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Anticholinergic medication
Hyoscine butylbromide Trade names Buscopan, others Other names scopolamine butylbromide, butylscopolamine bromide (JAN JP ) License data
Routes of administration By mouth , rectal , intravenous ATC code
Legal status
AU : S2 (Pharmacy medicine)[1]
CA : OTC (Pharmacist only)
UK : General sales list (GSL, OTC)
US : ℞-only [2]
In general: Over-the-counter (OTC)
Bioavailability <1% Protein binding Low Elimination half-life 5 hours Excretion Kidney (50%) and fecal[3]
[7(S )-(1α,2β,4β,5α,7β)]-9-butyl-7-(3-hydroxy-1-oxo-2-phenylpropoxy)-9-methyl-3-oxa- 9-azonitricyclo[3.3.1.02,4 ]nonane
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA )
ECHA InfoCard 100.005.223 Formula C 21 H 30 Br N O 4 + Molar mass 440.378 g·mol−1 3D model (JSmol )
CCCC[N+]1(C2CC(CC1C3C2O3)OC(=O)C(CO )C4=CC=CC=C4)C.[Br-]
InChI=1S/C21H30NO4.BrH/c1-3-4-10-22(2 )17-11-15(12-18(22 )20-19(17 )26-20)25-21(24 )16(13-23)14-8-6-5-7-9-14;/h5-9,15-20,23H,3-4,10-13H2,1-2H3;1H/q+1;/p-1/t15?,16-,17-,18+,19-,20+,22?;/m1./s1 Y
Key:HOZOZZFCZRXYEK-HNHWXVNLSA-M Y
N Y (what is this?) (verify)
Hyoscine butylbromide , also known as scopolamine butylbromide [4] and sold under the brandname Buscopan among others,[5] is an anticholinergic medication used to treat abdominal pain , esophageal spasms , bladder spasms , biliary colic ,[6] and renal colic .[7] [8] It is also used to improve excessive respiratory secretions at the end of life .[9] Hyoscine butylbromide can be taken by mouth, injection into a muscle , or into a vein .[5]
Side effects may include sleepiness, vision changes, dry mouth, rapid heart rate, triggering of glaucoma , and severe allergies .[7] Sleepiness is uncommon.[10] It is unclear if it is safe in pregnancy .[5] It appears safe in breastfeeding.[11] Greater care is recommended in those with heart problems.[12] It is an anticholinergic agent ,[5] which does not have much effect on the brain .[13]
Hyoscine butylbromide was patented in 1950, and approved for medical use in 1951.[14] It is on the World Health Organization's List of Essential Medicines .[15] It is not available for human use in the United States,[16] and a similar compound methscopolamine may be used instead.[17] It is manufactured from hyoscine - also known as scopolamine - which occurs naturally in a variety of plants in the nightshade family, Solanaceae ,[18] including deadly nightshade (Atropa belladonna ).[19]
It is available in the United States only for the medical treatment of horses.[2]
Medical uses [ edit ]
A package of injectable buscopan
Hyoscine butylbromide is effective in treating crampy abdominal pain .[20]
Hyoscine butylbromide is effective in reducing the duration of the first stage of labour, and it is not associated with any obvious adverse outcomes in mother or neonate.[21]
It is also used during abdominal , pelvic MRI , virtual colonoscopy , and double barium contrasted studies to improve the quality of pictures.[22] Hyoscine butylbromide can reduce the peristaltic movement of the intestines and mucosal foldings, thus reducing the movement artifact of the images.[23]
Side effects [ edit ]
Since little of the medication crosses the blood-brain barrier , this drug has less effect on the brain and therefore causes a reduced occurrence of the centrally-mediated effects (such as delusions , somnolence and inhibition of motor functions) which reduce the usefulness of some other anticholinergic drugs.[13]
Hyoscine butylbromide is still capable of affecting the chemoreceptor trigger zone , due to the lack of a well-developed blood-brain barrier in the medulla oblongata , which increases the antiemetic effect it produces via local action on the smooth muscle of the gastrointestinal tract .[24]
Other side effects include accommodation reflex disturbances, tachycardia , dry mouth, nausea; urinary retention, reduced blood pressure; dyshidrosis ;[23] Other symptoms are dizziness, flushing and immune system disorders (anaphylactic shock, potentially fatal); anaphylactic reactions; dyspnoea; skin reactions and other hypersensitivity reactions. Cautions should be taken for those with untreated glaucoma, heart failure, benign prostatic hypertrophy with urinary retention as hyoscine may exacerbate these conditions.[23]
Pharmacology [ edit ]
Hyoscine butylbromide reduces smooth muscle contraction and the production of respiratory secretions. These are normally stimulated by the parasympathetic nervous system , via the neurotransmitter acetylcholine . As an antimuscarinic , hyoscine butylbromide binds to muscarinic acetylcholine receptors, blocking their effect.[25]
It is a quaternary ammonium compound and a semisynthetic derivative of hyoscine hydrobromide (scopolamine). The attachment of the butyl-bromide moiety effectively prevents the movement of this drug across the blood–brain barrier , effectively minimising undesirable central nervous system side effects associated with scopolamine/hyoscine.[25]
Hyoscine butylbromide is not centrally active and has a low incidence of abuse.[13] In 2015, it was reported that prisoners at Wandsworth Prison and other UK prisons were smoking prescribed hyoscine butylbromide, releasing the potent hallucinogen scopolamine .[26] [27] There have also been reports of abuse in Mashhad Central Prison in Iran .[28]
References [ edit ]
^ Tytgat GN (2007). "Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain". Drugs . 67 (9 ). Springer Science and Business Media LLC: 1343–1357. doi :10.2165/00003495-200767090-00007 . PMID 17547475 . S2CID 46971321 .
^ Juo PS (2001). Concise Dictionary of Biomedicine and Molecular Biology (2nd ed.). Hoboken: CRC Press. p. 570. ISBN 9781420041309 . Archived from the original on 2015-12-08.
^ a b c d "Buscopan Tablets and Ampoules" . Therapeutic Goods Administration, Australia. 8 November 2010. Archived from the original on 30 March 2017. Retrieved 22 October 2013 .
^ "Biliary colic and complications from gallstones - BPJ 61 June 2014" . bpac.org.nz . Retrieved 2024-01-22 .
^ a b "Hyoscine butylbromide SXP" . www.ebs.tga.gov.au . 3 July 2017. Retrieved 15 March 2018 .
^ Hamilton R (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition . Jones & Bartlett Learning. p. 270. ISBN 9781284057560 .
^ Paice J (2015). Care of the Imminently Dying . Oxford University Press. p. 43. ISBN 9780190244309 . Archived from the original on 2015-12-08.
^ Handbook of Palliative Care (3rd ed.). New York: Wiley. 2012. p. 570. ISBN 9781118426814 . Archived from the original on 2015-12-08.
^ "Hyoscine" (PDF) . www.kemh.health.wa.gov.au . Retrieved 11 September 2019 .
^ "Hyoscine butylbromide (Buscopan) injection: risk of serious adverse effects in patients with underlying cardiac disease" . www.gov.uk . 20 February 2017. Retrieved 15 March 2018 . hyoscine butylbromide injection should be used with caution in patients with cardiac disease
^ a b c Hanks G (2011). Oxford textbook of palliative medicine (4th ed.). Oxford [etc.]: Oxford University Press. p. 805. ISBN 9780199693146 . Archived from the original on 2015-12-08.
^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery . John Wiley & Sons. p. 446. ISBN 9783527607495 .
^ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021) . Geneva: World Health Organization. hdl :10665/345533 . WHO/MHP/HPS/EML/2021.02.
^ Prommer EE, Thompson L, Casciato DA (2012). "Supportive Care" . In Casciato DA, Territo MC (eds.). Manual of Clinical Oncology (7th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. p. 146. ISBN 9781451115604 . Archived from the original on 2015-12-08.
^ Satoskar RS, Rege SD, Bhandarkar NN (1973). Pharmacology and Pharmacotherapeutics . Popular Prakashan. p. 296. ISBN 9788179915271 .
^ "Scopolamine | Anticholinergic, Hyoscine, Motion Sickness | Britannica" . www.britannica.com . Retrieved 2024-01-22 .
^ Twycross R (2003). Introducing palliative care (4th ed.). Oxford: Radcliffe Medical Press. p. 172. ISBN 9781857759150 . Archived from the original on 2015-12-08.
^ Tytgat GN (2007). "Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain". Drugs . 67 (9 ): 1343–57. doi :10.2165/00003495-200767090-00007 . PMID 17547475 . S2CID 46971321 .
^ Samuels LA, Christie L, Roberts-Gittens B, Fletcher H, Frederick J (December 2007). "The effect of hyoscine butylbromide on the first stage of labour in term pregnancies". BJOG . 114 (12 ): 1542–6. doi :10.1111/j.1471-0528.2007.01497.x . PMID 17903230 . S2CID 71523418 .
^ "Hyoscine butylbromide (Buscopan®)" (PDF) . UK: Guy's and St Thomas' NHS Foundation Trust . July 2014. Archived (PDF) from the original on 8 August 2016. Retrieved 16 June 2016 .
^ a b c Tytgat GN (November 2008). "Hyoscine butylbromide - a review on its parenteral use in acute abdominal spasm and as an aid in abdominal diagnostic and therapeutic procedures". Current Medical Research and Opinion . 24 (11 ): 3159–3173. doi :10.1185/03007990802472700 . PMID 18851775 . S2CID 73316713 .
^ Glare P, Miller J, Nikolova T, Tickoo R (12 September 2011). "Treating nausea and vomiting in palliative care: a review" . Clinical Interventions in Aging . 6 : 243–59. doi :10.2147/CIA.S13109 . PMC 3180521 . PMID 21966219 .
^ a b "Buscopan 10 mg Tablets - Summary of Product Characteristics (SmPC) - (emc)" . www.medicines.org.uk . Retrieved 2020-07-22 .
^ "Medics warned to review Buscopan prescriptions after prisoners found smoking it" . Pulse Today . Archived from the original on 2018-02-07. Retrieved 2018-02-07 .
^ Optimisation, NECS Medicines (2015-07-21). "Misuse of hyoscine butylbromide (Buscopan) |" . medicines.necsu.nhs.uk . Retrieved 2018-02-07 .
^ Jalali F, Afshari R, Babaei A (June 2014). "Smoking crushed hyoscine/scopolamine tablets as drug abuse". Substance Use & Misuse . 49 (7 ): 793–7. doi :10.3109/10826084.2014.880178 . PMID 24494624 . S2CID 25661684 .
t
e
mAChRs Tooltip Muscarinic acetylcholine receptors
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Receptor/signaling modulators
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R e t r i e v e d f r o m " https://en.wikipedia.org/w/index.php?title=Hyoscine_butylbromide&oldid=1217195014 "
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