ANTISPASMODICS

Katie Figueroa, Alison Guimmayen, Elizabeth De La Torre

NAME (GENERIC)
Scopolamine (scopolamin e hydrobromid e)

DRUG CLASS
Anticholinergic, Antiemetic, Antimotion sickness drug, Antimuscarinic, Antiparkinsonian, Antispasmodic, Belladonna alkaloid, Parasympatholyti c

INDICATIONS
Transdermal system: prevention and control of N/V associated with motion sickness and recovery from surgery. Adjunctive therapy with antacids and histamine-2 antihistamines in peptic ulcer supportive treatment of functional GI disorders.

ACTIONS
Blocks effects of acetylcholine at muscarinic cholinergic receptors that mediate effects of parasympathetic postganglionic impulses, thus depressing salivary and bronchial secretions, inhibiting vagal influences on the heart, relaxing the GI and GU tracts, inhibiting gastric acid secretion.

CONTRAINDICATIONS
Hypersensitivity to anticholinergic drugs; glaucoma; adhesions between iris and lens; stenosing peptic ulcer, pyloroduodenal obstruction, paralytic ileus, intestinal atony, sever ulcerative colitis, toxic megacolon, symptomatic prostatic hypertrophy, COPD, impaired metabolic, liver or renal function; lactation. Use cautiously with Down syndrome, brain damage, spasticity, hypertension, hyperthyroidism, glaucoma Use caution with the elderly, glaucoma, hepatic impairment, enlarged prostate, problems with urination due to a blocked urinary tract, slow gut, blockage, ulcerative colitis, infection, leostomy/colostomy patients with diarrhea, overactive thyroid, heart problems

SIDE/ADVERSE EFFECTS
Pupil dilation, photophobia, blurred vision, headache, drowsiness, dizziness, mental confusion, excitement, hallucinations, delirium in the presence of pain, palpitations, tachycardia, constipation, paralytic ileus, altered taste perception, N/V, heartburn, impotence, urticaria, suppression of lactation, flushing, fever, nasal congestion, decreased sweating. Diarrhea; painful or difficult urination; fast or pounding heartbeats; blurred vision with eye pain, or seeing halos around lights; feeling like you might pass out; or mouth sores, red or bleeding gums, or tooth decay (with longterm use)

NURSING IMPLICATIONS
Take 30-60 minutes before meals, avoid excessive dosage. Avoid hot environments. You will be heat intolerant, and dangerous reactions may occur. Avoid alcohol; serious sedation could occur. When using transdermal system, take care to wash hands thoroughly after handling patch and dispose of patch properly to avoid contact with children and pets. Remove the old patch before applying a new one. Do not take more of this medication than is prescribed. Measure the liquid form of belladonna alkaloids and phenobarbital with a special dose-measuring spoon or cup, not with a regular tablespoon. Do not crush, chew, or open any extended-release formulations of this medication. Swallow them whole. Store belladonna alkaloids and phenobarbital at room temperature away from moisture and heat. Ensure adequate hydration; control environmental temperature to prevent hyperpyrexia. Have patient void before each drug dose if urinary retention is a problem. Monitor lighting to minimize discomfort of photophobia. Take drug exactly as prescribed.

Donnatal (belladonna alkaloids and phenobarbit al)

Anticholinergic and Barbiturate combination

For use as adjunctive therapy in the treatment of irritable bowel syndrome (irritable colon, spastic colon, mucous colitis) and acute enterocolitis. May also be useful as adjunctive therapy in the treatment of duodenal ulcers.

Works by decreasing the motion of the muscles in the stomach and intestine and providing mild sedation.

Bentyl (dicyclomine hydrochlorid e)

Anticholinergic, Antimuscarinic, Antispasmodic, Parasympatholyti c

Treatment of functional bowel or IBS (irritable colon, spastic colon, mucous colitis)

Direct GI smooth muscle relaxant; competitively blocks the effects of acetylcholine at muscarinic cholinergic receptors that mediate the effects of parasympathetic postganglionic impulses, thus relaxing the GI tract.

Glaucoma; adhesions between iris and lens, stenosing peptic ulcer, pylorduodenal obstruction, paralytic ileus, intestinal atony, sever ulcerative colitis, toxic megacolon, symptomatic prostatic hypertrophy, COPD, cardiac arrhythmias, tachycardia, myocardial ischemia; impaired

Blurred vision, mydriasis, cycloplegia, increased IOP, palpitations, tachycardia, altered taste perception, N/V, dysphagia, heartburn, constipation, bloated feeling, paralytic ileus, GERD, urinary hesitancy and retention, impotence,

metabolic, live or renal function. Use cautiously with Down syndrome, brain damage, spasticity, hypertension, hyperthyroidism.

irritation at site of IM injection, decreased sweating and predisposition to heat prostration, suppression of lactation.

Avoid hot environments while taking this drug. Avoid tasks that require acute vision and wear sunglasses if outdoors.