Propantheline

Oral
Adult enuresis, Hyperhidrosis, Urinary incontinence

Oral
Adjunct in peptic ulcer, Gastrointestinal tract spasm

Should be taken on an empty stomach. Take 30 min before meals and at bedtime.

Glaucoma, obstructive diseases of GI or urinary tract, severe ulcerative colitis or toxic megacolon, intestinal atony, hiatus hernia associated with reflux oesophagitis, unstable cardiovascular adjustment in acute bleeding, prostatic enlargement, myasthenia gravis, paralytic ileus, pyloric stenosis, angle-closure glaucoma.

Hyperthyroidism, congestive heart failure, coronary heart disease, cardiac arrhythmias, acute MI, cardiac insufficiency, hypertension. Pregnancy and lactation; elderly. Patients with fever, diarrhoea, GI reflux disease or ulcerative colitis. Hepatic or renal impairment. Increased risk of fever or heat stroke in patients exposed to high environmental temperature. Caution when used in patients with Down's syndrome.

Dry mouth, thirst, difficulty in swallowing, skin dryness, flushing, reduced sweating, heat stroke, constipation, nausea and vomiting. Pupil dilatation with loss of accomodation and increased sensitivity to light; increased intra-ocular pressure. Bradycardia followed by tachycardia, arrhythmias and palpitations. Glaucoma, urinary hesitancy and retention, orthostatic hypotension especially in elderly.
Potentially Fatal: Toxic megacolon due to preexisting ulcerative colitis.

PO: C

Severe intoxication may result in convulsion, circulatory failure, coma, delirium, resp depression, restlessness and hallucinations. Treatment: Empty the stomach and administer activated charcoal. Supportive treatment (e.g. oxygen, admin of fluids and assisted ventilation) is recommended. In severe cases, the use of IV physostigmine may be considered.

Additive anticholinergic effect with MAOIs, TCAs, phenothiazines, antihistamines and disopyramide. Delayed gastric emptying causes delayed absorption of other drugs. May antagonise the GI effects of domperidone, cisapride and metoclopramide. May reduce absorption of ketoconazole and levodopa. May increase absorption of nitrofurantoin. May increase serum levels of digoxin. May reduce effects of haloperidol and sublingual tablets of nitrates. May antagonise effects of parasympathomimetics.

Description: Propantheline bromide is a quarternary ammonium antimuscarinic with antisecretory and antispasmodic effects.
Duration: About 6 hr.
Pharmacokinetics:
Absorption: Incompletely absorbed.
Metabolism: Extensive metabolism in small intestines.
Excretion: Mainly in urine as metabolites and <10% excreted as unchanged drug.

Oral:
Adjunct in peptic ulcer,Gastrointestinal tract spasm: Store below 25°.

Antispasmodics