Yes

Analgesic, Combination (Narcotic); Antispasmodic Agent, Urinary

Relief of moderate to severe pain associated with rectal or bladder tenesmus that may occur in postoperative states and neoplastic situations; pain associated with ureteral spasms not responsive to non-narcotic analgesics and to space intervals between injections of opiates

C-II

C

Glaucoma, severe renal or hepatic disease, bronchial asthma, respiratory depression, convulsive disorders, acute alcoholism, premature labor

Usual precautions of opiate agonist therapy should be observed; infants <3 months of age are more susceptible to respiratory depression, use with caution and generally in reduced doses in this age group

>10%:

Dermatologic: Dry skin

Gastrointestinal: Constipation, dry throat, xerostomia

Local: Irritation at injection site

Respiratory: Dry nose

Miscellaneous: Diaphoresis (decreased)

1% to 10%:

Dermatologic: Increased sensitivity to light

Endocrine & metabolic: Decreased flow of breast milk

Gastrointestinal: Dysphagia

<1%: Orthostatic hypotension, ventricular fibrillation, tachycardia, palpitations, confusion, drowsiness, headache, loss of memory, fatigue, ataxia, CNS depression, rash, antidiuretic hormone release, bloated feeling, nausea, vomiting, constipation, biliary tract spasm, dysuria, urinary retention, urinary tract spasm, increased intraocular pain, blurred vision, weakness, respiratory depression, histamine release, physical and psychological dependence, diaphoresis

Primary attention should be directed to ensuring adequate respiratory exchange; opiate agonist-induced respiratory depression may be reversed with parenteral naloxone hydrochloride

Anticholinesterase inhibitors reduce acetylcholinesterase, the enzyme that breaks down acetylcholine and thereby allows acetylcholine to accumulate and compete for receptor binding with the offending anticholinergic

For an overdose with severe life-threatening symptoms, physostigmine 1-2 mg (0.5 mg or 0.02 mg/kg for children) S.C. or I.V., slowly may be given to reverse these effects

Decreased effect: Phenothiazines

Increased effect/toxicity: CNS depressants, tricyclic antidepressants

Store at 15°C to 30°C (avoid freezing)

Anticholinergic alkaloids act primarily by competitive inhibition of the muscarinic actions of acetylcholine on structures innervated by postganglionic cholinergic neurons and on smooth muscle; resulting effects include antisecretory activity on exocrine glands and intestinal mucosa and smooth muscle relaxation. Contains many narcotic alkaloids including morphine; its mechanism for gastric motility inhibition is primarily due to this morphine content; it results in a decrease in digestive secretions, an increase in GI muscle tone, and therefore a reduction in GI propulsion.

Onset of action: Belladonna: 1-2 hours; Opium: Within 30 minutes

Metabolism: Opium metabolized in the liver with formation of glucuronide metabolites

Elimination: Belladonna is excreted unchanged in urine

Adults: Rectal: 1 suppository 1-2 times/day, up to 4 doses/day

aminotransferase [ALT (SGPT)/AST (SGOT)] (S)

No information available to require special precautions

This drug has atropine-like effects and the patient may experience drowsiness; dry mouth, nose, and throat

If self-administered, use exactly as directed (do not increase dose or frequency); may cause physical and/or psychological dependence. Take with food or milk. While using this medication, do not use alcohol and other prescription or OTC medications (especially sedatives, tranquilizers, antihistamines, or pain medications) without consulting prescriber. Maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake). May cause hypotension, dizziness, or drowsiness (use caution when driving, climbing stairs, or changing position (rising from sitting or lying to standing) or when engaging in tasks requiring alertness until response to drug is known); dry mouth or throat (frequent mouth care, frequent sips of fluids, chewing gum, or sucking lozenges may help); constipation (increased exercise, fluids, or dietary fruit and fiber may help - if constipation remains an unresolved problem, consult prescriber about use of stool softeners); photosensitivity (use sunscreen, wear protective clothing and eyewear, and avoid direct sunlight); decreased perspiration (avoid extremes in temperature or excessive activity in hot environments). Report chest pain or palpitations; persistent dizziness; changes in mentation; changes in gait; blurred vision; shortness of breath or difficulty breathing. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Consult prescriber if breast-feeding.

Prior to rectal insertion, the finger and suppository should be moistened; assist with ambulation, monitor for CNS depression

Suppository:

#16 A: Belladonna extract 15 mg and opium 60 mg