Scopolamine (Isopto-Hyoscine, TransdermScop)

Category:

  • Nervous system  

Description:

  • Mydriatic, cycloplegic, antiemetic, antivertigo agent, anticholinergic

Indications:

  • Systemic: reduction of secretions before surgery, calm delirium

  • Transdermal: motion sickness, vertigo

  • Ophth: uveitis, iritis, cycloplegia, mydriasis

Contraindications:

  • Narrow-angle glaucoma, increased intraocular pressure, adhesions between iris and lens

  • Unstable cardiovascular status, myasthenia gravis, GI or GU obstruction

Precautions:

  • Pregnancy category C

  • Children, elderly, prostatic hypertrophy, Down’s syndrome

  • Debilitated COPD, asthma, CHF, hypertension, dysrhythmia, hiatal hernia

Adverse Reactions (Side Effects):

  • CNS: anxiety, confusion, delirium, delusions, depression, dizziness, drowsiness, excitement, headache, flushing, hallucinations, incoherence, irritability, restlessness

  • CV: palpitations, paradoxical bradycardia, postural hypotension, tachycardia

  • EENT: blurred vision, difficulty swallowing, dilated pupils, photophobia

  • GI: abdominal distress, constipation, dry mouth, paralytic ileus, nausea, vomiting

  • GU: hesitancy, retention

  • METAB: decreased sweating, fever

  • MISC: nasal congestion, suppression of lactation, urticaria

Dosage:

Administered topically, intravenously, intramuscularly, subcutaneously

  • Adult:            

    • Preoperatively: 

      • SC/IM/IV 0.32-0.65mg; dilute IV with sterile water; transderm 1.5mg

    • Uveitis or iritis: 

      • OPHTH 1-2 drops 3-4 times daily; 1-2 drops before refraction

    • Motion sickness: 

      • Place 1 patch behind ear 4-5 hours before travel, replace every 72 hours as needed

    • Nausea associated with analgesia and opiate anesthesia: 

      • Transderm 1.5mg every 72 hours

  • Child:            

    • OPHTH: 1-2 drops twice daily for 2 days before refraction

    • Preoperatively: 

      • SC 0.006 mg/kg or 0.2 mg/meter square

 
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