atropine/belladonna/hyoscyamine/phenobarbital/scopolamine (Donnatal)

Introduction

Elixir. Belladonna alkaloids with phenobarbital.

Indications

• adjunctive treatment for:
  • peptic ulcer disease
  • irritable bowel syndrome
  • spastic colitis
  • spastic bladder
  • renal colic

Contraindications

pregnancy-category C

safety in lactation -

Dosage

• adults: 1-2 tabs or 5-10 mL PO TID/QID
• children: 0.1 mL/kg every 4 hours; max: 5mL/dose

Tabs: (contain)

• 16.2 mg phenobarbital
• 0.02 mg atropine
• 0.1 mg hyoscyamine
• 6.5 mg scopolamine

Elixir: contains equivalent of 1 tab/5 mL

Pharmacokinetics

elimination: liver > kidney

Adverse effects

• common (> 10%)
  • constipation
  • decreased sweating
  • dry mouth, nose, throat or skin
  • irritation at site of injection
• less common (1-10%)
  • decreased flow of breast milk
  • difficulty swallowing
  • increased sensitivity to light
• uncommon (< 1%)
  • rash, confusion, increased intraocular pain, orthostatic hypotension, bloating, difficult urination, blurred vision, drowsiness, headache, loss of memory, nausea/vomiting, weakness, tiredness, ventricular fibrillation, tachycardia, palpitations, ataxia

More general terms

• antiulcer combination

Component of

• Maalox/Mylanta/viscous lidocaine/Donnatal (GI cocktail, 'Green Goddess')

Components

• atropine (Atropair, Atropine-Care)
• belladonna alkaloid
• hyoscyamine (Anaspaz, Levsin)
• phenobarbital; PB; PHB (Luminal, Barbita, Solfoton)
• scopolamine (Transderm Scop, Hyoscine)