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Library / Pharmacology / Autonomics / Anticholinergics / Scopolamine

Scopolamine

Key Board Facts Grid

Target Receptors

Non-selective M1, M2, M3 muscarinic antagonist

BBB Penetration

Tertiary amine; crosses the BBB

Primary Indication

Motion sickness prophylaxis, postoperative nausea, end-of-life secretions

First-Line Antidote

Physostigmine if CNS anticholinergic toxicity occurs

Mechanism of Action

  • Antagonizes M1 receptors in the vestibular nuclei and vomiting center, reducing motion sickness.
  • Peripheral M3 blockade causes dry mouth, mydriasis, urinary retention, tachycardia.
  • CNS M1 blockade causes sedation, amnesia, and confusion.

Adverse Effects & Toxicities

  • Sedation, amnesia, confusion, delirium (especially in elderly).
  • Dry mouth, blurred vision, mydriasis, urinary retention, constipation, tachycardia.
  • Contraindications: narrow-angle glaucoma, urinary retention, severe BPH, GI obstruction.

DO / OMM Board Pearl

CNS-penetrating tertiary amine with vestibular ganglion modulation. The transdermal patch is placed behind the ear, an area with cranial nerve somatic landmark relevance.