ANTI-SPASMODIC

DRUGS
Antispasmodic drugs
-drugs used to treat symptoms such as
pain and spasm in irritable bowel syndrome.

• There are two main classes of antispasmodic ,

the antimuscarinic drugs and drugs that are
direct smooth muscle relaxants.
Antimuscarinic drugs

• These drugs block cholinergic transmission at

parasympathetic postganglionic nerve and cause smooth
muscle to relax. The synthetic antimuscarinic dyclomine
and propantheline are probably the most useful in IBS
(irritable bowel syndrome), but therapeutic efficacy is
often limited by other anticholinergic effects. The drugs are
contraindicated in patients with glaucoma and prostatism,
and should be avoided in patients with gastro-esophageal
reflux.
Direct smooth muscle relaxants

• Mebeverine is a reserpine derivative that has a direct

effect on colonic muscle activity, especially, it appears,
on colonic hypermotility. As it does not possess
antimuscarinic activity, it does not exhibit the
troublesome effects of that group of drugs.

• Alverine and peppermint oil also have direct smooth

muscle relaxing activity
Mechanism of Action

• Movement of food along the gut occurs because of the

regular relaxation and contraction of muscles of gut.
• In conditions such as IBS these muscle contractions can
occur too often or be painful, causing symptoms such as pain
and bloating.
• Anti muscarinics work by attaching to the muscarinic
receptors and stopping the chemicals to act and make
muscle contract.
• Reducing muscle contractions in this way often helps to
relieve some of the symptoms caused by IBS.
• Hyoscine Butylbromide
MOA: Also known as scopolamine butylbromide and sold
under brandname Buscopan has anticholinergic action. Its
high affinity for muscarinic receptors located on the GI
tract exerts a smooth-muscle relaxing/spasmolytic effect.

• Dicyclomine
• Has direct smooth muscle relaxant action and weak anti
cholinergic
• Exerts anti spasmodic action
• Also has anti-emetic property
• Drotaverine
• A novel non anticholinergic smooth muscle relaxant
• Exerts anti spasmosdic action
Nursing considerations
• Be alert for adverse reactions and drug
interactions.
• Assess for urinary hesitancy
• Assess for constipation
• Encourage patient to void
• Monitor BP for possible hypertension
• For pregnant women, monitor cervical
effacement and dilatation.