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Pronunciation: pro-PAN-thuh-leen BROE-mide
Class: Quaternary anticholinergic
- Tablets 15 mg
Exerts anticholinergic effects, resulting in GI smooth muscle relaxation and diminished volume and acidity of GI secretions. Also inhibits the action of acetylcholine at the post ganglionic nerve endings of the parasympathetic nervous system.
Poor GI absorption, only 10% to 25% of oral dose is absorbed. T max is approximately 1 h.
Extensively metabolized by hydrolysis to inactive metabolites.
Renal (70%, mostly as metabolites and 3% as propantheline). Half-life is 1.6 h.
Indications and Usage
Adjunctive therapy in treatment of peptic ulcer.
Glaucoma; obstructive uropathy (eg, bladder neck obstruction due to prostatic hypertrophy); obstructive disease of GI tract (eg, pyloroduodenal stenosis, achalasia, paralytic ileus, etc.); intestinal atony of elderly or debilitated patient; severe ulcerative colitis; toxic megacolon complicating ulcerative colitis; unstable cardiovascular status in acute hemorrhage; myasthenia gravis.
Dosage and AdministrationPeptic Ulcer
PO 15 mg 30 min before meals and 30 mg at bedtime.
- Do not crush or allow patient to chew tablets.
- Administer antacids 1 h before or after propantheline.
Store between 68° and 77°F.
Decreased absorption of propantheline if given together.Corticosteroids
Increased intraocular pressure may result with coadministration.Drugs with anticholinergic effects (eg, antihistamines, belladonna alkaloids, meperidine, Type 1 antiarrhythmics [eg, disopyramide, procainamide, quinidine], tricyclic antidepressants)
Additive peripheral anticholinergic adverse reactions.Digoxin, slow dissolving
Concurrent use may cause increased digoxin levels. Avoid this interaction by only using digoxin tablets that rapidly dissolve by USP standards.Phenothiazines
May decrease antipsychotic effectiveness of phenothiazines; may produce additive anticholinergic effects.
Headache; flushing; nervousness; drowsiness; weakness; dizziness; confusion; insomnia.
Severe allergic reactions including anaphylaxis, urticaria, and dermal manifestations.
Blurred vision; mydriasis; cycloplegia; increased IOP; altered taste perception.
Dry mouth; nausea; vomiting; constipation; bloated feeling.
Urinary hesitancy and retention; impotence.
Suppression of lactation; decreased sweating.
Category C .
Safety and efficacy not established.
For elderly or debilitated patients, drug may cause excitement, agitation, drowsiness, and other untoward manifestations, even in small doses. Use with caution.
Special Risk Patients
Use drug with caution in patients with autonomic neuropathy, hepatic or renal disease, hyperthyroidism, cardiac tachyarrhythmias, heart disease, hypertension, and hiatal hernia associated with reflux esophagitis.
May be symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. Treatment of diarrhea with drug is inappropriate and possibly harmful.
May delay gastric emptying rate and complicate therapy.
Can occur in presence of high environmental temperature.
Large doses may suppress intestinal motility to the point of precluding paralytic ileus and may precipitate or aggravate toxic megacolon.
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.
- Advise patient to take drug 30 min before meals and at bedtime unless directed otherwise by health care provider.
- 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 health care provider: 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.
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