Antispasmodic Drugs

Definition

Antispasmodic drugs relieve cramps or spasms of the stomach, intestines, and bladder.

Purpose

Antispasmodic drugs have been used to treat stomach cramps. Traditionally, they were used to treat stomach ulcers, but for this purpose they have largely been replaced by the acid inhibiting compoundsa, the H-2 receptor blockers such as cimetidine and ranitidine and the proton pump inhibtors such as omeprazole, lansoprazole and rabetazole.

Most of the drugs used for this purpose as "anticholinergics", since they counteract the effects of the neurohormone acetylcholine. Some of these drugs are derived from the plant belladonna, also known as Deadly Nightshade. There is also a group of drugs with similar activity, but not taken from plant sources. The anticholingergics decrease both the movements of the stomach and intestine, and also the secretions of stomach acid and digestive enzymes. They may be used for other purposes including treatment of Parkinson's Disease, and bladder urgency. Because these drugs inhibit secretions, they cause dry mouth and dry eyes because of reduced salivation and tearing. Dicyclomine is an antispasmodic with very lettle effect on secretions. It is used to treat irritable bowel syndrome.

Description

Dicyclomine is available only with a prescription and is sold as capsules, tablets (regular and extended-release forms), and syrup.

Recommended dosage

The usual dosage for adults is 20 mg, four times a day. However, the physician may recommend starting at a lower dosage and gradually increasing the dose to reduce the chance of unwanted side effects.

The dosage for children depends on the child's age. Check with the child's physician for the correct dosage.

Precautions

Dicyclomine makes some people sweat less, which allows the body to overheat and may lead to heat prostration (fever and heat stroke ). Anyone taking this drug should try to avoid extreme heat. If that is not possible, check with the physician who prescribed the drug. If heat prostration occurs, stop taking the medicine and call a physician immediately.

This medicine can cause drowsiness and blurred or double vision. People who take this drug should not drive, use machines, or do anything else that might be dangerous until they have found out how the medicine affects them.

Dicyclomine should not be given to infants or children unless the physician decides the use of this drug is necessary. Diclyclomine should not be used by women who are breast feeding. Women who are pregnant or plan to become pregnant should check with their physicians before using this drug.

KEY TERMS

Heat stroke— A serious condition that results from exposure to extreme heat. The body loses its ability to cool itself. Severe headache, high fever, and hot, dry skin may result. In severe cases, a person with heat stroke may collapse or go into a coma.

Hiatal hernia— A condition in which part of the stomach protrudes through the diaphragm.

Hyperthyroidism— Secretion of excess thyroid hormones by the thyroid gland.

Inflammation— Pain, redness, swelling, and heat that usually develop in response to injury or illness.

Myasthenia gravis— A condition in which certain muscles weaken and may become paralyzed.

Reflux esophagitis— Inflammation of the lower esophagus caused by the backflow of stomach contents.

Spasm— Sudden, involuntary tensing of a muscle or a group of muscles

Ulcerative colitis— Long-lasting and repeated inflammation of the colon with the development of sores.

Anyone with the following medical conditions should not take dicyclomine unless directed to do so by a physician:

• Previous sensitivity or allergic reaction to dicyclomine
• Glaucoma
• Myasthenia gravis
• Blockage of the urinary tract, stomach, or intestines
• Severe ulcerative colitis
• Reflux esophagitis.

In addition, patients with these conditions should check with their physicians before using dicyclomine:

• Liver disease
• Kidney disease
• High blood pressure
• Heart problems
• Enlarged prostate gland
• Hiatal hernia
• Autonomic neuropathy (a nerve disorder)
• Hyperthyroidism.

Side effects

The most common side effects are dizziness, drowsiness, lightheadedness, nausea, nervousness, blurred vision, dry mouth, and weakness. Other side effects may occur. Anyone who has unusual symptoms after taking dicyclomine should get in touch with his or her physician.

Interactions

Dicyclomine may interact with other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Among the drugs that may interact with Dicyclomine are:

• Antacids such as Maalox
• Antihistamines such as clemastine fumarate (Tavist)
• Bronchodilators (airway opening drugs) such as albuterol (Proventil, Ventolin)
• Corticosteroids such as prednisone (Deltasone)
• Monoamine oxidase inhibitors (MAO inhibitors) such as phenelzine (Nardil) and tranylcypromine (Parnate)
• Tranquilizers such as diazepam (Valium) and alprazolam (Xanax).

The list above does not include every drug that may interact with dicyclomine. Be sure to check with a physician or pharmacist before combining dicyclomine with any other prescription or nonprescription (over-the-counter) medicine.