Question

Scenario 1

Puan Mas was expecting in a week. Judging from the position of the baby in her womb, Dr. G, the obstetrician, decided that a Caesarean section was needed to deliver her baby. An epidural injection of a local anaesthetic agent was required to manage Puan Mas’s pain during the procedure. Dr. G estimated that the Caesarean section would take about 45 minutes to 1 hour to complete. The most suitable local anaesthetic agent to use is chloroprocaine.

a) The drug for pain management during the delivery is chloroprocaine. Explain why that drug is chosen.

Scenario 2

Mr. Sam, a bus driver, suffered from stomach cramps and pain after taking a big bowl of tomyam which he loved very much. He knew he had a tendency to get such stomach upsets after taking spicy food, but he just could not help it. He visited your pharmacy and you sold him hyoscine butylbromide (BuscopanR) 10 mg tablets to relieve his stomach “attack”.

a. Mr. Sam is concerned that the medication may cause him to feel sleepy because he has to drive the bus on a long-distance trip tonight. Will hyoscine butylbromide cause drowsiness? Explain your answer based on the structure of the drug and its relationship to its physicochemical properties.

b. State ONE (1) major difference between hyoscine butylbromide and the prototypical antimuscarinic agent.

Answer 1

Scenario 1a) It is observed that intraperitoneal chloroprocaine can be used an alternative option to avoid general anesthesia during cesarean delivery. It helps to alleviate mother's discomfort from surgical pain, reduce complications, and improve the birth experience. It is the preferred method of anesthesia for cesarean delivery.

Scenario 2a) Buscopan R 10mg which contains hyoscine butylbromide which may cause dizziness, tiredness, drowsiness in some people. If you have any of these symptoms, do not drive, operate machinery or do anything else that could be dangerous. A person should not drink alcohol while taking this medicine. Sam should not take this medicine if he is going to drive as he would feel drowsy and this could cause an accident.

2b) Hyoscine butylbromide is used to enable respiratory secretions during end of life stage whereas the prototypical antimuscarinic agents help reduce any involuntary detrusor contractions and increase bladder capacity.