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Gastrointestinal disease
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
Antispasmodic agents act to relax intestinal smooth muscle and are used widely in the management of IBS in the non-pregnant woman. There is no evidence for teratogenesis with anticholinergic agents such as hyoscine (Buscopan®) and dicyclomine (Merbentyl®). There is no evidence of harm with smooth muscle relaxants such as mebeverine (Colofac®).
Rational Medical Therapy of Functional GI Disorders
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Richard M. Sperling, Kenneth R. McQuaid
Symptom subsets—IBS is a heterogeneous disease, with patients complaining of different presenting symptoms. Patients with diarrhea-predominant symptoms may respond differently to certain agents than patients with constipation- or pain/bloating-predominant symptoms. For example, an antispasmodic may relieve pain and bloating but exacerbate constipation. It may be important to either study specific symptom subsets or stratify IBS patients before randomization into symptom subsets. The use of “mean” symptom scores for the entire study population rather than for specific symptom subsets dilutes the ability to detect beneficial drug therapies.
Disorders of the digestive tract
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
Symptoms may increase in pregnancy (Nelson-Piercy, 2006) and diet modification (for example stool-bulking agents, increased fluid intake and an increase in dietary fibre) may help. If necessary, antispasmodic medication may be prescribed.
Pharmacological approaches to treat intestinal pain
Published in Expert Review of Clinical Pharmacology, 2023
Mikolaj Swierczynski, Adam Makaro, Agata Grochowska, Maciej Salaga
Accurate pharmacological treatment depends on the cause of pain. In IBS optimal therapy is of particular importance for today’s medicine, since this disorder is observed in approximately 10% of the population [19]. Moreover, the disease is categorized into subtypes characterized by highly variable symptoms, which require adequate therapeutic approaches. Current strategies are based on the non-pharmacological approach based on explanation any doubts about the disease to the patients, psychotherapy and dietary intervention. The pharmacological treatment is generally considered as second line therapy, in case of high intensity of pain, lack of effectiveness or applicability of non-pharmacological methods. In pharmacological treatment the use of antispasmodics is the most common approach, because of their accessibility, pricing, good safety profile and ‘universal’ mechanism of action targeting the intestinal muscle layers, whose hypercontractility often serves as effector exerting intestinal pain in various conditions. In IBS patients with accompanying psychologic conditions, the antidepressants should also be taken into consideration as component of basic treatment. Other groups of drugs are administered in later therapeutic lines or based on clinical presentation of the patients including IBS subtype and intensity of other symptoms, including diarrhea and constipation [22].
Antispasmodic medications may be associated with reduced recovery during inpatient rehabilitation after traumatic spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2018
Eric R. Theriault, Vincent Huang, Gale Whiteneck, Marcel P. Dijkers, Noam Y. Harel
The strength of these findings is limited in several ways. First and most importantly, the findings are, strictly speaking, only correlative—no causation can be inferred. Spasticity itself was not measured with any standard tool. Neither were the indications for prescribing medications recorded. Therefore, medications classified as antispasmodics may have been administered for other conditions such as pain, insomnia, or anxiety. Likewise, medications used for these latter indications are sometimes used to treat spasticity as well. Without direct knowledge of the indications for each prescribed medication, we chose to include in the analysis benzodiazepines and additional medications that have effects on both spasticity and other symptoms. We specifically excluded narcotics, non-benzodiazepine sleep medications, anti-depressants, and anti-epileptics from our analysis.
Pharmacological and non-pharmacological pain relief for office hysteroscopy: an up-to-date review
Published in Climacteric, 2020
G. Riemma, A. Schiattarella, N. Colacurci, S. G. Vitale, S. Cianci, A. Cianci, P. De Franciscis
Antispasmodics are commonly used in outpatient gynecologic procedures due to their specific action on the cervical–uterine plexus, reducing spasms achieved by cervical smooth muscle cells and at the same time acting as a bland cervical dilatator. However, no agreement about their usefulness is available in the current literature. The antispasmodic drotaverine, administered orally with mefenamic acid before in-office hysteroscopy and endometrial biopsy, was compared to paracervical block achieved with 1% lignocaine. In this randomized controlled trial, oral drotaverine plus mefenamic acid was more effective than paracervical block in reducing pain perception36.