Definition. - The dried rhizome of Scopola Carniolica, Jacquin. Scopola is closely related to belladonna and hyoscyamus.

The Pharmacopoeia demands that the drug contain not less than 0.5 per cent. of alkaloids; it is assayed by the same process as are belladonna leaves.

Dose. - Average dose: 0.045 Gm. =45 milligrammes (3/4 grain). U. S. P.

The alkaloid of scopola is almost wholly hyoscine. The content of the alkaloids of scopola is remarkably uniform (about 0.55 per cent.), whereas the percentage of alkaloids in belladonna varies from 0.2 to above 1 per cent.

Official Preparations

Scopolamine? Hydrobromidum - Scopolaminee Hydrobromidi - Scopolamine Hydrobromide (U. S. P.). - Definition. - The hydrobromide of an alkaloid, C17H11-N04HBr+3H1O, obtained from plants of the Solanacea; chemically identical with hyoscine hydrobromide.

Although hyoscine hydrobromide, which was admitted into the U. S. Pharmacopoeia, 1890, and scopolamine hydrobromide are identical, both names are used in the U. S. Pharmacopoeia, Eighth Decennial Revision, as separate headings, because physicians are more familiar with the name hyoscine than with scopolamine. Scopolamine is formed by the union of tropic acid and scopoline, a compound similar to tropine. (See Horn-atropine.)

Dose. - Average dose: 1/128 grain (0.0005 Gm. =0.5 milligramme). U. S. P.

Extractum Scopolae - Extracti Scopolae - Extract of Scopola (U. S. P.). - The U. S. Pharmacopoeia demands that the extract of scopola contain 2 per cent. of mydriatic alkaloids; for method of assay see Pharmacopoeia.

Dose. - Average dose: 1/5 grain (0.010 Gm. = 10 milligrammes), U. S. P.

Fluidextractum Scopolae - Fluidextracti Scopolae - Fluidextract of Scopola (U. S. P.). - Prepared from scopola (q. v.) and containing 0.5 per cent. of the mydriatic alkaloids of this drug.

Dose. - Average dose: 1 minim (0.05 Cc), U. S. P. This dose contains 1/256 grain (0.00025 Gm.) of the scopola alkaloids.

Antagonists, incompatibles, and synergists the same as for belladonna.

Physiological Action. - The action of hyoscyamine is analogous to that of belladonna, with the following difference: (1) It shows more cerebral depression, as a rule, than does atropine. Excitement is, however, by no means infrequent.

(2) Pure hyoscyamine is thought to act more strongly on the heart, pupils, and sweat glands than atropine. Others deny this. According to Merck, there is absolutely no difference between atropine and hyoscyamine. Cushny says that while the resemblance is very close, there are differences. The consensus of clinical experience, however, seems to be that, while hyoscyamine closely resembles atropine, the former is milder in action.

(3) As for hyoscine (scopolamine), the action is quite different. Hyoscine is a distinct hypnotic. It depresses the cerebrum. Whether this depression is analogous to the depression of atropine with a very slight or no preliminary stimulation is not yet known. It is not improbable that hyoscine may be regarded as causing a more profound coma with less of the other effects of atropine. In its action on the peripheral nervous system it very closely resembles atropine in its action, being perhaps more powerful. Profound collapse has occurred from its use in disease with rapid and feeble pulse. The action in the medulla does not seem to be as stimulating as is that of atropine.

Untoward action, poisoning, and treatment of poisoning are the same as for belladonna.

Therapeutics. - Hyoscyamus may be used for the same purposes as belladonna, but is considered superior to the latter drug as a urinary sedative in the treatment of incontinence of urine, vesical tenesmus, cystitis, prostatitis, etc.

For the relief of colic of various forms, and to allay the griping produced by certain purgatives, hyoscyamus is better than belladonna.

In mental disorders it is useful in any maniacal state. In convulsive disorders, hysterical convulsions, chorea,paralysis agitans, etc., hyoscine is valuable. It has been recently advocated as a hypnotic in the treatment of the morphine habit.

Hyoscyamine has been found useful in aggressive mania, chronic forms with hallucinations, subacute and recurrent mania, the irritative stages of general paralysis, and in epilepsy.

Hyoscyamus and its alkaloids are fully equal to belladonna in the treatment of asthma, whooping cough, neuralgia, enteralgia, etc.

As an anodyne and hypnotic for children hyoscyamus is frequently used. Hyoscine and morphine have recently been used extensively as an anesthetic. Morphine - gr. 1/8 (0.008 Gm.) to gr. 1/4 (0.015 Gm.) - with hyoscine - gr. 1/100 (0.0006 Gm.) - is injected hypodermically, repeated in half or one hour if necessary, and again, when usually even a capital operation may be performed painlessly, or with the aid of the merest whiff of chloroform. This method of securing anesthesia is being widely tested and rapidly coming into favor in obstetrical practice.

Administration. - Like belladonna, this drug should be administered tentatively. Any of the preparations may be given. The salts of the alkaloids may be administered either subcutaneously or internally.

The hyoscine is tasteless, and may be easily given in various drinks. When used internally its action is slower, but more prolonged, than when given hypodermically, though the dose under the former method should be twice that of the latter.