tests using
technology will also be ordered. Most than likely you will be sent to one or more specialists: an
otolaryngologist (ear nose and throat) or a neurologist (brain). The eyes, ears, and brain are in
close proximity.

The fluid-filled semicircular canals of the inner ear, plus the 8th cranial nerve, control balance
and our sense of position. Meniere's Disease involves a swelling of the part of that canal that
controls the filtration and excretion of the fluid in the inner ear.

Each individual's case must be checked against the possible cause of middle ear infections, otitis
media, syphilis, or head injury. Other risk factors include recent a viral illness, respiratory
infection, stress, fatigue, use of prescription or nonprescription drugs including aspirin, and a
history of allergies, smoking, and alcohol use.

Please remember that the body wants to be in harmony: with all systems working together to
create balance.

The diagnostic tests will include MRI, EEG, Audiometry Tests (Hearing) including
Electronystagmography, Transtympanic electrocochleography (ECOG)

For more description and an excellent overview, please go to

American Academy of Otolaryngology - Head and Neck Surgery

Detailed History

In your details, you will need to describe what happens when you have an attack. It really helps
to have this written down. Better still, give the doctor a copy of your description.

He will need a history of the frequency, duration, severity, and character of your attacks, the
duration of hearing loss and whether it has been changing.

You will be asked if you have any history of:

 diabetes, high blood pressure, high blood cholesterol, thyroid, neurologic or emotional
disorders.
 tinnitus or fullness in either or both ears
 syphilis, mumps, or other serious infections in the past, inflammations of the eye,
 auto-immune disorders or allergy, or
 ear surgery in the past.
A physical examination of the ears and other structures of the head and neck will be done, but
these findings are usually normal, except during an attack.

Several other tests will be done. They include:

Magnetic Resonance Imaging "MRI"

This will be one of the first as it simply rules out any abnormal physical conditions in your head.

It provides detailed pictures of brain and nerve tissues from multiple planes without obstruction
by overlying bone.

What will this test tell you? MRI is the procedure of choice for most brain disorders because it
can clearly show various types of nerve tissue. It provides clear pictures. It is noninvasive and
can evaluate blood flow and the flow of cerebrospinal fluid (CSF). An MRI can distinguish
tumors or other lesions from normal tissues. MRI is sometimes used to avoid the dangers of
repeated exposure to radiation

How the test is performed The MRI scanner is in an area that has been shielded from outside
magnetic fields. You lie on a narrow table that can slide inside a large tunnel-like tube within the
scanner. The scanner creates a magnetic field around you, then directs radio waves at the tissues
in question. Several sets of images are usually required, each taking from 2 to 15 minutes. The
complete scan takes about 1 hour; some scans take more than 90 minutes. This test will not cause
any discomfort.

Electroencephalogram "EEG"

What will this test tell you? It helps to diagnose the presence and type of seizure disorders,
confusion, head injuries, brain tumors, infections, degenerative diseases, and metabolic
disturbances that all could affect the brain. Incidentally the procedure cannot be used to "read the
mind," measure intelligence, or diagnose mental illness.

How the test is performed. It will be done by an specially-trained technician in a room designed
for this purpose only. It may be in an office or in a hospital setting. You will be asked to lie on
your back on the table or to sit in a reclining chair. Many flat metal discs (electrodes) will be
placed in different positions on your scalp. (They are held in place with a sticky paste.) These
electrodes are connected by wires to an amplifier and a recording machine. The recording
machine converts the electrical signals into a series of wavy lines. (Like an ECG.) These are then
shown on a monitor and can be printed out. Because any movement can alter the results, you will
need to lie very still with your eyes closed. You may be asked to do certain things during the
recording, such as breathe deeply and rapidly for several minutes or look at a very bright
flickering light. (It will be OK to move during these requests.) This test is without discomfort.
Hearing Tests: Audiometry/Audiology

What will this test tell you?

These measure hearing ability. There are several different ones. Each is done for a specific
purpose.

An audiometric examination typically indicates a sensory type of hearing loss in the affected ear.
With Meniere's Disease the ability to distinguish "sit" and "fit" is often diminished in the affected
ear. (Speech discrimination)

Audiometry is particularly helpful in making the diagnosis of Ménières syndrome. This can
determine and measure low frequency or mixed low and high frequency, "Pike's Peak" pattern.
When trying to make a diagnosis of Ménières, iIt is very helpful to have precise documentation
of fluctuating hearing loss.

How the test is performed

Audiography provides a more precise measurement of hearing. Air conduction is tested by

having you wear earphones attached to the audiometer. Pure tones of controlled intensity are
delivered, usually to one ear at a time. You are asked to indicate (by raising a hand, pressing a
button, or other means) when they hear a sound, and the minimum intensity (volume) required to
hear each tone is graphed. An attachment is placed against the bone behind each ear to test bone
conduction.

Transtympanic electrocochleography (ECOG)

This can show evidence for cochlear involvement. It may indicate increased inner ear fluid
pressure in some cases of Meniere's disease.

Electronystagmography "ENG"

This test may be performed to evaluate balance function.

Caloric Stimulation

Why is the test done Caloric stimulation is performed to evaluate the acoustic nerve, which
provides hearing and helps with balance. This test may be recommended when the person is
experiencing dizziness or vertigo, when there is impaired hearing, with suspected toxicity from
certain antibiotics, with some anemia, when psychological causes of vertigo are suspected.
How the test is performed

Each ear is tested separately. One teaspoon of cold water is gently instilled in the ear canal with a
bulb syringe. This should cause nystagmus (quick movement of both eyes away from the
direction of ice water and then slowly back). If it does not cause nystagmus, 2 teaspoons of cold
water are instilled in the ear canal. If nystagmus still fails to occur, 4 and then 8 teaspoons of
cold water are used.

At times, hot water may be used in addition to cold water. The nystagmus should occur in the
opposite direction (toward the hot water then slowly away). Use of both cold water and hot water
makes the test more accurate.

http://www.menieres-disease.ca/diagnosis.htm