Kwells


Also found in: Dictionary, Encyclopedia.

scopolamine (hyoscine (UK))

Scopoderm TTS (UK), Transderm-Scop, Transderm-V (CA)

scopolamine hydrobromide (hyoscine hydrobromide)

Buscopan (UK), Kwells (UK)

Pharmacologic class: Antimuscarinic, belladonna alkaloid

Therapeutic class: Antiemetic, antivertigo agent, anticholinergic

Pregnancy risk category C

Action

Acts as competitive inhibitor at postganglionic muscarinic receptor sites of parasympathetic nervous system and on smooth muscles that respond to acetylcholine but lack cholinergic innervation. May block cholinergic transmission from vestibular nuclei to higher CNS centers and from reticular formation to vomiting center.

Availability

Injection: 1 mg/ml in 1-ml vials, 0.4 mg/ml in 0.5-ml ampules and 1-ml vials, 0.86 mg/ml in 0.5-ml ampules

Transdermal system (Transderm-Scop): 1.5 mg/patch (releases 0.5 mg scopolamine over 3 days)

Indications and dosages

Preanesthetic sedation and obstetric amnesia

Adults: 0.3 to 0.6 mg I.M., I.V., or subcutaneously 45 to 60 minutes before anesthesia, usually given with analgesics

Postoperative nausea and vomiting

Adults: One transdermal patch placed behind ear on evening before surgery and kept in place for 24 hours after surgery. For cesarean section, one transdermal patch placed behind ear 1 hour before surgery.

Motion sickness

Adults: One transdermal patch placed behind ear 4 hours before anticipated need, replaced q 3 days if needed

Contraindications

• Hypersensitivity to scopolamine, other belladonna alkaloids, or barbiturates

• Hypersensitivity to bromides (injection only)

• Angle-closure glaucoma

• Acute hemorrhage

• Myasthenia gravis

• Obstructive uropathy (including prostatic hypertrophy)

• Obstructive GI disease (including paralytic ileus and intestinal atony)

• Reflux esophagitis

• Ulcerative colitis or toxic megacolon

• Hepatic or renal impairment

• Chronic lung disease (with repeated doses)

Precautions

Use cautiously in:

• suspected intestinal obstruction; pulmonary or cardiac disease; tachyarrhythmia or tachycardia; open-angle glaucoma; autonomic neuropathy; hypertension; hyperthyroidism; ileostomy or colostomy

• history of seizures or psychosis

• elderly patients

• pregnant or breastfeeding patients (safety not established)

• children.

Administration

• For I.V. use, give by direct injection at prescribed rate after diluting with sterile water.

• After removing protective strip from transdermal patch, avoid finger contact with exposed adhesive layer to prevent contamination.

Adverse reactions

CNS: drowsiness, dizziness, confusion, restlessness, fatigue

CV: tachycardia, palpitations, hypotension, transient heart rate changes

EENT: blurred vision, mydriasis, photophobia, conjunctivitis

GI: constipation, dry mouth

GU: urinary hesitancy or retention

Skin: decreased sweating, rash

Interactions

Drug-drug. Antidepressants, antihistamines, disopyramide, quinidine: additive anticholinergic effects

Antidepressants, antihistamines, opioid analgesics, sedative-hypnotics: additive CNS depression

Oral drugs: altered absorption of these drugs

Wax-matrix potassium tablets: increased GI mucosal lesions

Drug-herbs. Angel's trumpet, jimsonweed, scopolia: increased anticholinergic effects

Drug-behaviors. Alcohol use: increased CNS depression

Patient monitoring

• Assess vital signs and neurologic, cardiovascular, and respiratory status.

• Monitor patient for urinary hesitancy or retention.

Patient teaching

• Tell patient transdermal patch is most effective if applied to dry skin behind ear 4 hours before traveling.

• Caution patient to avoid touching exposed adhesive layer of transdermal patch.

• Advise patient to wash and dry hands thoroughly before and after applying patch.

• If patch becomes dislodged, instruct patient to remove it and apply new patch on a different site behind ear.

• Tell patient that using patch for more than 72 hours may cause withdrawal symptoms (headache, nausea, vomiting, dizziness). Advise him to limit use when feasible.

• Inform patient that his eyes may be markedly sensitive to light during patch use. Instruct him to wear sunglasses and use other measures to guard eyes from light.

• Caution patient to avoid alcohol because it may increase CNS depression.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

Kwells

A brand name for HYOSCINE.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
According to a new survey, by Kwells travel sickness tablets, the Geordie TV favourites are the celebrities Brits would most like to find themselves seated next to on a long-haul flight.
The makers of travel sickness products, Kwells, has issued advice on how to avoid motion sickness.
`I'm going to take the entire day's output of the Kwells factory' he assured friends shortly before he and Rosemary left for a brief spell as resident scholars at the University of California, Santa Cruz.
"I'll be going Monday week." "Fancy, a mystery trip, and you never were a good traveller." "I'll take some Kwells, just in case."
I hate boats, where are the Kwells?" He isn't best pleased and starts begging over and over every time the blasted boat appears on the telly.
Hyoscine (Kwells) tablets can be taken at least 30 minutes before getting on the boat.
It is Ant and Dec's cheeky banter that would help to ease the pain of flying for most Brits, as the research, commissioned by travel sickness tablets Kwells showed that UK travellers favour wit and conversation over good looks.
This can be taken by mouth 30 minutes before travel (eg Joy-Rides, Kwells), or used as a patch (Scopoderm TTS on prescription) applied to skin behind the ear five to six hours before travelling.