BELLADONNA TINCTURE
(bell-a-don'na)
Classifications: autonomic nervous system agent; anticholinergic (parasympatholytic); antimuscarinic, antispasmodic
Prototype: Atropine
Pregnancy Category: C

Availability

27–33 mg/100 mL tincture

Actions

Reversibly blocks action of acetylcholine at parasympathetic neuroeffector sites.

Therapeutic Effects

Belladonna inhibits smooth muscle contractions and suppresses secretions of secretory glands.

Uses

Adjunct in treatment of peptic ulcer disease, irritable bowel syndrome, and neurogenic bowel disturbances. Also has been used for dysmenorrhea, nocturnal enuresis, spasms of urinary tract, nausea and vomiting of pregnancy, vertigo, and for symptomatic relief of parkinsonism.

Contraindications

Hypersensitivity to anticholinergic drugs; obstructive uropathy, atony of urinary bladder; esophageal reflux, obstructive disease of GI tract, intestinal atony, paralytic ileus, severe ulcerative colitis, toxic megacolon; myasthenia gravis; narrow-angle glaucoma; unstable cardiovascular status in acute hemorrhages. Safety during pregnancy (category C), lactation, or in children is not established.

Cautious Use

Autonomic neuropathy; heart disease, hypertension; patients >40 y (higher incidence of glaucoma).

Route & Dosage

Antispasmodic
Adult: PO 0.6–1 mL t.i.d. or q.i.d.
Child: PO 0.1 mL/kg/d in 3–4 divided doses (max: 3.5 mL/d)

Administration

Oral

Administer 30–60 min before meals and at bedtime.
Space administration of antacid and belladonna preparations at least 2 h apart.
Store at 15°–30° C (59°–86° F) in tightly covered, light-resistant containers, unless otherwise directed.

Adverse Effects (1%)

All: Dose related. CNS: Excitement (young children and the older adults), confusion, delirium. CV: Rapid heart beat, tachycardia, palpitation. Special Senses: Blurred vision, mydriasis, photophobia. GI: Dry mouth, constipation. Urogenital: Urinary retention, urgency.

Interactions

Drug: Amantadine, antihistamines, tricyclic antidepressants, quinidine, disopyramide, procainamide have additive anticholinergic effects; levodopa effects decreased; methotrimeprazine may precipitate extrapyramidal effects; antipsychotic effects of phenothiazines decreased (decreased absorption).

Pharmacokinetics

Absorption: Readily absorbed from GI tract. Onset: 1–2 h. Distribution: Well distributed in body; crosses blood brain barrier. Elimination: Excreted unchanged in urine.

Nursing Implications

Assessment & Drug Effects

Monitor ambulation of older adults or debilitated patients carefully, since drug may cause drowsiness and confusion.
Monitor I&O and assess for urinary retention.

Patient & Family Education

Note: Increase in fluid intake and bulk in diet may prevent or relieve constipation. Notify physician if constipation persists.
Avoid hot baths, saunas, and strenuous work or exercise during hot and humid weather.
Do not drive or engage in potentially hazardous activities until response to drug is known.
Practice meticulous oral hygiene. Sugarless gum, lemon drops, and frequent sips of water may help dry mouth.
Do not breast feed while taking this drug without consulting physician.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug