Note: this monograph does not apply to hyoscine butylbromide (see previous entry)
ADMINISTRATION ROUTES:
IV, IM, SC
ALTERNATIVE NAMES:
Scopolamine hydrobromide
ICU INDICATIONS:
- Reduction of respiratory tract and oral secretions (particularly in the palliative setting)
Note: for this indication, hyoscine butylbromide is preferred by the palliative care team.
PRESENTATION AND ADMINISTRATION:
IV:
0.4 mg in 1 mL (solution)
Store at room temperature. Protect from light.
Dilute required dose to 10 mL with Normal saline. Inject slowly over 3-5 minutes.
Compatible with the following IV fluids: Normal saline, 5% Glucose, Hartmanns
IM or SC:
Inject undiluted into a large muscle mass or subcutaneously
DOSAGE:
IV, IM, SC:
0.3 - 0.6 mg 6-8 hourly
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
Dose as in normal renal function
DOSAGE IN PAEDIATRICS:
IV, IM, SC:
6-8 mcg/kg 6-8 hourly
CLINICAL PHARMACOLOGY:
Hyoscine hydrobromide is one of the major antimuscarinic agents that inhibit the action of acetylcholine (ACh) on autonomic effectors innervated by postganglionic cholinergic nerves as well as on smooth muscles that lack cholinergic innervation. It exerts little effects on the actions of ACh at nicotinic receptor sites such as autonomic ganglia.
CONTRAINDICATIONS:
- Hypersensitivity to hyoscine hydrobromide
WARNINGS:
May cause significant sedation
PRECAUTIONS:
General:
Because of the tachycardic effects of the drugs, care must be exercised when tachycardia, other tachyarrhythmias, coronary heart disease, congestive heart disease or hyperthyroidism preexist.
Laboratory Tests:
No tests in addition to routine ICU tests are required
Drug/Laboratory Test Interactions:
None known
IMPORTANT DRUG INTERACTIONS IN ICU:
Other drugs, such as phenothiazines, tricyclic antidepressants, certain antihistamines, which have weak antimuscarinic activity, may considerably intensify the effects of antimuscarinic drugs.
ADVERSE REACTIONS:
Body as a Whole:
Suppression of sweating causes reflexive flushing and heat intolerance
Nervous System:
Sedation, confusion, hallucinations
Cardiovascular:
Hypotension, tachycardia
Gastrointestinal:
Dry mouth
Urogenital:
Urinary Retention