Hyoscyamine treatment

Geriatric Considerations-Summary Hyoscyamine and related anticholingerics have limited benefits in the treatment of GI tract disorders and present significant risk to older adults. These drugs possess potent anticholinergic effects and can cause cognitive impairment, delirium, dry mouth, blurred vision, and increased risk of falls. The use of this drug and related compounds should be limited and when used, patients should be closely monitored. 

Uses antidote for excessive cholinergic stimulation tremor treatment wide angle glaucoma stomach disorders preanesthesia Arco-Lase Plus -mixture of enzymes, hyoscyamine, atropine, and phenobarbital Donnatal -hyoscyamine, atropine, scopolamine, and phenobarbital... 

Treatment of colitis Donnatal and Kinesed - mixture of phenobarbital, scopolamine, hyoscyamine, atropine (what a combination )... 

Atropine is a racemic compound but the (S)-enantiomer occurs in henbane (tfyoscyamus niget ) and was given a different name, hyoscyamine, before the structures were known. In fact, hyoscyamine racemizes very easilyjust on heating in water or on treatment with weak base. This is probably what happens in the deadly nightshade plant. 

Atropine does not occur as such in the solanaceae plants but is formed from the hyoscyamine present by treatment with dilute alkalies, when isomerization takes place and the inactive form of the alkaloid is obtained. It is crystalline, m.p. 115.5°, and only slightly soluble in water but soluble in alcohol and chloroform. The salts are crystalline and soluble in water. 

Atropine is the racemic mixture of l- and o-hyoscya-mine and possesses 50% of the antimuscarinic potency of L-hyoscyamine. Atropine is derived from components of the Belladonna plant and is also present in other plants from the Solanaceae family. Women in ancient times often dripped the plant s juices into their eyes, causing mydriasis and thereby enhancing their beauty. In Italian, Belladonna translates to beautiful lady . In the United States, the atropine autoinjector has been in use since 1973 for the treatment of exposures to chemical warfare nerve agents and insecticides. 

Conventional methods of alkaloid isolation are used to obtain a crude mixture of atropine and (-)-hyoscyamine from the plant products. This crude mixture of alkaloids is racemizedto atropine by refluxing in chloroform or by treatment with cold dilute alkali (67). 

Scopolamine (hyoscine) is isolated from the mother liquor remaining after the isolation of hyoscyamine, and is marketed as its hydrobromide. Scopolamine is readily race-mized to atroscine, when subjected to treatment with dilute alkali. 

Alkaloids in Belladonnae, Hyoscyami and Stramonii folium (1-3). The tropane alka-loid.s (-)-hyoscyamine (during extraction procedures partly changed into ( ) atropine) and scopolamine as major compounds of the aUcaloidal fraction of Solanaceae drugs respond to Dragendorff reagent with orange, unstable colour. Treatment with NaNO, increa.ses the colour stability of the hyoscyamine zones. 

The use of elicitors can significantly enhance the production of metabolites. The elicitors are divided mainly in two groups. The biotic elicitors which are compounds of biological origin (e.g. fungal spores, fungal cell wall fractions, cellulase, chitosane) and the abiotic elicitors which include metal ions, high salt concentrations, UV radiations, sonication. Treatment of Hyoscyamus muticus hairy roots with 50-500 jig/ml of chitosane resulted in a 5-fold increase in the accumulation of hyoscyamine [84]. Similar results were obtained by Halperin and Flores [85] who obtained, with hairy roots of the same species, hyoscyamine up to 6-fold when elicited with mannitol. 

Another important natural product lead compound is the tropane alkaloid ester atropine [( )-hyoscyamine], from the piant Atropa belladonna (deadiy nightshade) Atropine has served as a prototype moiecuie for severai antichoiinergic and antispasmodic drugs. One recentiy introduced exampie cf an antichoiinergic compound modeied on atropine is tiotropium bromide, which is used fcr the maintenance treatment of bronchospasm associated with chronic obstructive puimcnary disease (54). 

Based on the above reports we investigated the possibility of using "hairy root" cultures in studies of secondary metabolism. We focused on the tropane alkaloids, synthesized in the roots of various Solanaoeae genera (Atropa, Datura, Brugmanaia, Hyosayamua, and Duboisia). Hyoscyamine and scopolamine are widely used in narcotic medicine as sedatives and in the treatment of sea sickness. Scopolamine tilso happens to be the best known antidote against nerve gas. 

A review of 16 trials was conducted by Grigoleit and Grigoleit in 2005. They concluded that there was reasonable evidence that the administration of enteric-coated peppermint oil (180 200 mg) thrice daily was an effective treatment for irritable bowel syndrome when compared to placebo or the antispasmodic drugs investigated (mebeverine, hyoscyamine, and alverine citrate). 

---