Belladonna adverse effects

Because chlorpromazine (CPZ, aka Thorazine) had commonly been used clinically to treat belladonna-induced delirium, George Aghajanian tested its effectiveness in reversing cognitive impairment in NF% scores when given in doses of either 25 or 50 mg of Thorazine at 45 minutes (Fig. 72). Decrements in NF% scores were actually increased by chlorpromazine - clearly an adverse effect on cognitive function rather than a beneficial one. 

The most common source of belladonna in the U.S. is in legitimate medicines (asthma preparations, particularly Asthmador, contain belladonna) so this accounts for some of the problems. Also, you will notice traces of belladonna alkaloids in such drugs as Contac capsules and other cold remedies, though in these the adverse effects are minimal, and virtually unnoticeable. Overdose potential on purer forms, including wild jimson weed and Asthmador, is very great. 

Systemic administration of belladonna alkaloids or their derivatives for bronchial asthma or COPD carries the disadvantage of reducing bronchial secretions and inspissation of the residual secretions. This viscid material is difficult to remove from the respiratory tree, and its presence can dangerously obstruct airflow and predispose to infection. By contrast, ipratropium and tiotropium, administered by inhalation, do not produce adverse effects on mucocfliary clearance, and can be used safely in the treatment of airway disease see Chapter 27). 

Numerous other cases of belladonna intoxication have been reported in the literature and include adverse effects from accidental or intentional consumption of the leaf, berry, or root of belladonna (e.g., Ceha et al. 1997 Gabel 1968 Gibbons 1954 Lange and Toft 1990 Minors 1948 Montoya et al. 2009 Schneider et al. 1996 Southgate et al. 2000 Trabattoni et al. 1984). 

Geriatric Considerations - Summary Belladonna possesses potent anticholinergic effects and can cause dry mouth, blurred vision, delirium, confusion, psychosis, and increased risk of falls. Opium is a narcotic and when discontinued, physical dependence and withdrawal symptoms can occur. Adverse G1 effects include constipation and abdominal pain. This compound has no role in treating the older adult. 

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