Butylscopolamine

/CASE REPORTS/ ... Three middle-aged females unexpectedly suffered from anterograde amnesia after intramuscular injection of hyoscine butylbromide as an antispasmodic premedication for endoscopy ... . /Butylscopolamine bromide/

/CASE REPORTS/ A 40-year-old man experienced cardiopulmonary arrest after intramuscular injection of 20 mg of butylscopolamine bromide. No pathological changes were found at autopsy, and 1.19 ug/mL of butylscopolamine bromide was detected in his serum. Since he had taken no other drugs, his severe symptoms were thought to have been caused by an anaphylactic reaction to butylscopolamine bromide. /Butylscopolamine bromide/

/CASE REPORTS/ Impetigo herpetiformis (IH) is a rare dermatosis arising during the third trimester of pregnancy which is generally considered as a form of pustular psoriasis of unknown etiology. Clinically it is characterized by erythematous plaques surrounded by sterile pustules associated with fever, diarrhea, sweating and increasing risk of stillbirth for placental insufficiency. ... A case of developed erythematous plaques surrounded by pustules localized initially to the trunk of a 35-year-old woman at the 34th week of gestation after 5 days of treatment with N-Butyl-Scopolammonium, and which later involved the upper and lower limbs /is described/. Skin histology confirmed the diagnosis of generalised pregnancy pustular psoriasis (impetigo herpetiformis). Impetigo herpetiformis is reported to be associated with hypocalcemia, hypoparathyroidism, use of oral contraceptives and bacterial infections. ... /N-butyl-scopolammonium/

/CASE REPORTS/ Heart-rate responses to intravenous hyoscine butylbromide, atropine and physiological saline in cumulative dosage regimens have been recorded in six healthy subjects. Atropine sulfate induced bradycardia at low, and tachycardia at higher, dose levels whereas hyoscine butylbromide caused only tachycardia but with a flatter dose-response relationship. Exact potency ratios could not be calculated because of the differing dose-response curves. However, an approximate estimate from a comparison of equiactive doses at the upper part of the curve yielded a value less than one half that obtained from the drugs' affinity constants in guinea-pig ileum. The findings suggest that, in addition to its action as a muscarinic antagonist, hyoscine butylbromide is a ganglion blocker in man as it is in animals.

For more Human Toxicity Excerpts (Complete) data for BUTYLSCOPOLAMINE (6 total), please visit the HSDB record page.

Emergency and supportive measures: Maintain an open airway and assist ventilation if needed. Treat hyperthermia, coma, rhabdomyolysis, and seizures if they occur. /Anticholinergics/

Specific drugs and antidotes: A small dose of physostigmine .... can be given to patients with severe toxicity (e.g., hyperthermia, severe delirium, or tachycardia). Caution: Physostigmine can cause AV block, asystole, and seizures, especially in patients with tricyclic antidepressant overdose. Neostigmine, a peripherally acting cholinesterase inhibitor, may be useful in treating anticholinergic-induced ileus. /Anticholinergics/

Decontamination: Administer activated charcoal orally if conditions are appropriate. Gastric lavage is not necessary after small to moderate ingestions if activated charcoal can be given promptly. Because of slowed gastrointestinal motility, gut decontamination procedures may be helpful even in late-presenting patients. /Anticholinergics/

Enhanced elimination: Hemodialysis, hemoperfusion, peritoneal dialysis, and repeat-dose charcoal are not effective in removing anticholinergic agents. /Anticholinergics/

For more Antidote and Emergency Treatment (Complete) data for BUTYLSCOPOLAMINE (7 total), please visit the HSDB record page.

Scopolamine butylbromide has extremely low oral bioavailability with only 0.25-0.82% reaching systemic circulation. Peak plasma concentration is reached 0.25-2 hours. Scopolamine butylbromide does not cross the blood brain barrier.

Mainly eliminated in the feces (69.7%) with very little in the urine (4.4%). Only 2.8% is eliminated via the bile owing to scopolamine butylbromide's poor absorption.

The volume of distribution is 128 liters.

Total clearace is 1.2 liters per minute.

After intravenous administration (100 mg as infusion), the plasma concentration of hyoscine butylbromide declines rapidly and the elimination half-life ranges between 1 and 5 hours. The total clearance is 1.2 L/min, of which 50% is excreted as unchanged drug through the kidneys . ... Elimination following oral administration is primarily via fecal excretion with a minor urinary component. /Hyoscine butylbromide/

Oral hyoscine butylbromide is poorly absorbed (8%) and has a low systemic bioavailability; blood levels are difficult to detect at therapeutic doses (e.g., 30-60 mg). ... Plasma levels were detectable only after a single oral dose of 500 mg, and the maximum plasma concentration observed was 5 ng/mL. The amount of drug recovered in urine after oral administration of the 500 mg dose was 0.16%. The bioavailability of oral hyoscine butylbromide (100 or 500 mg), based on urinary excretion data, was generally < 1%. The volume of distribution is 128 L. As a quaternary ammonium derivative, hyoscine butylbromide does not pass across the blood-brain barrier or enter the CNS. /Hyoscine butylbromide/