METHSCOPOLAMINE BROMIDE

METHSCOPOLAMINE BROMIDE
(meth-skoe-pol'a-meen)
Pamine
Classifications: anticholinergic; antimuscarinic; antispasmodic;
Therapeutic: antispasmodic; anticholinergic

Prototype: Atropine
Pregnancy Category: C

Availability

2.5 mg tablets

Action

Methscopolamine decreases GI tone and decreases amplitude and frequency of peristaltic contractions of the esophagus, stomach, duodenum, jejunum, ileum, and colon. Greater selectivity in blocking vagal impulses from GI tract than either scopolamine or atropine.

Therapeutic Effect

Its spasmolytic and antisecretory actions are quantitatively similar to those of atropine but they last longer.

Uses

Adjunct in treatment of peptic ulcer, irritable bowel syndrome, and a variety of other GI conditions. Also may be used to control excessive sweating and salivation, migraine headaches, and premenstrual cramps.

Contraindications

Hypersensitivity to any of the drug's constituents; prostatic hypertrophy; pyloric obstruction; intestinal atony; tachycardia, cardiac disease; MS; pyloric stenosis; pregnancy (category C), lactation.

Cautious Use

Older adult and debilitated patients; chronic pulmonary diseases (COPD).

Route & Dosage

Irritable Bowel Syndrome
Adult: PO 2.5–5 mg 30 min a.c. and h.s.

Administration

Oral
  • Give 30 min before meals and at bedtime.
  • Preserve in tight, light-resistant containers.

Adverse Effects (≥1%)

GI: Dry mouth, constipation. Special Senses: Blurred vision. CNS: Dizziness, drowsiness, flushing of skin. Urogenital: Urinary hesitancy or retention.

Interactions

Drug: Amantadine, tricyclic antidepressants increase anticholinergic effects; may increase effects of atenolol, digoxin; may decrease effectiveness of phenothiazines.

Pharmacokinetics

Absorption: Erratic after PO administration. Onset: Approximately 1 h. Duration: 4–6 h. Elimination: Primarily in urine and bile; some unchanged drug excreted in feces.

Nursing Implications

Assessment & Drug Effects

  • Incidence and severity of adverse effects are generally dose related. Dosage is usually maintained at a level that produces slight dryness of mouth.
  • Report urinary retention promptly; may indicate discontinuation.

Patient & Family Education

  • Do not drive or engage in potentially hazardous activities until response to drug is known.
  • Make position changes slowly and in stages.
  • Learn measures to relieve dry mouth; rinse mouth frequently with water, suck hard candy.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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