hyoscine


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Related to hyoscine: scopolamine, Buscopan

scopolamine

 [sko-pol´ah-mēn]
an anticholinergic and antimuscarinic alkaloid derived from various plants, having a depressant effect on the central nervous system. Used as an antisialagogue preanesthetic medication and as an adjunct to general anesthesia, administered parenterally; as an antiemetic, administered orally or parenterally; and as a cycloplegic and mydriatic, applied topically to the conjunctiva. Called also hyoscine.

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.

sco·pol·a·mine

(skō-pol'ă-mēn, -min),
An alkaloid found in the leaves and seeds of Hyoscyamus niger, Duboisia myoproides, Scopolia japonica, S. carniolica, Atropa belladonna, and other solanaceous plants; exerts anticholinergic actions similar to that of atropine, but is thought to have greater central nervous system effects; useful in preventing motion sickness; available as various salts.
Synonym(s): hyoscine

hyoscine

(hī′ə-sēn′)

hyoscine

Scopolamine. A drug structurally related to ATROPINE and having similar properties. It is used to treat painful menstruation and bowel colic. A brand name is Buscopan.

sco·pol·a·mine

(skō-pol'ă-mēn, -min)
An alkaloid found in the leaves and seeds of various plants; exerts anticholinergic actions similar to that of atropine, but is thought to have greater central nervous system effects; useful in preventing motion sickness.
Synonym(s): hyoscine.
References in periodicals archive ?
Hyoscine, a quaternary derivative of atropine, is an antimuscarinic agent which acts by inhibiting cholinergic transmission in the parasympathetic ganglia, thus relieving spasm in the smooth muscle of female genital organs, especially the cervicouterine plexus, thus aiding cervical dilatation.
The study was designed as a randomized, double blind, controlled clinical trial that compared two groups: hyoscine given to group- A, while the placebo given to group-B.
According to the results of current study, hyoscine was the predominant tropane alkaloid in the seeds of H.
Bowel prep that was adequate or better was associated with an almost 40% increased chance for detection (P less than .001) and the use of hyoscine was associated with a 30% increase (P less than .001), although it is possible that hyoscine use is "an indicator of a good colonoscopist," Dr.
We treated the patient with IV hyoscine butylbromide, an antimuscarinic, anticholinergic agent used as an abdominal-specific antispasmodic (Tytgat 2008).
However, in view of the fact that this pain was alleviated with hyoscine, an antispasmodic, it is possible that postoperative spasm in bowel smooth muscles has contributed to the high number of abdominal complaints following the use of the drug.
Another examination of 504 dying patients found hyoscine hydrobromide to be more effective at controlling the death rattle than glycopyrrolate when both were administered subcutaneously (Back et al., 2001).
The alkaloids in mandrake are hyoscyamine C17H 23O3N (scopoletin 2500-3500 ppm), hyoscine C17H 21O4N (scopolamine 30-50 ppm), atropine [C.sub.17][H.sub.23][O.sub.3]N (10-20 ppm) and small quantities of mandragorine that is only found in the root (Ramoutsaki et al.
He also received hyoscine butyl bromide and chlorpheniramine maleate.
On January 10, 1910, Doctor Hawley Harvey Crippen purchased five grains (325 mg) of hydrobromide of hyoscine at a chemist's shop in London.
They can cause drowsiness For more serious travel sickness a doctor may prescribe patches containing hyoscine (an anti-nausea drug).