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scopolamine (Transderm Scop, Hyoscine)

Tradenames: Transderm Scop, Hyoscine. Indications: 1) injection 1) adjunct to general anesthesia - pre-anesthetic sedation in conjunction with analgesics 2) salivation - inhibition of salivation & excessive respiratory secretion prior to surgery - sialorrhea 3) prevention of cholinergic effects during surgery - cardiac arrhythmias - hypotension - bradycardia 2) Transderm Scop: - prevention of motion sickness 3) ophthalmic: - mydriasis & cycloplegia - acute inflammatory conditions of the iris & uveal tract - posterior synechiae 4) irritable bowel syndrome [4] Contraindications: narrow-angle glaucoma Dosage: 1) Transderm Scop: a) one patch (1.5 mg) behind ear b) lasts up to 3 days c) box of 4 2) 0.32-0.65 mg SC/IM/IV (after dilution) TID-QID 3) ophthalmic: a) mydriasis & cycloplegia: 1-2 drops of 0.25% solution 1 hour before procedure b) iridocyclitis: 1-2 drops of 0.25% solution QD-TID Solution (ophthalmic): 0.25% (5 mL, 15 mL) Injection: (as hydrobromide) 0.4 mg/mL (1 mL) Pharmacokinetics: 1) injection - rapidly absorbed from GI tract, IM & SC injections - distribution is unknown; does cross the blood-brain barrier - metabolic & excetory fate is unknown, but thought to be completely metabolized by the liver & excreted in the urine 2) ophthalmic - maximal mydriasis in 15-30 minutes; effects may last for several days - maximal cycloplegia in 30-45 minutes; effects may last up to 7 days Adverse effects: 1) common (> 10%) a) constipation b) decreased sweating c) dry nose, throat, or skin d) irritation at site of injection 2) less common (1-10%) - decreased flow of breast milk, difficulty swallowing, increased sensitivity to light 3) uncommon (< 1%) - rash, confusion, increased intraocular pain, orthostatic hypotension, bloating, difficulty urinating, blurred vision, drowsiness, headache, loss of memory, nausea/vomiting, weakness, tiredness, ventricular fibrillation, tachycardia, palpitations, ataxia 4) other a) drowsiness b) cycloplegia c) hallucinations 5) ophthalmic a) common (> 10%) - blurred vision, photophobia b) less common (1-10%) - local irritation, congestion, increased intraocular pressure c) uncommon (< 1%) - vascular congestion, edema, drowsiness, exudate, eczematoid dermatitis, follicular conjunctivitis Drug interactions: incompatible with alkali solutions Mechanism of action: 1) more potent anti-muscarinic activity than atropine on the iris, ciliary body, salivary glands, sweat glands 2) less potent anti-muscarinic activity than atropine on the heart, bronchial smooth muscle & intestinal smooth muscle

Interactions

drug interactions drug adverse effects of parasympatholytics

Related

atropine/attapulgite/hyoscyamine/scopolamine (Donnagel) atropine/belladonna/hyoscyamine/phenobarbital/scopolamine (Donnatal)

General

anti-emetic belladonna alkaloid cycloplegic agent mydriatic agent parasympatholytic (anticholinergic, antimuscarinic agent)

Properties

KINGDOM: plant MISC-INFO: elimination route LIVER

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  4. Deprecated Reference

Component-of

atropine/attapulgite/hyoscyamine/scopolamine (Donnagel) atropine/belladonna/hyoscyamine/phenobarbital/scopolamine (Donnatal) atropine/chlorpheniramine/hyoscyamine/pseudoephedrine/scopolamine atropine/hyoscyamine/phenobarbital/scopolamine atropine/hyoscyamine/scopolamine chlorpheniramine/hyoscyamine/phenylephrine/phenylpropanolamine/scopolamine chlorpheniramine/hyoscyamine/phenylephrine/scopolamine chlorpheniramine/hyoscyamine/pseudoephedrine/scopolamine chlorpheniramine/phenylephrine/scopolamine hyoscyamine/phenobarbital/scopolamine hyoscyamine/phenylephrine/pseudoephedrine/scopolamine hyoscyamine/scopolamine phenylephrine/scopolamine