Propantheline anticholinergic

Anticholinergics (cholinergic blocking drug) reduce gastric motility and decrease the amount of acid secreted by the stomach (see Chap. 25). Examples of anticholinergics used for GI disorders include propantheline (Pro-Banthine) and glycopyrrolate (Robinul). 

Contraindications GI or genitourinary (GU) obstruction, myasthenia gravis, narrow-angle glaucoma, toxic megacolon, severe ulcerative colitis, unstable cardiovascular adjustment in acute hemorrhage, hypersensitivity to propantheline or other anticholinergics... 

Geriatric Considerations - Summary Propantheline is a peripheral anticholinergic drug that does not cross the blood-brain barrier so should cause less risk of psychosis and other central effects. Other anticholinergic side effects such as urinary retention and decreased bowel motility do occur and can limit the usefulness of this drug. 

Metoclopramide Anticholinergic drugs such as atropine, benzhexol, propantheline, narcotic analgesics Antagonism - they have opposing effects on gastrointestinal activity. 

Anticholingergic drugs such as propantheline should be taken 1 h before meals. Anticholinergic drugs are able to inhibit the secretion of gastric juice, which is ordinarily stimulated by food. 

Colitis may result from various gut infections, especially amoebic colitis. Clindamycin, vancon cin or metronidazole may be used in treatment. The diarrhoea of colitis states may be treated with normal ANTIDIARRHOEALS, e.g. the opioids codeine, morphine, diphenoxylate and loperamide. The colic may respond to ANTISPASMODICS, e.g. the anticholinergics atropine, hyoscine, dicyclomine, propantheline. Meheverine is a direct-acting antispasmodic effective in some types of gut colic. 

Some of the drugs responsible are amitriptyline, amoxapine, atropine, benztropine, biperiden, didinium, cyclobenzaprine, desipramine, doxepin, hyoscyamine, imipramine, lorazepam, maprotiline, nortriptyline, protriptyline, propantheline, scopolamine, trimipramine. Some herbals that can elicit the anticholinergic syndrome are black henbane, deadly nightshade, Devil s apple, Jimson weed, Loco seeds or weeds, Matrimony vine, night blooming jessamine, stinkweed. 

Propantheline, a quaternary ammonium anticholinergic and potential treatment, produces a high incidence of adverse effects and is only modestly effective for UUI. " When used, propantheline appears to be best tolerated at a dose of no more than 15 mg three times daily plus 60 mg at bedtime. ... 

Propantel Prop-antelina bromuro Propantheline bromide PiDpanthelini bromidum SC-3171 Xanthene- carboxylic acid, ester with (2-hydroxyethyi)diisoprapylmethylammonium brom-ide. Anticholinergic agent, mp - 159-161 very soluble in H2O, EtOH, CHQ3, insoluble in Et20, CeHe. Ellis Everard. 

Diphenoxylate and anticholinergic drugs such as propantheline can double the absorption of nitrofurantoin in some patients, but the clinical importance of this is uncertain. 

---