A Case of Scopolamine-Induced Central Anticholinergic Syndrome / 영남의대학술지

Central anticholinergic syndrome occurs when an anticholinergic substance works in vivo or as a result of the insufficient release of acetylcholine. Its symptoms include confusion, agitation, behavioral change, hallucination, blurred vision, and dysarthria. Occasionally, these symptoms occur with the use of a scopolamine patch. A 54-year-old female complained of behavioral change and confused mentality. She attached a scopolamine patch at the postauricular area in the morning of the day before her hospital visit. Neurological examination revealed bilateral symmetric mydriasis without light reflex. The brain MRI was normal, and electroencephalography showed nonspecific abnormalities. The patient recovered completely after the removal of the scopolamine patch.

Short Term Effects of Transdermal Scopolamine Patch for Drooling of Saliva in Patients with Cerebral Palsy

OBJECTIVE: To investigate the clinical usefulness of the transdermal scopolamine patch applied to control drooling of saliva in patients with cerebral palsy. METHOD: We enrolled twenty two patients with cerebral palsy residing in a rehabilitation center. The mean age of the patients was 24.0 years old. Transdermal scopolamine patch was applied to the patients for 2 weeks. We measured drooling quantity, severity of drooling, and visual analog scale of care givers' labor intensity at pre-application, post 1 week, and post 2 weeks. RESULTS: Drooling quantity decreased significantly from 4.1+/-1.9 ml to 2.8+/-1.5 ml at post 1 week (p<0.01), and 2.2+/-1.6 ml at post 2 weeks (p<0.01). Severity of drooling decreased from 4.1+/-0.8 to 2.9+/-1.1 at post 2 weeks (p<0.01). Visual analog scale of care givers' labor intensity decreased from 78.2+/-17.4 (mm) to 52.7+/-18.6 at post 1 week (p<0.01), and 45.9+/-22.8 at post 2 weeks (p<0.01). CONCLUSION: These findings suggested that the transdermal scopolamine patch is effective to reduce the drooling of saliva in patients with cerebral palsy within short term.

Effect of Transdermal scopolamine Patch on Nausea or Vomiting Associated with General Anesthesia / 대한마취과학회지

To evaluate the efficacy of transdermal scopolamine patch in reducing nausea and vomiting associated with general anesthesia, we studied 60 healthy women undergoing major gynecologic surgery. The patients were divided into 2 groups. Each group was composed of 30 patients. Group I; not applied a transdermal scopolamine patch. Group II: applied one transdermal scopolamine patch on the skin behind her ear at the night before surgery. Anesthesia was induced by thiopental sodium(5 mg/kg) and succinylcholine(1.5 mg/kg) and maintained with fentanyl(3-6 ug/kg), enflurane(0.5-1.5 vol%) and nitrous oxide(50 vo1%) in oxygen. A comparison with Group I and Group II indicated that the transdermal scopolamine patch reduced the incidence of postoperative nausea or vomiting associated with general anesthesia significantly(Group I; 36.67%, Group II; 13.33%, p<0.05).

Effects of Scopolamine Patches on Pupil and Accommodation

Scopolamine Patch is transdermal drug delivery system that contains 1.5mg of scopolamine This agent is used for prevention of motion sickness, but a few partients note dilated pupils and complain of difficulty in near work in the use of the patches. The cause of pupil dilation and cycloplegia from scopolamine patches has been thought to be a result of ocular contamination from handling of the patches, but there was no definitive proof. Moreover, the duration and amplitudes of mydriasis and cycloplegia from this patches have not been fully described. The authors studied the effects of the scopolamine patches on pupil size and accommodative amplitude. The results were as follows: 1. Mydriasis and cycloplegia from scopolamine patchs were not results of systemic absorption, but of ocular contamination from finger which already touched to the patches. 2. The maximal pupil dilation was observed in all age groups between 1+1/2 and 4 hours after contamination, and its effect lasted 3 to 5 days. 3. The maximal reduction of the accommodative amplitude was observed at 4 hours after contamination and the reduction of the accommodative amplitude was statistically significant in older age group(p>0.05). 4. Return to original pupil size or miosis and recovery from the reduction of the accomodative amplitude were observed in 40%, 50%, and 71%, respectively by the first day on instillation of 1%, 2% and 4% pilocarpine.