GI smooth muscle spasm

Question 1

Causes

Answer 1

IBS
IBD
Bowel colic in palliative care

Question 2

Treatment

Answer 2

Antispasmodics
Antimuscarinics

Question 3

Antimuscarinics

Answer 3

Hyoscine butylbromide
Propantheline bromide
Dicycloverine
Atropine - outdated, rarely used due to atropinic SE

Question 4

Antimuscarinics - MoA

Answer 4

Reduces intestinal motility
Stimulation of muscarinic receptors = parasympathetic effects (rest + digest)
Antimuscarinics block muscarinic receptors = opposite affect

Question 5

Side effects

Answer 5

Cant see, pee, poo or spit
- Blurred vision
- Urinary retention
- Constipation
- Dry moutth

Question 6

Other side effects

Answer 6

• CV = tachycardia, palpitations + arrthymias
• Pupil dilation
• Reduced bronchial secretions
• Angle closure glaucoma (raises intraocular pressure)
• Confusion (elderly)
• Drowsiness

Question 7

Cautions

Answer 7

CV disease
Conditions that cause tachycardia (hyperthyroidism)
Susceptibility to angle-closure glaucome

Question 8

Contraindications

Answer 8

• Prostatic enlargement, urinary retention
• Paralytic ileus, GI obstruction, toxic megacolon
• Myasthenia gravis (muscle weakness)
• Narrow angle (closed angle) glaucoma

Question 9

Hyoscine butylbromide

Answer 9

HYDROBROMIDE - Commonly used in motion sickness
MHRA: hyoscine butylbromide is associated with risk of serious adverse effects in patients with underlying cardiac disease
- C/I in tachycardia
- Monitor patients have resuscitation available

Question 10

Antispasmodics

Answer 10

Direct relaxants of smooth muscle.
Mebeverine
Alverine - dizziness, driving!
Peppermint oil - can cause heartburn/local irritation of mouth. swallow capsules whole.