Yes

Anticholinergic Agent; Antispasmodic Agent, Gastrointestinal

Adjunct in treatment of peptic ulcer disease, irritable bowel, spastic colitis, spastic bladder, and renal colic

C

Hypersensitivity to hyoscyamine, atropine, scopolamine, phenobarbital, or any component; narrow-angle glaucoma, tachycardia, GI and GU obstruction, myasthenia gravis

Use with caution in patients with hepatic or renal disease, hyperthyroidism, cardiovascular disease, hypertension, prostatic hypertrophy, autonomic neuropathy in the elderly; abrupt withdrawal may precipitate status epilepticus. Because of the anticholinergic effects of this product, it is not recommended for use in the elderly.

>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, rash, bloated feeling, nausea, vomiting, dysuria, increased intraocular pain, blurred vision

Symptoms of overdose include unsteady gait, slurred speech, confusion, hypotension, respiratory collapse, dilated unreactive pupils, hot or flushed skin, diminished bowel sounds, urinary retention

Anticholinergic toxicity is caused by strong binding of the drug to cholinergic receptors. 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 anticholinergic 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.

Increased toxicity: CNS depressants, coumarin anticoagulants, amantadine, antihistamine, phenothiazides, antidiarrheal suspensions, corticosteroids, digitalis, griseofulvin, tetracyclines, anticonvulsants, MAO inhibitors, tricyclic antidepressants

Refer to individual agents

Absorption: Well absorbed from GI tract

Oral:

Children: Donnatal® elixir: 0.1 mL/kg/dose every 4 hours; maximum dose: 5 mL OR see below for alternative dose (mL) based on weight (kg):

4.5 kg: 0.5 mL q4h OR 0.75 mL q6h

10 kg: 1 mL q4h OR 1.5 mL q6h

14 kg: 1.5 mL q4h OR 2 mL q6h

23 kg: 2.5 mL q4h OR 3.8 mL q6h

34 kg: 3.8 mL q4h OR 5 mL q6h

greater than or equal to 45 kg: 5 mL q4h OR 7.5 mL q6h

Adults: 1-2 capsules or tablets 3-4 times/day; or 1 Donnatal® Extentab® in sustained release form every 12 hours; or 5-10 mL elixir 3-4 times/day or every 8 hours

Should be administered 30-60 minutes before meals unless otherwise directed

No information available to require special precautions

>10% of patients experience dry mouth (normal salivary flow returns with cessation of drug therapy)

See individual agents. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to get pregnant. Consult prescriber if breast-feeding.

Do not crush extended release tablets

Capsule (Donnatal®, Spasmolin®): Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg, scopolamine hydrobromide 0.0065 mg, and phenobarbital 16.2 mg

Elixir (Donnatal®, Hyosophen®, Spasmophen®): Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg, scopolamine hydrobromide 0.0065 mg, and phenobarbital 16.2 mg per 5 mL (120 mL, 480 mL, 4000 mL)

Tablet:

Barbidonna®: Hyoscyamine hydrobromide 0.1286 mg, atropine sulfate 0.025 mg, scopolamine hydrobromide 0.0074 mg, and phenobarbital 16 mg

Barbidonna® No. 2: Hyoscyamine hydrobromide 0.1286 mg, atropine sulfate 0.025 mg, scopolamine hydrobromide 0.0074 mg, and phenobarbital 32 mg

Donnatal®, Hyosophen®: Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg, scopolamine hydrobromide 0.0065 mg, and phenobarbital 16.2 mg

Long-acting (Donnatal®): Hyoscyamine sulfate 0.3111 mg, atropine sulfate 0.0582 mg, scopolamine hydrobromide 0.0195 mg, and phenobarbital 48.6 mg

Spasmophen®: Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg, scopolamine hydrobromide 0.0065 mg, and phenobarbital 15 mg