hyoscine-N-butylbromide Nursing Considerations & Management

 Drug Name

Generic Name: Hyoscine-N-butylbromideBrand Name:  Buscopan

Classification: Antispasmodic; Anticholinergic

Therapeutic Actions:

Hyoscine-N-butylbromide (HNBB) acts by interfering with the transmission of nerve impulses by acetylcholine in the parasympathetic nervous system.

Buscopan exerts a spasmolytic action on the smooth muscle of the gastrointestinal, biliary and urinary tracts. As a quaternary ammonium derivative, hyoscine-N- butylbromide does not enter the central nervous system. Therefore, anticholinergic side effects at the central nervous system do not occur. Peripheral anticholinergic effects result from a ganglion-blocking action within the visceral wall as well as from anti- muscarinic activity.

Indications:

Buscopan Tablets are indicated for the relief of spasm of the genito-urinary tract or gastro- intestinal tract and for the symptomatic relief of Irritable Bowel Syndrome

Presentation & Administration
Intravenous (IV)
  • 20mg in 1ml (solution)
  • Dilute required dose to 10ml with normal saline. Inject slowly over 3-5 minutes.
  • Compatible with the following IV fluids:
  • Normal saline, 5% glucose glucose and sodium chloride
  • May be given into the side arm when the above IV fluids are being infused. Store at room temperature. Protect from light.
IM or SC:
  • Inject undiluted into a large muscle mass or subcutaneously
Per-orem
  • Buscopan 10mg (white)
  • Gastro-Soothe 10mg (white)
Contraindications

Buscopan Tablets should not be administered to patients with myasthenia gravis, megacolon and narrow angle glaucoma. In addition, they should not be given to patients with a known hypersensitivity to hyoscine-N-butylbromide or any other component of the product.

Adverse Effects:
  • CNS: dizziness, anaphylactic reactions, anaphylactic shock, increased ICP, disorientation, restlessness, irritability, dizziness, drowsiness, headache, confusion, hallucination, delirium, impaired memory
  • CV: hypotension, tachycardia, palpitations, flushing
  • GI: Dry mouth, constipation, nausea, epigastric distress
  • DERM: flushing, dyshidrosis
  • GU: Urinary retention, urinary hesitancy
  • Resp: dyspnea, bronchial plugging, depressed respiration
  • EENT: mydriasis, dilated pupils, blurred vision, photopobia, increased intraocular pressure, difficulty of swallowing.
Nursing Considerations
  • Drug compatibility should be monitored closely in patients requiring adjunctive therapy
  • Avoid driving & operating machinery after parenteral administration.
  • Avoid strict heat
  • Raise side rails as a precaution because some patients become temporarily excited or disoriented and 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.