propantheline bromide (redirected from Propanthel)

propantheline bromide

[-pan′thəlēn]

an anticholinergic/antispasmodic.

indications It is prescribed as an adjunct in peptic ulcer therapy, irritable bowel syndrome, and pancreatitis and for spasm of the ureters or urinary bladder.

contraindications Narrow-angle glaucoma, asthma, obstruction of the genitourinary or GI tract, severe ulcerative colitis, megacolon, myasthenia gravis, or known hypersensitivity to this drug prohibits its use.

adverse effects Among the more serious adverse effects are blurred vision, central nervous system effects, tachycardia, dry mouth, decreased sweating, and hypersensitivity reactions.

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propantheline bromide, (prōpan´thlēn brō´mīd),

n brand name: Pro-Banthine;
drug class: anticholinergic;
action: inhibits muscarinic actions of acetylcholine at postganglionic parasympathetic neuroeffector sites;
uses: treatment of peptic ulcer disease, irritable bowel syndrome, duodenography, urinary incontinence.

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propantheline bromide

Pro-Banthine, Propanthel (CA)

Pharmacologic class: Parasympatholytic

Therapeutic class: Anticholinergic, antimuscarinic, antispasmodic

Pregnancy risk category C

Action

Prevents muscarinic action of acetylcholine at postganglionic parasympathetic neuroeffector sites, relaxing GI tract and blocking gastric acid secretion

Availability

Tablets: 7.5 mg, 15 mg

⊘Indications and dosages

➣ Peptic ulcer

Adults: 15 mg P.O. 30 minutes before each meal and 30 mg at bedtime, for a total of four daily doses

Adults of small stature: 7.5 mg P.O. t.i.d. before each meal

Dosage adjustment

• Mild peptic ulcer symptoms
• Elderly patients

Off-label uses

• Neurogenic bladder
• Urinary incontinence
• Antisecretory and antispasmodic effects

Contraindications

• Hypersensitivity to drug or other anticholinergics
• Angle-closure glaucoma
• Unstable cardiovascular adjustment in acute hemorrhage
• GI tract obstruction
• GI atony in elderly or debilitated patients
• Toxic megacolon, severe ulcerative colitis
• GU tract obstruction
• Myasthenia gravis

Precautions

Use cautiously in:
• heart failure, hypertension, arrhythmias, coronary artery disease, hepatic disease, hiatal hernia, chronic lung disease in debilitated patients, hyperthyroidism, autonomic neuropathy
• elderly patients
• pregnant or breastfeeding patients
• children.

Administration

• Give 30 minutes before meals and at bedtime - except in adults of small stature, who should receive doses three times daily before meals.

Route	Onset	Peak	Duration
P.O.	30-60 min	2-6 hr	6 hr

Adverse reactions

CNS: confusion, stimulation, headache, insomnia, dizziness, anxiety, asthenia, hallucinations

CV: palpitations, orthostatic hypotension, tachycardia

EENT: blurred vision, photophobia, mydriasis, cycloplegia, increased intraocular pressure, nasal congestion

GI: nausea, vomiting, constipation, heartburn, dysphagia, bloating, gastroesophageal reflux disease (GERD), dry mouth, paralytic ileus

GU: urinary hesitancy or retention, erectile dysfunction, suppressed lactation

Skin: rash, urticaria, pruritus, anhidrosis

Other: taste loss, fever, heat prostration, allergic reaction

Interactions

Drug-drug. Amantadine: increased propantheline effects

Atenolol: increased pharmacologic effects of atenolol

Phenothiazines: decreased antipsychotic efficacy of phenothiazines, increased adverse effects of propantheline

Tricyclic antidepressants: increased anticholinergic effects

Drug-herbs. Henbane, jimsonweed, scopolia: increased anticholinergic effects

Patient monitoring

• Monitor vital signs. Watch for orthostatic hypotension.
• Assess patient for sensory and neurologic impairment.

Patient teaching

• Tell patient drug may inhibit sweating and make him susceptible to heat prostration. Teach him effective ways to maintain normal body temperature.
• Describe drug's adverse anticholinergic effects. Recommend appropriate measures to minimize these.
• Advise patient to report GERD symptoms.
• Tell male patient drug may cause erectile dysfunction. Encourage him to discuss this problem with prescriber.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, vision, and alertness.
• Instruct patient to move slowly when sitting up or standing, to avoid dizziness from sudden blood pressure decrease.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and herbs mentioned above.