Pro-Banthine

Pro-Banthine

 [pro-ban-thīn´] trademark for preparations of propantheline bromide, an anticholinergic used to treat peptic ulcers.

propantheline

(proe-pan-the-leen) propantheline,

Pro-Banthine

(trade name)

Classification

Therapeutic: antiulcer agents
Pharmacologic: anticholinergics
Pregnancy Category: C

Indications

Adjunctive therapy in the treatment of peptic ulcer disease.Antisecretory or antispasmodic agent.

Action

Competitively inhibits the muscarinic action of acetylcholine, resulting in decreased GI secretions.

Therapeutic effects

Reduction of signs and symptoms of peptic ulcer disease.

Pharmacokinetics

Absorption: Incompletely absorbed from the GI tract.Distribution: Distribution not known. Does not cross the blood-brain barrier.Metabolism and Excretion: Inactivated in the upper small intestine.Half-life: Unknown.

Time/action profile (anticholinergic effects)

ROUTEONSETPEAKDURATION
PO30–60 min2–6 hr6 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Angle-closure glaucoma; Tachycardia secondary to cardiac insufficiency or thyrotoxicosis; Myasthenia gravis.Use Cautiously in: Prostatic hypertrophy; Chronic renal, cardiac, or pulmonary disease; Patients who may have intra-abdominal infections; Geriatric: Appears on Beers list; may have ↑ sensitivity to anticholinergics; Geriatric: Geriatric patients or patients of small stature (dose ↓ required); Obstetric / Lactation / Pediatric: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

  • confusion
  • dizziness
  • drowsiness
  • excitement

Ear, Eye, Nose, Throat

  • blurred vision
  • mydriasis
  • photophobia

Cardiovascular

  • tachycardia (most frequent)
  • orthostatic hypotension
  • palpitations

Gastrointestinal

  • constipation (most frequent)
  • dry mouth (most frequent)

Genitourinary

  • urinary hesitancy (most frequent)
  • urinary retention (most frequent)

Dermatologic

  • rash

Miscellaneous

  • ↓ sweating

Interactions

Drug-Drug interaction

Additive anticholinergic effects with other drugs possessing anticholinergic properties, including antihistamines, antidepressants, atropine, haloperidol, phenothiazines, quinidine, and disopyramide.May alter the absorption of other orally administered drugs by slowing motility of the GI tract.Antacids and adsorbentantidiarrheals ↓ the absorption of anticholinergics (avoid taking within 2–3 hr of propantheline).May ↑ GI mucosal lesions in patients taking solid oral potassium chloride supplements.↑ anticholinergic effects with angel’s trumpet, jimson weed, and scopolia.

Route/Dosage

Oral (Adults) 15 mg 3 times daily before meals and 30 mg at bedtime.Oral (Geriatric Patients, Patients with Mild Symptoms, or Small Stature) 7.5 mg 3–4 times daily.Oral (Children) 0.375 mg/kg (10 mg/m2) 4 times daily.

Availability (generic available)

Tablets: 7.5 mg, 15 mg

Nursing implications

Nursing assessment

  • Assess for abdominal pain prior to and periodically throughout therapy.
  • Lab Test Considerations: Antagonizes effects of pentagastrin and histamine during gastric acid secretion test. Avoid administration for 24 hr preceding the test.

Potential Nursing Diagnoses

Acute pain (Indications)
Constipation (Side Effects)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Oral: Administer 30 min before meals. Bedtime dose should be administered at least 2 hr after last meal of the day.
    • Do not administer within 1 hr of antacids or antidiarrheal medications.

Patient/Family Teaching

  • Instruct patient to take medication as directed. If a dose is missed, take as soon as remembered unless almost time for next dose. Do not double doses.
  • May cause drowsiness or blurred vision. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
  • Instruct patient that frequent oral rinses, sugarless gum or candy, and good oral hygiene may help relieve dry mouth. Consult health care professional regarding use of saliva substitute if dry mouth persists >2 wk.
  • Advise patient that increasing fluid intake, adding bulk to the diet, and exercise may help alleviate the constipating effects of the drug.
  • Advise elderly patients to change positions slowly to minimize the effects of drug-induced orthostatic hypotension.
  • Caution patient to avoid extremes of temperature. This medication decreases the ability to sweat and may increase the risk of heat stroke.
  • Advise patient to wear sunglasses and avoid bright lights to prevent photosensitivity.
  • Instruct patient to notify health care professional if confusion, excitement, dizziness, rash, difficulty with urination, or eye pain occurs. Health care professional may recommend periodic ophthalmic examinations to monitor intraocular pressure, especially in elderly patients.

Evaluation/Desired Outcomes

  • Decrease in GI pain in patients with peptic ulcer disease.

Pro-Banthine

A brand name for the antispasmodic drug propantheline.