The most significant symptom is nystagmus as it is essential to determine the kind of nystagmus ( horizontal, vertical, or diagonal ) to select the correct cure maneuver. Cause
Within the labyrinth of the inner ear lie collections of calcium crystals known as otoconia or otoliths. In people with BPPV, the otoconia are dislodged from their usual position within the utricle, and over time, migrate into one of the three semicircular canals (the posterior canal is most commonly affected due to its anatomical position). When the head is reoriented relative to gravity, the gravity-dependent movement of the heavier otoconial debris (colloquially "ear rocks") within the affected semicircular canal causes abnormal (pathological) endolymph fluid displacement and a resultant sensation of vertigo. This more common condition is known as canalithiasis. There is a direct link between the kind of nystagmus and which of the three semicircular canals is affected. With horizontal nystagmus ( left-right eye movement ) the horizontal ( also called lateral ) canal is affected, with vertical nystagmus ( up-down eye movement ) the superior ( also called anterior ) canal is affected, and with diagonal nystagmus ( diagonal or rotational eye movement ) the posterior canal is affected. Diagonal eye movement is easily confused with horizontal movement. This is important since it might result in selecting a wrong and thus ineffective cure maneuver. In rare cases, the crystals themselves can adhere to a semicircular canal cupula, rendering it heavier than the surrounding endolymph.
Ipratropium bromide/salbutamol, is sold under the brand name DuoNeb as a nebulized solution, is a combination medication used to treat chronic obstructive pulmonary disease (COPD). It contains ipratropium (an anticholinergic) and salbutamol (albuterol, a β2-adrenergic agonist).Common side effects include sore throat, muscle cramps, and nausea. Other side effects may include bronchospasm, allergic reactions, and upper respiratory tract infections. Safety in pregnancy is unclear. Each medication typically decreases bronchospasm and does so via different mechanisms.The combination was approved for medical use in the United States in 1996. It is available as a generic medication. In 2019, it was the 151st most commonly prescribed medication in the United States, with more than 4 million prescriptions. Society and culture
Since Combivent contains a chlorofluorocarbon-based propellant, its use was discontinued in 2013 in the United States and other countries. This was because Chloroflourocarbons (CFC) are attributed to depletion of the ozone layer. References
External links
DailyMed
Consumer Medication Information from PubMed Archived 2012-12-03 at the Wayback Machine
Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. National Heart, Lung, and Blood Institute. 2007.