Gastro-intestinal smooth muscle spasm

Question 1

Antimuscarinics

Answer 1

Antimuscarinics reduce intestinal motility. They can be used for the management of irritable bowel syndrome.

Antimuscarinics that are used for gastro-intestinal smooth muscle spasm include the tertiary amines atropine sulfate and dicycloverine hydrochloride below and the quaternary ammonium compounds propantheline bromide and hyoscine butylbromide. The quaternary ammonium compounds are less lipid soluble than atropine sulfate and are less likely to cross the blood–brain barrier; they are also less well absorbed from the GI tract.

Question 2

Hyoscine butylbromide IV MHRA alert

Answer 2

HYOSCINE BUTYLBROMIDE (BUSCOPAN) INJECTION: RISK OF SERIOUS ADVERSE EFFECTS IN PATIENTS WITH UNDERLYING CARDIAC DISEASE - 
The MHRA advises that hyoscine butylbromide injection can cause serious adverse effects including tachycardia, hypotension, and anaphylaxis; several reports have noted that anaphylaxis is more likely to be fatal in patients with underlying coronary heart disease. Hyoscine butylbromide injection is contra-indicated in patients with tachycardia and should be used with caution in patients with cardiac disease; the MHRA recommends that these patients are monitored and that resuscitation equipment and trained personnel are readily available.

Question 3

ANTISPASMODICS examples

Answer 3

alverine, mebeverine, peppermint oil

Question 4

Antimuscarinic side effects

Answer 4

• Blurred vision, constipation, dry mouth, urinary retention, tachycardia, palpitations

Question 5

Antimuscarinic examples

Answer 5

• Atropine
• Hyoscine butylbromide
• Dicycloverine
• Propantheline bromide