Scopolamine dosage

D-Cycloserine is a central partial agonist of NMDA receptors in place of P-glycine, which in low doses has shown an antagonism of cognitive deterioration induced by scopolamine. Confusion, disorientation, and memory loss have been observed at high doses. D-Cycloserine can provide a symptomatic treatment of AD at low dosage (Bowen et al. 1992 B. L. Schwartz et al. 1996). 

In the doses usually used, atropine has minimal stimulant effects on the CNS, especially the parasympathetic medullary centers, and a slower, longer-lasting sedative effect on the brain. Scopolamine has more marked central effects, producing drowsiness when given in recommended dosages and amnesia in sensitive individuals. In toxic doses, scopolamine, and to a lesser degree atropine, can cause excitement, agitation, hallucinations, and coma. 

Dimenhydrinate, which is promoted almost exclusively for the treatment of motion sickness, is a salt of diphenhydramine. The piperazines (cyclizine and meclizine) also have significant activity in preventing motion sickness and are less sedating than diphenhydramine in most patients. Dosage is the same as that recommended for allergic disorders (Table 16-2). Both scopolamine and the Hi antagonists are more effective in preventing motion sickness when combined with ephedrine or amphetamine. 

In low dosages scopolamine can produce effects on the CNS, presmnably due to its ability to penetrate the blood-brain barrier. Drowsiness and confusion are frequently reported. Patients also tend to exhibit a higher incidence of idiosyncratic reactions to scopolamine than to other anticholinergic agents, and, hence, it is not the drug of first choice for cycloplegic refraction or treatment of anterior uveal inflammations. Its use is reserved primarily fiar patients who exhibit sensitivity to atropine. 

Management of the ocular aspects of Reiter s syndrome is directed toward control of inflammation.The uveitis can be fairly severe and resistant to therapy. In most instances such topical steroids as 1% prednisolone acetate or 0.1% dexamethasone are recommended. Dosage is variable but in severe cases should be administered initially every 1 to 2 hours and accompanied by such cycloplegic agents as 5% homatropine or 0.25% scopolamine two to three times daily. Aggressive treatment reduces formation of synechiae and subsequent secondary glaucoma. In patients who have severe uveitis, either sub-Tenon s capsule or oral steroids may be used in conjimction with topical management. 

Transdermal drug delivery can be used in pediatric patients (1) to avoid problems of drug absorption from the oral route and complications from the intravenous route and (2) to maximize duration of effect and minimize adverse effects of drugs. Unfortunately, the commercially available transdermal dosage forms (e.g., clonidine and scopolamine) are not intended for pediatric patients these would deliver doses much higher than those needed for infants and children. 

This new dosage form recently was introduced to the pharmaceutical industry. Transdermal preparations now are commercially available for the alleviation of the symptoms of motion sickness (scopolamine), to provide symptomatic relief of angina pectoris (nitroglycerin), and for replacement estrogen therapy (estradiol), Transdermal systems offer advantages commonly associated with con-... 

Hyoscine-N-butyl bromide is a quaternary ammonium variant of hyoscine (scopolamine) formed by adding a butyl group to the tertiary amine group. It is mainly used to relieve temporal spasms of the intestine or menstrual cramps. It produces very moderate side effects, especially in the CNS. The long-term use of hyoscine-N-butyl bromide for the treatment of irritable bowel syndrome (IBS) has been reported as well (three daily doses of 10 mg). The dmg is available in oral dosage forms with doses of 10-35 mg. 

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