HYOSCINE BUTYLBROMIDE
Properties *
Buscopan has a special site of action at the parasympathetic ganglia in the walls of
the viscera. Because of this it exerts a specific antispasmodic action on the smooth
muscle of the gastro -intestinal, biliary and urinary tracts. Because of this selective
action the side effects characteristic of atropine-like substances rarely occur,
Hence, no side effects on the central nervous system or salivary glands are
observed when Buscopan is administered in therapeutic doses.
Pharmacokinetics :
Upon oral administration, hyoscine butylbronnide is quickly absorbed by the tissue
and concentrates especially in the tissue of the gastrointestinal tract, liver and
kidneys. The high affinity of this.agent to the tissue is reflected by the very short
half-life t-alpha of 3-minutes (distribution phase) of the blood levels, while the
excretion rates are slow. Thus, in spite of the extremely low blood levels
measurable over a short period of time.hyoscinebutylbromide remains available at the site of action in the tissues in high concentrations.
Indications :
Gastric and duodenal ulcers, gastro-intestinat spasm and hypermotility
pylorospasm in infants, post-operative vomiting, spastic constipation, biliary
dyskinesia and spasm of the urinary tract, delayed relaxation of the lower uterine
segment, dysmenorrhoea.
Buscopan is also indicated in radiologic and endoscopic diagnostic procedures of
gastrointestinal tract to reduce spasm .
Contraindications :
There are no known contraindications for the oral administration of Buscopan.
' Buscopan should not be administered parenterally in the following disorders
Glaucorna, hypertrophy of the prostate with a tendency towards retention of urine
mechanical stenoses in the region of the gastro-intestinal tract, tachycardia
megacolon .
SIDE EFFECTS :
No adverse effects characteristic of atropine are observed on the salivary glands or
sweat secretion when Buscopan is administered in the usual dose* A slight
increase in pulse rate,may occur when it Is administered intravenously.Parenteral
administration, especially of large doses, may occasionally cause a transient
disturbance of accomodation, which recedes spontanbousty. For these reasons
following parenteral administration, even when given as Instructed, Buscopan can
affect vision and consequently reactions white driving or operating machinery.
In some cases hypersensitivity reactions such as urticaria may occur.'Following
parenteral administration (ampoules) very rare cases of shock reactions have been
observed.
Special precautions
AVAILABLE BUT LIMITED DATAS HAS SHOWN NO HAZARDS,BUT SAFETY DURING
pregnancy has not yet been established. The usual precautions regarding the use
of drugs at this time, especially during the first trimester should be observed.
Safety during lactation has not yet been established.
INTERACTIONS:
" On parenteral administration of Buscopan tricyclic antidepressants, quinidine and
amantadinee can potentiate the, anticholinergic effect of Buscopan.
Dosage and administration :
Unless otherwise prescribed by the physician.
Oral
Sugar-coated tablets
Adults and children over 6 years- -- 3-5 times daily 1-2 s.c. tablets.
The sugar-coated tablets should be swallowed whole with a little fluid.
Parenteral
In acute attacks of colic 1 ampoule of Buscopan (20 mg) may be administered
subcutaneously, Intramuscularly or by intravenous injection several times daily.
Infants and young children:
In severe casfes, 1/4 of an ampoule 3 times daily.
0verdose :
Symptoms
Signs of poisoning following acute overdosage have not been observed in man.
Single oral doses of up to 590 mg and quantities of the active substance of up to
1090 mg within 5 hours merely produced dry mouth, tachycardia, slight drowsi-
ness and transient visual disorders.
Results from toxicity studies in.animals after parenteral administration suggest the
following may be possible: shock, Cheyne-Strokes respiration, respiratory
paralysis , clonic spasms, paresis of the striated muscle, coma, paralytic ileus
cystoparalysis, retention of urine.
Therapy :
In the case of oral poisoning,gastrjc lavage with animal charcoal followed by
magnesium sulfate (15%). Symptoms of Buscopan overdosage respond to
parasympathomimetics. For patients with glaucoma, pilocarpine given locally
Boost circulation with sympathomimetics. For coma, central analeptics
Neuroleptics for mental excitation. In the case of respiratory paralysis, intubation
artificial respiration. In the case of orthostatic fall in blood pressure, it is sufficient
for the patient to lie flat. Catheterisation in the case ef urine retention.