Hyoscine butylbromide Buscopan

Individuals on very small amounts of heroin are prescribed diazepam for anxiety, agitation or craving, zopiclone or zolpidem for insomnia, hyoscine butylbromide (Buscopan) for stomach cramps, and diphenoxylate/atropine (Lomotil) for diarrhoea, over a seven-day period. The medication schedule provided to the user explains which drug is for which symptoms, and the maximum doses of each that can be taken in a day, which for diazepam varies during the course. The basic medication regime is included in the Appendix. 

Asthmatic attacks due to non-narcotic analgesics, mostly occur in patients with so-called intrinsic or idiosyncratic asthma (often associated with nasal polyposis, sinusitis and eosinophilia of the blood) (McFadden and Austen 1977). About 10% of patients with this kind of asthma show severe reactions to aspirin, methyl-salicylate, pyrazolone derivatives, indomethacin, ibuprofen, diclofenac and sometimes even phenacetin and paracetamol. (Sodium salicylate is often tolerated.) The special reactivity may appear only in later life and concerns a number of chemically unrelated drugs. In some of these patients analgesic therapy with a morphine derivative such as pentazocine (Fortalgesic) or hyoscine butylbromide (Buscopan) may be necessary. However, in other patients, those with aspirin urticaria rather than asthma, the reaction may also rely on a drug-specific allergic mechanism (de Weck 1971). 

Buscopan contains hyoscine butylbromide, which is a quaternary ammonium compound with antimuscarinic properties. It is used as an antispasmodic and therefore may be useful in irritable bowel syndrome. Hyoscine butylbromide, as with all antimuscarinics, must be used with caution in patients with prostatic hypertrophy, as they may lead to urinary retention. 

Buscopan is a branded preparation containing hyoscine butylbromide, an antimuscarinic agent that reduces gastrointestinal motility. Antimuscarinic agents are contraindicated in cases of angle-closure glaucoma as they may aggrevate the condition. Hyoscine butylbromide is a quaternary ammonium compound, unlike atropine, which is a tertiary ammonium compound. 

Several other atropine-like drugs are used as antispasmodics. These include homatropine, hyoscine, hyoscine-n-butylbromide (Buscopan), propantheline (Pro-Banthine). Some care should be exercised in their use in children and the elderly, as relative overdosage has been reported, leading to signs of hyoscine poisoning. 

Hyoscine butylbromide (strictly N-butylhyosdne bromide, Buscopan) also blocks autonomic ganglia. If injected, it is an effective relaxant of smooth muscle, including the cardia in achalasia, the pyloric antral region and the colon, which properties are utilised by radiologists and endoscopists. It may sometimes be useful for colic. 

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