Subcutaneous Dihydrocodeine Tartrate: Compatibility in a Syringe Pump With Other Drugs Frequently Prescribed for the Management of Symptoms Associated With Brain Tumors

Background Dihydrocodeine can be more effective in the management of headache due to brain tumor than other opioids. It can be used as a subcutaneous infusion, but at present, there is little available data to support its use in combination with other medicines in a syringe pump. Aim This project aimed to establish physical stability data for the use of dihydrocodeine with other drugs when combined in a syringe pump. Design: Dihydrocodeine was combined in a syringe pump with either cyclizine, midazolam, or hyoscine butylbromide at different doses chosen to represent routine clinical practice. Each drug combination was repeated twice—with 0.9% sodium chloride and with water for injections. Setting: The project was conducted in an independent hospice after seeking appropriate approvals to use the drugs for this purpose. Results Dihydrocodeine and midazolam appear compatible at when 0.9% sodium chloride is used as the diluent. Dihydrocodeine and cyclizine appeared compatible when either 0.9% saline or water for injections was used as the diluent. Dihydrocodeine and hyoscine butylbromide appeared compatible with either diluent at 24 hours. Conclusions Physical stability data has been described that will support the use of dihydrocodeine and other drugs that are commonly used to manage symptoms due to brain tumors at the end of life. This information will benefit patients and ensure that one syringe pump can be used where possible. Future work could expand on this data and explore the physical stability of three drug combinations in each syringe.

The effect of Hyoscine Butylbromide on the rate of vaginal delivery in cases of secondary arrest of cervical dilatation: A rondomized controlled clinical trial

Background For decades, health providers have worked to manage labor actively and safely, with the goal of shortening the duration of painful labor. Reduction of cesarean sections and maternal complication is also an important aspect of labor management. Antispasmodic are commonly administrating during labor in both developing and developed countries, although there is a paucity of scientific reports validating this. Hyoscine butylbromide is an effective antispasmodic drug. Therefore, We aim to assess efficacy of Hyoscine butylbromide on rate of vaginal delivery in cases of 2ry arrest of cervical dilatation. Objective To assess whether the intravenous injection of hyoscine butylbromide is effective in progress of labor in which cases with 2ry arrest of cervical dilatation. Patients and Methods The study included 100 pregnant women (PG, P1, P2, P3) conducted at Ain Shams University Maternity Hospital, the inclusion Criteria were: term uncomplicated singleton pregnancy in a spontaneous active labor, with cephalic presentation. The patient must be free from any medical disorder associated with pregnancy and free from any obstetric complication. Cases were subdivided into 2 groups: Study group: 50 patients received 40mg iv Hyoscine Butylbromide (as Buscopan 20mg\mrl) when the cervix >4cm dilated and was >50% effaced. Control group: 50 patients received 2ml saline as placebo. Results Significant increase in vaginal delivery rate (72%) in Hyoscine group; compared to Saline group (52%); with significant statistical difference (p = 0.04). Highly significant decrease in 1st and 2nd stage labor time in Hyoscine group; compared to Saline group; with highly significant statistical difference (p < 0.05 respectively). These results observed without significant difference as regards 3rd stage labor time and postpartum hemorrhage (p > 0.05), APGAR score and NICU admission (p > 0.05). Conclusion From the current study we can conclude that HBB 40 mg is safe and effective in increasing vaginal delivary rate in cases of 2ry arrest of 12 dilatation. It is effective in decreasing first and second stage of labor. It has no maternal or neonatal adverse effect. It is easy and available.

The Outpatient Prescribing Pattern of Hyoscine-N-Butylbromidein Alkharj

Objective: This study aims to assess the prescribing pattern of hyoscine butylbromide in out-patient department in Al Saih. Methods: This is a cross-sectional study that was conducted in in Al Saih city. The data were collected from electronic records retrospectively in the outpatient setting of a public hospital. Results: A total of 784 patients received hyoscine butylbromide during the study period. More than half of the patients were in the age level of 20-39 years (51.53%). Hyoscine-N-Butylbromide was prescribed mainly as a tablet (91.71%) followed by syrup (7.91%).Most of the prescriptions were written by the emergency department (96.17%). Conclusion: The present study showed that hyoscine butylbromidewas commonly prescribed. It was uncommonly prescribed to elderly patients. A continuous assessment of its prescribing is required to prevent its adverse events and drug interactions.

A feasibility study of hyoscine butylbromide (buscopan) to improve image quality of cone beam computed tomography during abdominal/pelvic Stereotactic Ablative Radiotherapy

Objectives: Cone beam computed tomography (CBCT) is used for image guidance of stereotactic ablative radiotherapy (SABR), but it is susceptible to bowel motion artefacts. This trial evaluated the impact of hyoscine butylbromide (buscopan) on CBCT image quality and its feasibility within a radiotherapy workflow. Methods: A single-centre feasibility trial (ISRCTN24362767) was performed in patients treated with SABR for abdominal/pelvic oligorecurrence. Buscopan was administered to separate cohorts by intramuscular (IM) or intravenous (i.v.) injection on alternate fractions, providing within-patient control data. 4-point Likert scales were used to assess overall image quality (ranging from excellent to impossible to use) and bowel motion artefact (ranging from none to severe). Feasibility was determined by patient/radiographer questionnaires and toxicity assessment. Descriptive statistics are presented. Results: 16 patients were treated (8 by IM and 8 by i.v. buscopan). The percentage of images of excellent quality with/without buscopan was 47 vs 29% for IM buscopan and 65 vs 40% for i.v. buscopan. The percentage of images with no bowel motion artefact with/without buscopan was 24.6 vs 8.9% for IM buscopan and 25.8 vs 7% for i.v. buscopan. Four patients (25%) reported dry mouth. 14 patients (93%) would accept buscopan as routine. 11 radiographers (92%) reported no delay in treatments. Conclusions: A trend towards improved image quality/reduced bowel motion artefact was observed with IM/i.v. buscopan. Buscopan was well tolerated with limited impact on workflow. Advances in knowledge: This is the first trial of buscopan within a radiotherapy workflow. It demonstrated a trend to improved image quality and feasibility of use.