Scopolamine
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Clinical data | |
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Trade names | Transdermscop, Kwells, others |
Other names | Hyoscine[1] |
AHFS/Drugs.com | Monograph |
MedlinePlus | a682509 |
License data |
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Pregnancy category |
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intramuscular | |
Drug class |
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ATC code | |
Legal status | |
Legal status | |
Pharmacokinetic data | |
Metabolism | Liver |
Elimination half-life | 4.5 hours[6] |
Excretion | Kidney |
Identifiers | |
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JSmol) | |
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Scopolamine, also known as hyoscine,[7] or Devil's Breath,[8] is a natural or synthetically produced tropane alkaloid and anticholinergic drug that is used as a medication to treat motion sickness[9] and postoperative nausea and vomiting.[10][1] It is also sometimes used before surgery to decrease saliva.[1] When used by injection, effects begin after about 20 minutes and last for up to 8 hours.[1] It may also be used orally and as a transdermal patch since it has been long known to have transdermal bioavailability.[1][11]
Scopolamine is in the
Medical uses
Scopolamine has a number of formal uses in modern medicine where it is used in its isolated form and in low doses to treat:[20][21]
- Postoperative nausea and vomiting.
- Gastrointestinal spasms
- Renal or biliaryspasms
- Aid in gastrointestinal radiology and endoscopy
- Irritable bowel syndrome
- Clozapine-induced drooling
- Bowel colic
- Eye inflammation[26]
It is sometimes used as a
Breastfeeding
Scopolamine enters breast milk by secretion. Although no human studies exist to document the safety of scopolamine while nursing, the manufacturer recommends that caution be taken if scopolamine is administered to a breastfeeding woman.[27]
Elderly
The likelihood of experiencing adverse effects from scopolamine is increased in the elderly, relative to younger people. This phenomenon is especially true for older people who are also on several other medications. Scopolamine use should be avoided in this age group because of these potent anticholinergic adverse effects, which have also been linked to an increased risk for dementia.[28][29]
Adverse effects
Adverse effect incidence:[5][30][31][32]
Uncommon (0.1–1% incidence) adverse effects include:
- Dry mouth
- Anhidrosis (reduced ability to sweat to cool off)
- Tachycardia (usually occurs at higher doses and is succeeded by bradycardia)
- Bradycardia
- Urticaria(hives)
- Pruritus(itching)
Rare (<0.1% incidence) adverse effects include:
- Constipation
- Urinary retention
- Hallucinations
- Agitation
- Confusion
- Restlessness
- Seizures
Unknown frequency adverse effects include:
- reactions
- Dyspnea(shortness of breath)
- Rash
- Erythema
- Other hypersensitivity reactions
- Blurred vision
- Mydriasis (dilated pupils)
- Drowsiness
- Dizziness
- Somnolence
- Death
Overdose
- Tachycardia
- Arrhythmia
- Blurred vision
- Photophobia
- Urinary retention
- hallucinations
- Cheyne-Stokesrespiration
- Dry mouth
- Skin reddening
- Inhibition of gastrointestinal motility
Interactions
Due to interactions with metabolism of other drugs, scopolamine can cause significant unwanted side effects or unpredictable
Route of administration
Scopolamine can be taken
Pharmacokinetic
Scopolamine undergoes first-pass metabolism and about 2.6% is excreted unchanged in urine. Grapefruit juice decreases metabolism of scopolamine, consequently increasing plasma concentration.[35]
Pharmacodynamics
The pharmacological effects of scopolamine are mediated through the drug's competitive antagonism of the peripheral and central muscarinic acetylcholine receptors. Scopolamine acts as a nonspecific muscarinic antagonist at all four (M1, M2, M3, and M4) receptor sites.[36][37]
In doses higher than intended for medicinal use; the hallucinogenic
Although often broadly referred to as simply being 'anticholinergic',
Biosynthesis in plants
Scopolamine is among the
![](http://upload.wikimedia.org/wikipedia/commons/thumb/5/5b/Tropane_alkaloids_biochemistry.png/220px-Tropane_alkaloids_biochemistry.png)
The
A
Subsequently,
![](http://upload.wikimedia.org/wikipedia/commons/thumb/1/11/Scopolamine_biosynthesis.svg/800px-Scopolamine_biosynthesis.svg.png)
History
Plants naturally containing scopolamine such as
In 1899, a Dr. Schneiderlin recommended the use of scopolamine and morphine for surgical anaesthesia, and it started to be used sporadically for that purpose.[12][47] The use of this combination in obstetric anesthesiology (childbirth) was first proposed by Richard von Steinbuchel in 1902 and was picked up and further developed by Carl Gauss in Freiburg, Germany, starting in 1903.[48] The method, which was based on a drug synergy between both scopolamine and morphine came to be known as Dämmerschlaf ("twilight sleep") or the "Freiburg method".[47][48] It spread rather slowly, and different clinics experimented with different dosages and ingredients; in 1915, the Canadian Medical Association Journal reported, "the method [was] really still in a state of development".[47] It remained widely used in the US until the 1960s, when growing chemophobia and a desire for more natural childbirth led to its abandonment.[49]
Society and culture
Names
Hyoscine hydrobromide is the international nonproprietary name, and scopolamine hydrobromide is the United States Adopted Name. Other names include levo-duboisine, devil's breath, and burundanga.[15][50]
Australian bush medicine
A
Recreational and religious use
While it has been occasionally used recreationally for its hallucinogenic properties, the experiences are often unpleasant, mentally and physically. It is also physically dangerous and officially classified as a
Historically, the various plants that produce scopolamine have been used psychoactively for
In Christianity, although not explicitly designated for
Interrogation
The effects of scopolamine were studied for use as a truth serum in interrogations in the early 20th century,[63] but because of the side effects, investigations were dropped.[64] In 2009, the Czechoslovak state security secret police were proven to have used scopolamine at least three times to obtain confessions from alleged antistate dissidents.[65]
Crime in Colombia
A travel advisory published by the US Overseas Security Advisory Council (OSAC) in 2012 stated:
One common and particularly dangerous method that criminals use in order to rob a victim is through the use of drugs. The most common [in Colombia] has been scopolamine. Unofficial estimates put the number of annual scopolamine incidents in Colombia at approximately 50,000. Scopolamine can render a victim unconscious for 24 hours or more. In large doses, it can cause respiratory failure and death. It is most often administered in liquid or powder form in foods and beverages. The majority of these incidents occur in night clubs and bars, and usually men, perceived to be wealthy, are targeted by young, attractive women. It is recommended that, to avoid becoming a victim of scopolamine, a person should never accept food or beverages offered by strangers or new acquaintances, nor leave food or beverages unattended in their presence. Victims of scopolamine or other drugs should seek immediate medical attention.[66]
Between 1998 and 2004, 13% of emergency-room admissions for "poisoning with criminal intentions" in a clinic of Bogotá, Colombia, have been attributed to scopolamine, and 44% to benzodiazepines.[15] Most commonly, the person has been poisoned by a robber who gave the victim a scopolamine-laced beverage, in the hope that the victim would become unconscious or unable to effectively resist the robbery.[15]
Beside robberies, it is also allegedly involved in
Research
Scopolamine is used as a research tool to study memory encoding. Initially, in human trials, relatively low doses of the muscarinic receptor antagonist scopolamine were found to induce temporary cognitive defects.
Scopolamine produces detrimental effects on short-term memory, memory acquisition, learning, visual recognition memory,
Scopolamine has been identified as a psychoplastogen, which refers to a compound capable of promoting rapid and sustained neuroplasticity in a single dose.[92] It has been, and continues to be investigated as a rapid-onset antidepressant, with a number of small studies finding positive results, particularly in female subjects.[93][94][95][96]
NASA agreed to develop a nasal administration method. With a precise dosage, the NASA spray formulation has been shown to work faster and more reliably than the oral form to treat motion sickness.[97]
Although a fair amount of research has been applied to scopolamine in the field of medicine, its
References
- ^ a b c d e f g h "Scopolamine". The American Society of Health-System Pharmacists. Archived from the original on 7 October 2016. Retrieved 8 December 2016.
- ^ "Poisons Standard October 2020". Federal Register of Legislation. 30 September 2020. Retrieved 23 October 2020.
- ^ "Hyoscine Hydrobromide 400 micrograms/ml Solution for Injection - Summary of Product Characteristics (SmPC)". (emc). Archived from the original on 27 October 2020. Retrieved 23 October 2020.
- ^ "Kwells 300 microgram tablets - Summary of Product Characteristics (SmPC)". (emc). Archived from the original on 26 October 2020. Retrieved 23 October 2020.
- ^ a b "Transderm Scop- scopolamine patch, extended release". DailyMed. Retrieved 4 February 2022.
- S2CID 27507555.
- ISBN 978-1-4200-4130-9. Archivedfrom the original on 10 September 2017.
- ^ Duffy R (23 July 2007). "Colombian Devil's Breath". Vice. Retrieved 3 February 2022.
- ^ "About hyoscine hydrobromide". nhs.uk. 24 October 2022. Retrieved 14 March 2023.
- ^ ISBN 978-0-387-85498-4. Archivedfrom the original on 10 September 2017.
- ^ a b Sollmann T (1957). A Manual of Pharmacology and Its Applications to Therapeutics and Toxicology (8th ed.). Philadelphia and London: W.B. Saunders.
- ^ ISBN 978-0-9614932-7-1.
- ISBN 978-3-527-60749-5.
- LCCN 2013031617. Archivedfrom the original on 17 September 2021. Retrieved 17 September 2021.
- ^ a b c d Uribe M, Moreno CL, Zamora A, Acosta P (September 2005). "Perfil epidemiológico de la intoxicación con burundanga en la clínica Uribe Cualla S. A. de Bogotá, D. C" (PDF). Acta Neurológica Colombiana (in Spanish). 21 (3): 197–201. Archived (PDF) from the original on 7 October 2016.
- ^ a b Raetsch C (2005). The encyclopedia of psychoactive plants: ethnopharmacology and its applications. US: Park Street Press. pp. 277–282.
- ^ ISBN 978-81-86062-25-8.
- ^ Cattell HW (1910). Lippincott's new medical dictionary: a vocabulary of the terms used in medicine, and the allied sciences, with their pronunciation, etymology, and signification, including much collateral information of a descriptive and encyclopedic character. Lippincott. p. 435. Archived from the original on 10 September 2017. Retrieved 25 February 2012.
- hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- ^ ISBN 978-0-85711-084-8.
- ^ ISBN 978-0-9805790-9-3.
- PMID 1853467. Archived from the original on 20 August 2008. Retrieved 13 August 2008.)
{{cite journal}}
: CS1 maint: unfit URL (link - PMID 3363755. Archived from the original on 20 August 2008.)
{{cite journal}}
: CS1 maint: unfit URL (link - PMID 3363755.
- ^ "Motion Sickness". Divers Alert Network.
- ^ "scopolamine solution - ophthalmic, Isopto". MedicineNet.com. Retrieved 12 February 2019.
- ^ ISBN 978-0-683-01060-2.
- ^ "Study suggests link between long-term use of anticholinergics and dementia risk". Alzheimer's Society. 26 January 2015. Archived from the original on 12 November 2015. Retrieved 17 February 2015.
- S2CID 29065240.
- ^ "DBL HYOSCINE INJECTION BP". TGA eBusiness Services. Hospira Australia Pty Ltd. 30 January 2012. Archived from the original on 30 March 2017. Retrieved 22 October 2013.
- ^ a b "Buscopan Tablets - Summary of Product Characteristics (SPC)". electronic Medicines Compendium. Boehringer Ingelheim Limited. 11 September 2013. Archived from the original on 23 October 2013. Retrieved 22 October 2013.
- ^ a b c "Kwells 300 microgram tablets - Summary of Product Characteristics". electronic Medicines Compendium. Bayer plc. 7 January 2008. Archived from the original on 23 October 2013. Retrieved 22 October 2013.
- ISBN 978-0-7817-8763-5.
- ^ S2CID 44784425.
- S2CID 32720769.
- ^ "Google Scholar". scholar.google.com. Retrieved 16 December 2017.
- ^ "PDSP Ki Database".
- ^ PMID 26589572.
Delirium is only associated with the antagonism of post‐synaptic M1 receptors and to date other receptor subtypes have not been implicated
- PMID 18178702.
- S2CID 45125074.
- ^ PMID 18251710.
- PMID 16720272.
- ISBN 3-904144-77-4
- ^ Rätsch, Christian, The Encyclopedia of Psychoactive Plants: Ethnopharmacology and Its Applications pub. Park Street Press 2005
- ^ "Pharmacognosy and Phytochemistry : Drugs Containing Alkaloids".
- .; see pp. 299–307.
- ^ PMID 20310688.
- ^ a b "TWILIGHT SLEEP; Is Subject of a New Investigation". The New York Times. 31 January 1915.
- ^ Finkbeiner A (31 October 1999). "Labor Dispute. Book review: What a Blessing She Had Chloroform: The Medical and Social Response to the Pain of Childbirth from 1800 to the Present". The New York Times.
- ^ Bell V (3 March 2011). "Mind controller: What is the 'burundanga' drug?". Wired UK (published April 2011). Archived from the original on 11 August 2017.
- ^ "Visitors to Art of Healing exhibition told how Australian Indigenous bush medicine was given to every allied soldier landing at Normandy on D-Day". King's College London. 7 June 2019. Retrieved 2 June 2020.
- ISBN 978-90-481-2447-3.
- ^ "Bilsykemedisin i falske rohypnol-tabletter". Aftenposten.no. Archived from the original on 27 June 2008.
- ^ "Perth backpacker overdose linked to common anti-nausea drug". ABC News. 4 January 2018. Retrieved 4 January 2018.
- S2CID 213559151.
- ISBN 1-55209-598-3.
- ISBN 978-0-06-250373-2.
- ISBN 0-9664027-0-7.
- ^ "The Datura Cult Among the Chumash; The Journal of California Anthropology" (PDF).
- ^ ISBN 978-0913300473
- ^ "Genesis 30:14–16 (King James Version)". Bible Gateway. Retrieved 6 January 2014.
- ^ "Song of Songs 7:12–13 (King James Version)". Bible Gateway. Retrieved 6 January 2014.
- ^ House RE (September 1922). "The Use of Scopolamine in Criminology". Texas State Journal of Medicine. 18: 256–263.
Reprinted in: House RE (July–August 1931). "The Use of Scopolamine in Criminology". American Journal of Police Science. 2 (4): 328–336.JSTOR 1147361. - ^ Bimmerle G (22 September 1993). "'Truth' Drugs in Interrogation". CIA.gov. Central Intelligence Agency. Archived from the original on 27 September 2012. Retrieved 14 June 2012.
- iDnes. Archivedfrom the original on 11 August 2009. Retrieved 10 August 2009.
- Overseas Security Advisory Council, United States Department of State. 4 March 2012. Archivedfrom the original on 15 March 2013. Retrieved 6 August 2015.
- ^ a b c d Domínguez I (25 July 2016). "Burundanga: the stealth drug that cancels the victim's willpower". Crime. El País, Madrid. Archived from the original on 20 August 2016. Retrieved 12 August 2016.
- ^ "Burundanga Business Card Drug Warning". Hoax-Slayer.com. 12 October 2008. Archived from the original on 7 March 2009.
- ^ "Beware the Burundanga Man!". About.com Entertainment. Archived from the original on 10 January 2017. Retrieved 19 December 2016.
- ^ Mikkelson D. "Burundanga/Scopolamine Warning". snopes.com. Retrieved 19 December 2016.
- (PDF) from the original on 22 April 2021.
- ^ "World's Scariest Drug (Documentary Exclusive)". YouTube.
- ^ "أخطر مخدر في العالم (عدنا إلى كولومبيا)". YouTube (in Arabic).
- ^ "المخدر الأخطر في العالم ستتعرض له بدون أن تشعر في أمريكا اللاتينية". YouTube (in Arabic).
- ^ Anderson L. "Devil's Breath: Urban Legend or the World's Most Scary Drug?". Drugs.com. Retrieved 9 July 2019.
- ^ Saner E (2 September 2015). "'Devil's breath' aka scopolamine: can it really zombify you?". The Guardian. Retrieved 4 January 2019.
- ^ "Colombia Travel Advisory". travel.state.gov. Archived from the original on 5 April 2022.
- ^ Global Affairs Canada (16 November 2012). "Travel Advice and Advisories for Colombia". Travel.gc.ca. Archived from the original on 16 May 2022.
- ^ "Escopolamina, la droga "borra recuerdos" que acecha a los extranjeros en Colombia; estos son sus mortales efectos". 23 January 2024.
- ^ "Devil's Breath: Why Scopolamine Abuse is So Terrifying". Northpoint Washington. 9 May 2019.
- ^ Forest E (27 July 2008). "Atypical Drugs of Abuse". Articles & Interviews. Student Doctor Network. Archived from the original on 27 May 2013.
- ^ S2CID 9872819.
- PMID 4359364.
- ^ S2CID 584350.
- ^ PMID 27598124.
- S2CID 7110504.
- S2CID 24645744.
- S2CID 58655082.
- PMID 25979787.
- PMID 22541290.
- S2CID 22731716.
- S2CID 52877093.
- PMID 23200525.
- PMID 24938776.
- S2CID 19740245.
- PMID 27270172.
- ^ "NASA Signs Agreement to Develop Nasal Spray for Motion Sickness". NASA (Press release). 12 October 2012. Retrieved 3 February 2022.[permanent dead link]
- S2CID 52824516.
External links
Media related to Scopolamine at Wikimedia Commons
- "Scopolamine". Drug Information Portal. U.S. National Library of Medicine.