Hyoscine Hydrobromide

Hyoscine Hydrobromide

[1 vial $1.37]

Note: this monograph does NOT apply to hyoscine butyl bromide

ADMINISTRATION ROUTES:

  • IV, IM, SC

ALTERNATIVE NAMES:

  • Scopolamine hydrobromide

ICU INDICATIONS:

  1. reduction of respiratory tract and oral secretions (particularly in the palliative setting). Note, for this indication, hyoscine butylbromide is preferred by the palliative care team.

PRESENTATION AND ADMINISTRATION:

  • IV:
    0.4mg in 1ml (solution)
    Dilute required dose to 10ml with normal saline. Inject slowly over 3-5 minutes.
    Compatible with the following IV fluids:
    Normal saline, 5% glucose, Hartmanns
    Store at room temperature. Protect from light.
  • IM or SC:
    Inject undiluted into a large muscle mass or subcutaneously

DOSAGE:

  • IV, IM, SC:
    0.3-0.6 mg 6-8 hourly

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

  • Dose as in normal renal function

DOSAGE IN PAEDIATRICS:

  • IV, IM, SC:
    6-8mcg/kg 6-8 hourly

CLINICAL PHARMACOLOGY:

  • Hyoscine hydrobromide is one of the major antimuscarinic agents that inhibit the action of acetylcholine (ACh) on autonomic effectors innervated by postganglionic cholinergic nerves as well as on smooth muscles that lack cholinergic innervation. It exerts little effects on the actions of ACh at nicotinic receptor sites such as autonomic ganglia.

CONTRAINDICATIONS:

  • hypersensitivity to hyoscine hydrobromide

WARNINGS

  • May cause significant sedation

RECAUTIONS

  • General:
    Because of the tachycardic effects of the drugs, care must be exercised when tachycardia, other tachyarrhythmias, coronary heart disease, congestive heart disease or hyperthyroidism preexist.
  • Laboratory Tests:
    No tests in addition to routine ICU tests are required
  • Drug/Laboratory Test Interactions:
    None known

IMPORTANT DRUG INTERACTIONS FOR THE ICU

  • Other drugs, such as phenothiazines, tricyclic antidepressants, certain antihistamines, which have weak antimuscarinic activity, may considerably intensify the effects of antimuscarinic drugs.

ADVERSE REACTIONS

  • Body as a Whole:
    Suppression of sweating causes reflexive flushing and heat intolerance
  • Nervous System:
    Sedation, confusion, hallucinations
  • Cardiovascular:
    Hypotension, tachycardia
  • Gastrointestinal:
    Dry mouth
  • Urogenital:
    Urinary Retention

Critical Care Drug Manual

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