PROPANTHELINE BROMIDE
(proe-pan'the-leen)
Pro-Banthine, Propanthel 
Classifications: antispasmodic; anticholinergic; antimuscarinic agent
Prototype: Atropine
Pregnancy Category: C

Availability

7.5 mg, 15 mg tablets

Actions

Similar to atropine in peripheral effects. Has potent antimuscarinic activity and ganglionic blocking action. Very high doses block neurotransmission at myoneural junction.

Therapeutic Effects

Decreases motility (smooth muscle tone) in the GI, biliary, and urinary tracts. Results in antispasmodic action.

Uses

Adjunct in treatment of peptic ulcer, irritable bowel syndrome, pancreatitis, ureteral and urinary bladder spasm. Also used prior to radiologic diagnostic procedures to reduce duodenal motility.

Contraindications

Pregnancy (category C), lactation; narrow angle glaucoma; tachycardia, MI; paralytic ileus, GI obstructive disease; myasthenia gravis. Safety in children is not established.

Cautious Use

CAD, CHF, cardiac arrhythmias; liver disease, ulcerative colitis, hiatus hernia, esophagitis; kidney disease; prostatic hypertrophy; glaucoma; debilitated patients; hyperthyroidism; autonomic neuropathy; brain damage; Down's syndrome; spastic disorders.

Route & Dosage

Irritable Bowel Syndrome
Adult: PO 15 mg 30 min a.c. and 30 mg h.s. (max: 120 mg/d)
Geriatric: PO 7.5 mg 2–3 times/d a.c. (max: 90 mg/d)

Administration

Oral

Adverse Effects (1%)

GI: Constipation, dry mouth. Special Senses: Blurred vision, mydriasis, increased intraocular pressure. CNS: Drowsiness. Urogenital: Decreased sexual activity, difficult urination.

Interactions

Drug: Decreased absorption of ketoconazole; oral potassium may increase risk of GI ulcers; Food: Food significantly decreases absorption.

Pharmacokinetics

Absorption: Incompletely absorbed from GI tract. Onset: 30–45 min. Duration: 4–6 h. Metabolism: 50% metabolized in GI tract before absorption; 50% metabolized in liver. Elimination: Excreted primarily in urine; some excreted in bile. Half-Life: 9 h.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education


Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug