GI smooth muscle spasms

Question 1

Treatment

Answer 1

• Antimuscarinic
• Antispasmodic drugs

Question 2

Antimuscarinic: MOA

Answer 2

• Blocks muscarinic receptor to cause wide range of sympathetic effects
• RED gut motility

Question 3

Antimuscarinic: indication

Answer 3

• Gastro-intestinal spasms
• Asthma + COPD
• Motion sickness
• Arrhythmias
• Urinary incontinence
• Tremors

Question 4

Antimuscarinic: drugs

Answer 4

Atropine (outdated; central side effects (delirium)

Hyoscine butylbromide (Hyoscine hydrobromide has diff. indication: motion sickness)
- MHRA: risk of serious side effects in cardiac disease, CI: tachycardia, caution: cardiac disease, monitor patients + resuscitation available

Question 5

Antimuscarinic: side effect

Answer 5

• Blurred vision, dry mouth, confusion, drowsiness
  Constipation
• CI: paralytic ileus, obstruction, toxic megacolon

Tachycardia
- Caution: CVD

Urinary retention
- Caution: enlarged prostate
- CI: urinary retention

Glaucoma
- Caution: susceptibility
- CI: closed angle

Question 6

Antispasmodic: MOA

Answer 6

direct relaxants of intestinal smooth muscles

Question 7

Antispasmodic: indication

Answer 7

• Gastro-intestinal spasms
• IBS

Question 8

Antispasmodic: drugs

Answer 8

• Mebeverine
• Alverine (dizziness, driving warning
• Peppermint oil (heartburn, local irritation of mouth + oesophagus) - Counsel: swallow capsules whole

Question 9

Antispasmodic: CI

Answer 9

Paralytic ileus