Document Code No.

CHS/BSN-CURR -RLEFORM-002d
Revision No. Effective Date Page No.
00 02.24.2023 1 of 1

DRUG STUDY

Brand Name: Buscopan Generic NameHyoscine-N-butylbromide (HnBB) Drug Classification: Antispasmodic; Anticholinergic

Dosage, Route & Frequency Drug-Drug &

Side Effects Adverse Reactions
Drug Action Drug-Food Indications Contraindications
Recommended Prescribed Interactions (By System) (By System)
Always take your Hyoscine N- Drug-Drug: Buscopan Tablets are Buscopan Tablets should Anticholinergic side Immune system disorders:
Tablet: Adults and children medicine exactly as butylbromide (HnBB) indicated for the relief of not be administered to effects of Hyoscine-N- Anaphylactic shock including
over 6 years: 1-2 sugar coated your doctor or elieves the pain by The anticholinergic effect spasm of the genito- patients with myasthenia butylbromide fatal outcome, anaphylactic
tablets 3-5 times daily. pharmacist has told you. acting on the muscle of drugs such as tri- and urinary tract or gastro- gravis, megacolon and (BUSCOPAN) are reactions, dyspnoea, skin
The tablets should be You should check with spasm which causes tetracyclic intestinal tract and for narrow angle glaucoma. In generally mild and reactions (e.g. urticaria, rash,
swallowed whole with your doctor or the pain. antidepressants, the symptomatic relief of addition, they should not be self-limited. erythema, pruritus) and other
adequate fluid. pharmacist if you are antihistamines, irritable bowel given to patients with a hypersensitivity.
not sure. BUSCOPAN Hyoscine-N- antipsychotics, quinidine, syndrome. known hypersensitivity to
Injection: Adults and Tablets should not be butylbromide amantadine, hyoscine-N-butylbromide or Cardiac disorders:
adolescents over 12 years: 1-2 taken continuously for (BUSCOPAN) exerts disopyramide and other Tablet: It is an any other component of the Tachycardia.
ampoules of Hyoscine-N- long periods of time. a spasmolytic action anticholinergics (e.g. antispasmodic used for product. Gastrointestinal disorders: Dry
butylbromide (BUSCOPAN) on the smooth tiotropium, ipratropium, gastrointestinal tract mouth.
(20-40 mg) may be Taking this medicine muscle of the gastro- atropine-like spasm, spasm and Tablet: In case of rare
administered by slow Take your tablets with intestinal, biliary and compounds) may be dyskinesia of the biliary hereditary conditions that Skin and subcutaneous tissue
intravenous, intramuscular or water genito-urinary tracts. intensified by Hyoscine- system and may be incompatible with an disorders: Dyshidrosis.
subcutaneous injection several Do not break, crush or N-butylbromide genitourinary tract excipient of the product, the
times daily. chew the tablets As a quaternary (BUSCOPAN). spasm. use of the product is Renal and urinary disorders:
The maximum daily dose of How much to take ammonium contraindicated. Urinary retention.
100 mg should not be Adults and children over derivative, hyoscine Concomitant treatment Injection: Acute gastro-
exceeded. 12 years butylbromide does with dopamine intestinal, biliary and Injection: untreated narrow Injection: Eye disorders:
not enter the central antagonists such as genitourinary spasm, angle glaucoma, Accommodation disorders,
Infants and children: In severe The usual dose is two nervous system. metoclopramide may including biliary and hypertrophy of the prostate mydriasis, increased
cases: 0.3-0.6 mg/kg tablets 4 times a day result in diminution of the renal colic. As an aid in with urinary retention, intraocular pressure.
bodyweight, to be administered For Irritable Bowel Therefore, effects of both drugs on diagnostic and tachycardia.
by slow intravenous, Syndrome, your doctor anticholinergic side the gastrointestinal tract. therapeutic procedures, By intramuscular injection, Vascular disorders: Blood
intramuscular or subcutaneous may give you a lower effects at the central The tachycardic effects where spasm may be a Hyoscine-N-butylbromide pressure decreased,
injection several times daily. starting dose of one nervous system do of beta-adrenergic problem, e.g. gastro- (BUSCOPAN) ampoules are dizziness, flushing.
The maximum daily dose of tablet 3 times a day. not occur. Peripheral agents may be duodenal endoscopy, contraindicated: in patients
1.5 mg/kg bodyweight should This dose may be anticholinergic action enhanced by Hyoscine- and in radiology. being treated with
not be exceeded. increased, if further results from a N-butylbromide anticoagulant drugs since
relief is necessary ganglion-blocking (BUSCOPAN). intramuscular hematoma
Children 6 – 12 years: action within the may occur. In these patients,
visceral wall as well Drug-Food: the subcutaneous or
The usual dose is one as from an anti- intravenous routes may be
tablet 3 times a day muscarinic activity. Buscopan does not used.
BUSCOPAN Tablets are usually upset your
not recommended for stomach, so you can
children under 6 years. take it with or without
food.
If you take more
BUSCOPAN Tablets
than you should
If you take more
BUSCOPAN Tablets
 than you should, talk to
a doctor or go to a
hospital straight away.
Take the medicine pack
with you even if there
are no BUSCOPAN
Tablets left.

If you forget to take

BUSCOPAN Tablets
If you forget a dose,
take it as soon as you
remember. However, if it
is time for the next dose,
skip the missed dose.
Do not take a double
dose to make up for a
forgotten dose.

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment: Implementation
Obtain baseline vital signs, assess urine output, check medical history, obtain patient’s during drug Determine fluid intake and output and assess bowel sounds
history Examine for constipation caused by decrease in GI motility.
Administer medication as prescribed
Diagnosis Drug compatibility should be monitored closely in patients requiring adjunctive therapy
Impaired urinary elimination related to urinary retention Avoid driving & operating machinery after parenteral administration.
Avoid strict heat
Planning Raise side rails as a precaution because some patients become temporarily excited or disoriented and
Patient will not have side effects that may become a health problem some develop amnesia or become drowsy.
Reorient patient, as needed, Tolerance may develop when therapy is prolonged
Atropine-like toxicity may cause dose related adverse reactions. Individual tolerance varies greatly
Oerdose may cause curare-like effects, such as respiratory paralysis. Keep emergency equipment
available.

Evaluation
Evaluate patient’s response to the anticholinergic

EVALUATION TOOL:
UNACCEPTABLE
1-7
Only a few of the drugs were listed down; or some drugs were not
listed down; intended indication and mechanism of action of the
given medication/s as well as the side-effects, contraindications and
nursing responsibilities were incorrect and not relevant to the
assigned patient
SATISFACTORY EXCEPTIONAL REMARKS
8-12 13-20
some drugs were not listed down; intended indication and mechanism Listed down all the drugs; intended indication and
of action of the given medication/s as well as the side-effects, mechanism of action of the given medication/s as well as
contraindications and nursing responsibilities were correct and relevant the side-effects, contraindications and nursing
to the assigned patient responsibilities were correct and relevant to the assigned
patient

Antispasmsmoodics and Anticholinergic

- The anticholinergics and antispasmodics are a group of medicines that include the natural belladonna alkaloids (atropine, belladonna, hyoscyamine, and
scopolamine) and related products.
- The anticholinergics and antispasmodics are used to relieve cramps or spasms of the stomach, intestines, and bladder. Some are used together with antacids or
other medicines in the treatment of peptic ulcers. Others are used to prevent nausea, vomiting, and motion sickness.
- Anticholinergics and antispasmodics are also used in certain surgical and emergency procedures. In surgery, some are given by injection before anesthesia to help
relax you and to decrease secretions, such as saliva. During anesthesia and surgery, atropine, glycopyrrolate, hyoscyamine, and scopolamine are used to help keep
 the heartbeat normal. Scopolamine is also used to prevent nausea and vomiting after anesthesia and surgery. Atropine is also given by injection to help relax the
stomach and intestines for certain types of procedures.
- Anticholinergics are used to treat poisoning caused by medicines such as neostigmine and physostigmine, certain types of mushrooms, and “nerve” gases or
organic phosphorous pesticides (eg, demeton [Systox®], diazinon, malathion, parathion, and ronnel [Trolene®]). Anticholinergics can be used for painful
menstruation, runny nose, and to prevent urination during sleep.

Like all medicines, BUSCOPAN Tablets can cause side effects, although not everybody gets them. The following side effects may happen with this medicine.

Stop taking your medicine and see a doctor straight away if you notice any of the following serious side effects - you may need urgent medical treatment:
• Allergic reactions such as skin reactions e.g. nettle rash, itching (affects fewer than 1 in 100 people), rash, redness of the skin
• Severe allergic reactions (anaphylactic shock) such as difficulty breathing, feeling faint or dizzy (shock)
• Painful red eye with loss of vision
Other side effects
• Dry mouth (affects fewer than 1 in 100 people)
• Abnormal sweating or reduced sweating (affects fewer than 1 in 100 people)
• Increased heart rate (affects fewer than 1 in 100 people)
• Being unable to pass water (urine) (affects fewer than 1 in 1,000 people)

AR:
1. CNS: dizziness, anaphylactic reactions, anaphylactic shock, increased ICP, disorientation, restlessness, irritability, dizziness, drowsiness, headache, confusion, hallucination, delirium, impaired memory
2. CV: hypotension, tachycardia, palpitations, flushing
3. GI: Dry mouth, constipation, nausea, epigastric distress
4. DERM: flushing, dyshidrosis
5. GU: Urinary retention, urinary hesitancy
6. Resp: dyspnea, bronchial plugging, depressed respiration
7. EENT: mydriasis, dilated pupils, blurred vision, photophobia, increased intraocular pressure, difficulty of swallowing.

Active management of labor is a part and parcel of modern obstetrics. There are various mechanical and pharmacological
methods by which the cervical dilatation can be facilitated e.g., sweeping of membranes and stretching of the cervix causes
local release of prostaglandins resulting in reduction in the need for formal induction of labor, amniotomy, cervical application of
relaxin, estradiol and hylase, prostaglandins in various formulations for induction of labor, especially PGE2 gel for cervical
ripening. Oxytocin is proven to induce and augment labor. Buscopan (Hyoscine Butyl-N-Bromide) and Scopolamine have been
used for pain relief and shortening of labor. Epidosin (Valethemate bromide) has neurotropic and musculotropic actions,
resulting in relaxation of cervical musculature leading to quick dilatation of cervix and shortened labor. Drotaverine hydrochloride
shortens duration of the dilatation stage of labor [4]. Anafortan (Camylofin Dihydrochloride) is a selective PDE-4 enzyme
inhibitor which facilitates cervical effacement and dilatation, accelerates labor, regulates the autonomic system and thereby
prevents disordered progress of labor.

It was concluded that Anafortan is a potent and effective drug to shorten the first stage of labor. Its effect on shortening duration
of labor is significantly better than Epidosin + Buscopan group. However both the drugs have almost similar side effects and
have no effect on uterine activity. Both the drugs have no effect on second and third stage of labor as regards to duration or
complications. The difference between the two groups as regards to instrumental delivery was insignificant. Neonatal outcome
was not affected in both the groups.