Hyoscine butylbromide

Hyoscine butylbromide, also known as scopolamine butylbromide and sold under the brandname Buscopan among others, is a medication used to treat crampy abdominal pain, esophageal spasms, renal colic, and bladder spasms. It is also used to improve respiratory secretions at the end of life. Hyoscine butylbromide can be taken by mouth, injection into a muscle, or into a vein. Hyoscine butylbromide, also known as scopolamine butylbromide and sold under the brandname Buscopan among others, is a medication used to treat crampy abdominal pain, esophageal spasms, renal colic, and bladder spasms. It is also used to improve respiratory secretions at the end of life. Hyoscine butylbromide can be taken by mouth, injection into a muscle, or into a vein. Side effects may include sleepiness, vision changes, dry mouth, rapid heart rate, triggering of glaucoma, and severe allergies. Sleepiness however, is uncommon. It is unclear if it is safe in pregnancy. Greater care is recommended in those with heart problems. It is an anticholinergic agent, which does not have much effect on the brain. Hyoscine butylbromide was patented in 1950 and approved for medical use in 1951. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. It is not available in the United States, and a similar compound methscopolamine may be used instead. The wholesale cost in the developing world is US$0.004–0.11 per pill as of 2014. It is manufactured from hyoscine which occurs naturally in the plant deadly nightshade. Hyoscine butylbromide is effective in treating crampy abdominal pain. Hyoscine butylbromide is effective in reducing the duration of the first stage of labour, and it is not associated with any obvious adverse outcomes in mother or neonate. It is also used during abdominal or pelvic MRI or CT scans to improve the quality of pictures. As little of the medication crosses the blood brain barrier it has less effect on the brain and therefore has reduced occurrence of the centrally-mediated effects (such as delusions, somnolence, and inhibition of motor-functions) which hinder the usefulness of some other anticholinergic drugs. Hyoscine butylbromide is still capable of impacting the chemoreceptor trigger zone due to the lack of a well-developed blood-brain-barrier in the medulla oblongata, which potentiates the antiemetic effects that it produces via local action on the smooth muscle of the gastrointestinal tract. It is a quaternary ammonium compound and a semisynthetic derivative of hyoscine hydrobromide (scopolamine). The attachment of the butyl-bromide moiety effectively prevents the movement of this drug across the blood–brain barrier, effectively minimising undesirable central nervous system side effects associated with scopolamine/hyoscine. Hyoscine butylbromide is not centrally active and has a low incidence of abuse. In 2015, it was reported that prisoners at Wandsworth Prison and other UK prisons were smoking prescribed hyoscine butylbromide, releasing the potent hallucinogen scopolamine. There have also been reports of abuse in Mashhad Central Prison in Iran.