Scopolamine - Stepwards

Page Contents

1 WHAT IS IT?
2 WHEN DO WE USE IT?
3 WHEN DO WE AVOID USING IT?
4 HOW IS IT ADMINISTERED?
5 WHAT ARE THE SIDE EFFECTS/TOXICITY?
6 ANYTHING ELSE TO KEEP IN MIND?
7 FURTHER READING

WHAT IS IT?

Scopolamine is an anticholinergic that acts on the central nervous system. It is a selective anticholinergic that acts on only the muscarinic receptors (and does not block the nicotinic receptors). It is for this reason that this medication can block acetylcholine activity in the gut (which is mediated by muscarinic receptors) while leaving acetylcholine signaling unchanged in the skeletal muscle (which are mediated by nicotinic receptors).

WHEN DO WE USE IT?

Vertigo: BPPV

Motion sickness: this medication can help patients who become nauseous in situations such as car-rides, boat-rides, etc.

Post anesthesia nausea: patients who are at higher risk of nausea after procedures (ex. patients with past history of feeling nausea after general anesthesia) can be given scopolamine prophylactically to prevent it from occurring.

WHEN DO WE AVOID USING IT?

Older patients (>65 years old) given the risk anticholinergics have for causing delirium.

Angle-closure glaucoma: patients with this condition should not receive medications that tonically will dilate the eyes.

HOW IS IT ADMINISTERED?

Orally, IM, IV, or percutaneously by a patch.

WHAT ARE THE SIDE EFFECTS/TOXICITY?

CNS depression

ANYTHING ELSE TO KEEP IN MIND?

Dilated pupils can be the result of administering medications like scopolamine (which can cause parasympathetic dysfunction). It will not constrict with the administration of undiluted pilocarpine (I%) due to pharmacologic blockade.