N-Butylscopolammonium bromide - CAS 149-64-4

We present two patients who ingested homemade scopolamine leading to severe central anticholinergic effects on at least one patient. To the best of our knowledge, this is the first report in the medical literature of such a practice. Butylscopolamine (also known as butylscopolamine bromide, scopolamine butylbromide, butylhyoscine, or hyoscine butylbromide) is available as over-the-counter antispasmodic (Buscopan®) in nearly 100 countries world-wide and is included in the WHO Model List of Essential Medicines. The amount of ingested scopolamine (as estimated using the described protocol) and scopolamine concentrations measured in the patient’s serum and urine samples were in line with the published findings detailing the doses required to elicit the observed clinical symptoms. However, clinical effects are likely highly variable, given that the preparation of scopolamine was the same in both cases.

Intravenous scopolamine butylbromide was administered to four patients to facilitate the POEM procedure by inhibiting abnormal spastic contraction of the esophagus. An increase in heart rate from 60 to 140 beats per min was observed in one patient, who was treated with 20 mg scopolamine butylbromide. Randiolol hydrochloride, a short-acting beta1-adrenergic antagonist, was continuously infused intravenously at a rate of 5 mcg/kg/min for about 50 min to decrease the heart rate. The remaining three patients (two received 20 mg and one received 10 mg of scopolamine butylbromide intravenously) showed a slight increase in heart rate, which lasted about 30 min, but did not require any treatment to control their heart rate. The POEM procedure achieved the decrease in lower esophageal sphincter pressure in each patient. Mean lower esophageal pressure was decreased from 71.2 to 21.0 mmHg.

Demarcation of toxicity threshold of DILI in vitro Bambuterol hydrochloride, buspirone hydrochloride, and scopolamine butylbromide, which were defined as negative control drugs, showed no cytotoxic effects on all liver cell lines in vitro (see Fig. 1). Based on the 3 σ principles of biological statistical analysis (Wang et al.2013), we built a toxicity threshold to discriminate drugs with or without a cytotoxic effect. Moreover, the IC₅₀ values of these three drugs were all over 1000 μMas recorded in Table 3. Toxicity threshold = x ± SD× 3, where x represents the mean value of all inhibition values of different concentrations of negative control drugs administered to different cell lines. SD means standard deviation.