Propantheline Bromide

A to Z Drug Facts

Propantheline Bromide

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(pro-PAN-thuh-leen BROE-mide)

Pro-Banthine

Class: Anticholinergic; Antispasmodic

Action Exerts anticholinergic effects, resulting in GI smooth muscle relaxation and diminished volume and acidity of GI secretions.

Indications Adjunctive therapy in treatment of peptic ulcer. Unlabeled use(s): Treatment of secretory and spastic disorders of GI tract, biliary tract, urinary tract, and bladder.

Contraindications Hypersensitivity to anticholinergic drugs; narrow-angle glaucoma; adhesions between iris and lens; obstructive uropathy; obstructive disease of GI tract; paralytic ileus; intestinal atony of elderly or debilitated patient; severe ulcerative colitis; toxic megacolon complicating ulcerative colitis; hepatic or renal disease; tachycardia; myocardial ischemia; unstable cardiovascular status in acute hemorrhage; myasthenia gravis.

Route/Dosage

Peptic Ulcer

ADULTS: PO 15 mg 30 min before meals and 30 mg at bedtime. PATIENTS WITH MILD MANIFESTATIONS, ELDERLY PATIENTS OR THOSE OF SMALL STATURE: PO 7.5 mg tid.

Secretory Disorders

ADULTS: PO 1.5 mg/kg/day in 3 to 4 divided doses.

Spastic Disorders

ADULTS: PO 2 to 3 mg/kg/day in divided doses q 4 to 6 hr and at bedtime.

Interactions

Antacids: Decrease absorption of propantheline if given together. Drugs with anticholinergic effects (eg, antihistamines, antiparkinson drugs, tricyclic antidepressants): Additive peripheral anticholinergic side effects. Haloperidol: May cause decreased serum haloperidol levels, worsened schizophrenic symptoms and tardive dyskinesia. Phenothiazines: May decrease antipsychotic effectiveness of phenothiazines; may produce additive anticholinergic effects.

Lab Test Interferences None well documented.

Adverse Reactions

CV: Palpitations; tachycardia. CNS: Headache; flushing; nervousness; drowsiness; weakness; dizziness; confusion; insomnia; fever; mental confusion or excitement; restlessness; tremor. DERM: Severe allergic reactions including anaphylaxis, urticaria and dermal manifestations. EENT: Blurred vision; mydriasis; photophobia; cycloplegia; increased intraocular pressure; dilated pupils; nasal congestion; altered taste perception. GI: Dry mouth; nausea; vomiting; dysphagia; heartburn; constipation; bloated feeling; paralytic ileus. GU: Urinary hesitancy and retention; impotence. OTHER: Suppression of lactation; decreased sweating.

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Elderly or debilitated patients: Drug may cause excitement, agitation, drowsiness and other untoward manifestations, even in small doses. Special-risk patients: Use drug with caution in patients with glaucoma, autonomic neuropathy, hepatic or renal disease, ulcerative colitis, hyperthyroidism, coronary artery disease, CHF, cardiac tachyarrhythmias, tachycardia, hypertension, prostatic hypertrophy and hiatal hernia associated with reflux esophagitis. Diarrhea: May be symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. Treatment of diarrhea with drug is inappropriate and possibly harmful. Gastric ulcer: May delay gastric emptying rate and complicate therapy. Heat prostration: Can occur in presence of high environmental temperature.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Do not crush or allow patient to chew tablets.
Administer antacids 1 hr before or after propantheline.
Administer 30 min before meals and at bedtime (³ 2 hr after last meal) unless otherwise directed.
Store at room temperature in tight container.

Assessment/Interventions

Obtain patient history, including drug history and any known allergies.
Check patient's vital signs.
Monitor I&O.
Observe for drowsiness, dizziness, urinary hesitancy or retention, blurred vision, diarrhea or constipation and other anticholinergic side effects and report to physician.

OVERDOSAGE: SIGNS & SYMPTOMS

Dry mouth, thirst, vomiting, nausea, abdominal distention, paralytic ileus, difficulty swallowing, muscular weakness, paralysis, CNS stimulation (restlessness, anxiety), delirium (disorientation, hallucinations), drowsiness, stupor, fever, dizziness, headache, seizures, ataxia, coma, circulatory failure, rapid pulse and respiration, vasodilation, tachycardia with weak pulse, hypertension, hypotension, respiratory depression, palpitations, urinary urgency with difficulty in micturition, blurred vision, photophobia, dilated pupils, leukocytosis, flushed hot dry skin, rash

Patient/Family Education

Advise patient to take drug 30 min before meals and at bedtime unless directed otherwise by physician.
Instruct patient not to chew or crush tablets.
Warn patient that drug increases risk of heat prostration and caution patient to avoid becoming overheated by exercise or high environmental temperatures.
Instruct patient to report the following symptoms to physician: Drowsiness, dizziness, urinary hesitancy and retention, blurred vision, diarrhea or constipation, skin rash, flushing, or eye pain.
Tell patient to take sips of water frequently, suck on ice chips or sugarless hard candy or chew sugarless gum if dry mouth occurs.
Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.