Anticholinergic agents |
|
|
| Gastrointestinal antispasmotic agents: | Atropine,
Dicyclomine, Glycopyrrolate, Hyoscyamine, Donnatal, Propantheline. |
| Urinary antispasmotic agents: | Flavoxate,
Oxybutynin , Propantheline ,Tolterodine |
| Dicyclomine
(Bentyl ®): | Indications:
Treatment of functional disturbances of GI motility such as irritable bowel
syndrome. Onset: 1-2hrs. Duration: up to 4 hours. Dosing: 20mg
orally or intramuscularly every 6 hours (up to 40 mg every 6
hours). Do not give IV. |
| Donnatal ®: | [Hyoscyamine
0.1037mg + atropine 0.019mg +scopolamine 0.007mg + phenobarbital 16.2mg] Indications: Adjunct in the treatment of PUD, irritable bowel, spastic colitis, spastic
bladder, and renal colic. Dosing: 1-2 capsules or tablets three to
four times daily or 1
extentab orally every 12 hours; or 5-10 ml of elixir three to four times
daily. |
| Flavoxate
(Urispas ®): | Indications:
Antispasmotic used to provide symptomatic relief of dysuria, nocturia,
supra-pubic pain, urgency, and incontinence. Especially useful for treatment of
bladder spasticity. Onset: 55-60 min. Dosing: 100-200mg orally
three to four times daily. |
| Glycopyrrolate
(Robinul ®): | Indications:
Adjunct in the treatment of PUD; inhibits salivation and excessive secretions of the
respiratory tract preoperatively; reversal of neuromuscular blockade;
control of upper airway secretions. Onset: Oral: with in 50 min; IM: 20-40min ;
IV: 10-15min.
Dosing: Intraoperative: IV: 0.1 mg q2-3min
as needed; Peptic ulcer:
Oral: 1-2mg 2 to 3 times daily. Decrease secretions: 0.1 to 0.2 mg
3 to 4 times daily IM/IV or 1 mg orally 2 to 3 times a day. |
| Hyoscyamine
(Levsin ®): | Belladonna
alkaloid. Indications: Adjunctive therapy of gastrointestinal disorders caused by
spasm; treatment of urinary hypermotility as well as bladder spasm.
Onset: 2-3 min. Duration: 4-6hrs.
Dosing: Oral or S.L. : 0.125 to 0.25 mg (1-2 tabs)
three to four times daily before meals.
Levsinex ®: 0.375 to 0.75 mg (1-2 caps)
orally every 12 hours. IV, IM, SC:
0.25-0.5 mg every 6 hours. |
| Oxybutynin
(Ditropan ®): | Ditropan
®
Indications: (Overactive bladder) Antispasmotic for neurogenic bladder (urgency, frequency, urge incontinence)
and uninhibited bladder. Onset: 30-60min. Peak effect: 3-6
hours. Duration: 6-10
hrs. Dosing: 5 mg orally 2 to 3 times daily (up to 4
times a day--maximum). [Supplied: 5 mg
tablet and syrup: 5 mg/5 ml]
Ditropan XL ®: 5 to 10 mg orally once
daily. May increase dose if needed by 5 mg increments at weekly intervals to
a maximum dose of 30mg per day. [Supplied:
5 mg, 10mg , 15mg tablets]
Oxytrol ®: Transdermal Patch (3.9
mg/day). Apply patch twice weekly (every 3 to 4 days). Use a new
application site for each new patch. |
| Propantheline
(Pro-Banthine ®): | Indications:
Adjunctive therapy of peptic ulcer, irritable bowel syndrome, pancreatitis,
ureteral and urinary bladder spasm; reduce duodenal motility during
radiologic procedures. Onset: 30-45min. Duration: 4-6hrs.
Dosing: 15mg
orally 3 times a day before meals and 30mg at
bedtime. Supplied: [7.5mg, 15mg tab] |
| Tolterodine
(Detrol ®): | Selective
anticholinergic agent (increased selectivity for urinary bladder) Indications: Therapy of urinary frequency; urgency; urge incontinence. Reduces
bladder spasm. Onset: 1 hr.
Dosing: 2 mg orally twice a day, decreasing to 1 mg
twice a day in the event of bothersome anticholinergic effects.
Extented release tablets: 4 mg once daily. May decrease dose to 2 mg
once daily if there are bothersome anticholinergic effects. Supplied: [1 mg,
2 mg tablets. Extended release capsules: 2mg, 4 mg.] |
