Propantheline bromide (INN

International Nonproprietary Name

An International Nonproprietary Name is the official nonproprietary or generic name given to a pharmaceutical substance, as designated by the World Health Organization...

) is an antimuscarinic agent used for the treatment of excessive sweating (hyperhidrosis

Hyperhidrosis

Hyperhidrosis is the condition characterized by abnormally increased perspiration, in excess of that required for regulation of body temperature.-Classification:Hyperhidrosis can either be generalized or localized to specific parts of the body...

), cramps or spasms of the stomach, intestines (gut) or bladder, and involuntary urination (enuresis

Enuresis

Enuresis refers to an inability to control urination. Use of the term is usually limited to describing individuals old enough to be expected to exercise such control.Types of enuresis include:* Nocturnal enuresis* Diurnal enuresis...

). It can also be used to control the symptoms of irritable bowel syndrome

Irritable bowel syndrome

Irritable bowel syndrome is a diagnosis of exclusion. It is a functional bowel disorder characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any detectable organic cause. In some cases, the symptoms are relieved by bowel movements...

 and similar conditions. This agent can also be used for patients who experience intense GI symptoms while tapering off of TCAs.

Indications

By relaxing the gut muscle, propantheline can relieve pain in conditions caused by spasm

Spasm

In medicine a spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice. It is sometimes accompanied by a sudden burst of pain, but is usually harmless and ceases after a few minutes...

 of the muscle in the gut. Relaxing the smooth muscle in the bladder

Urinary bladder

The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...

 prevents the involuntary spasms that can allow leakage of urine

Urine

Urine is a typically sterile liquid by-product of the body that is secreted by the kidneys through a process called urination and excreted through the urethra. Cellular metabolism generates numerous by-products, many rich in nitrogen, that require elimination from the bloodstream...

 from the bladder in the condition known as enuresis

Enuresis

Enuresis refers to an inability to control urination. Use of the term is usually limited to describing individuals old enough to be expected to exercise such control.Types of enuresis include:* Nocturnal enuresis* Diurnal enuresis...

 (involuntary urination in adults). Propantheline can also be used to treat excessive sweating

Sweating

Perspiration is the production of a fluid consisting primarily of water as well as various dissolved solids , that is excreted by the sweat glands in the skin of mammals...

 because acetylcholine block also reduces secretions such as sweat and tears

Tears

Tears are secretions that clean and lubricate the eyes. Lacrimation or lachrymation is the production or shedding of tears....

.

Adverse effects

Side effects

Adverse drug reaction

An adverse drug reaction is an expression that describes harm associated with the use of given medications at a normal dosage. ADRs may occur following a single dose or prolonged administration of a drug or result from the combination of two or more drugs...

 include tachycardia

Tachycardia

Tachycardia comes from the Greek words tachys and kardia . Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate...

, constipation

Constipation

Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation...

, hypersensitivity to light

Photophobia

Photophobia is a symptom of abnormal intolerance to visual perception of light. As a medical symptom photophobia is not a morbid fear or phobia, but an experience of discomfort or pain to the eyes due to light exposure or by presence of actual physical photosensitivity of the eyes, though the term...

, dry mouth, and urinary retention

Urinary retention

Urinary retention, also known as ischuria, is a lack of ability to urinate. It is a common complication of benign prostatic hyperplasia , although it can also be caused by nerve dysfunction, constipation, infection, or medications...

.
This can also be prescribed by dentists for certain patients who salivate excessively. By taking this medication it becomes easier to do "dry" dentistry

Mechanism of action

Propantheline is one of a group of antispasmodic

Antispasmodic

An antispasmodic is a drug or a herb that suppresses muscle spasms.-Smooth muscle spasm:One type of antispasmodics is used for smooth muscle contraction, especially in tubular organs of the gastrointestinal tract...

 medications which work by blocking the action of the chemical messenger acetylcholine

Acetylcholine

The chemical compound acetylcholine is a neurotransmitter in both the peripheral nervous system and central nervous system in many organisms including humans...

, which is produced by nerve cells, to muscarinic receptors present in various smooth muscular

Smooth muscle

Smooth muscle is an involuntary non-striated muscle. It is divided into two sub-groups; the single-unit and multiunit smooth muscle. Within single-unit smooth muscle tissues, the autonomic nervous system innervates a single cell within a sheet or bundle and the action potential is propagated by...

tissues, in places such as the gut, bladder and eye. Normally, the binding of acetylcholine induces involuntary smooth muscular contractions.