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Scopolamine

Anticholinergic agent given by transdermal patch every 3 days and is associated with dry mouth, sleepiness, impaired eye accommodation, dizziness, hallucination, disorientation and impaired memory.

Hyoscine hydrobromide

Trade names Transdermscop, Kwells

Routes of administration -transdermal, ocular, oral, subcutaneous, intravenous, sublingual, rectal, buccal transmucousal, intramuscular.

Bioavailability 0.13–8% Oral), 3% Rectal.

Metabolism Liver

Biological half-life 4.5 hours

Excretion Kidney

Also known as scopolamine hydrobromide, is a medication used in the treatment of motion sickness and postoperative nausea and vomiting.

One common side effect is drowsiness.

A tropane alkaloid drug with muscarinic antagonist effects.

Exerts its effects by acting as a competitive antagonist at muscarinic acetylcholine receptors, and is thus classified as an anticholinergic, antimuscarinic drug.

Used to treat the following:

Postoperative nausea and vomiting and sea sickness

Motion sickness

Gastrointestinal spasms

Renal or biliary spasms

Aid in gastrointestinal radiology and endoscopy

Irritable bowel syndrome

Clozapine-induced hypersalivation

Bowel colic

Eye inflammation

As a premedication to reduce respiratory tract secretions prior to surgery, mostly commonly by injection.

Crosses the placenta and is a pregnancy category C medication, meaning a risk to the fetus cannot be ruled out.

Has been used as an adjunct to epidural anesthesia for Caesarean delivery without adverse CNS effects on the newborn.

Used during pregnancy only if the benefit to the mother outweighs the potential risk to the fetus.

Enters breast milk by secretion.

In the elderly can increase the likelihood of experiencing adverse effects from the drug, especially if concurrently on several other medications.

Uncommon adverse effects include:

Dry mouth

Reduced ability to sweat.

Tachycardia

Bradycardia

Urticaria

Pruritus

Constipation

Urinary retention

Hallucinations

Agitation

Confusion

Restlessness

Seizures

Physostigmine is an acetylcholinesterase inhibitor that readily crosses the blood-brain barrier, and has been used as an antidote to treat the CNS depression symptoms of scopolamine overdose.

Overdose symptoms include;

Tachycardia

Arrhythmia

Blurred vision

Photophobia

Urinary retention

Drowsiness or paradoxical excitement

Cheyne-Stokes respiration

Dry mouth

Skin reddening

Inhibition of gastrointestinal motility

Due to interactions with metabolism of other drugs, scopolamine can cause significant unwanted side effects.

Medications that could potentially interact with the metabolism of scopolamine: analgesics/pain medications, ethanol, zolpidem, thiazide diuretics, buprenorphine, anticholinergic drugs such as tiotropium.

Can be administered orally, subcutaneously, ophthalmically and intravenously, as well as via a transdermal patch.

The transdermal patch for prevention of nausea and motion sickness employs scopolamine base, and is effective for up to three days.

The oral, ophthalmic, and intravenous forms have shorter half-lives and are usually found in the form scopolamine hydrobromide.

 

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