title: Perspectives on transdermal scopolamine for the treatment of postoperative nausea and vomiting.
abstract: Transdermal scopolamine, a patch system that delivers 1.5 mg of scopolamine gradually over 72 hours following an initial bolus, was approved in the United States in 2001 for the prevention of postoperative nausea and vomiting (PONV) in adults. Scopolamine (hyoscine) is a selective competitive anatagonist of muscarinic cholinergic receptors. Low serum concentrations of scopolamine produce an antiemetic effect. Transdermal scopolamine is effective in preventing PONV versus placebo [relative risk (RR)=0.77, 95% confidence interval (CI), 0.61-0.98, P = 0.03] and a significantly reduced risk for postoperative nausea (RR=0.59, 95% CI, 0.48-0.73, P < 0.001), postoperative vomiting (RR=0.68, 95% CI, 0.61-0.76, P < 0.001), and PONV (RR 0.73, 95% CI, 0.60-0.88, P = 001) in the first 24 hours after the start of anesthesia.
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA. jpjmd@msn.com
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Pergolizzi
authors.forename: Beverly K
authors.initials: BK
authors.lastname: Philip
authors.forename: John B
authors.initials: JB
authors.lastname: Leslie
authors.forename: Robert
authors.initials: R
authors.lastname: Taylor
authors.forename: Robert B
authors.initials: RB
authors.lastname: Raffa
mesh_terms: D000279:Administration, Cutaneous; D000932:Antiemetics / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D006801:Humans; D018727:Muscarinic Antagonists / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D020250:Postoperative Nausea and Vomiting / Q000503:physiopathology / Q000517:prevention & control*; D012601:Scopolamine / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D000932:Antiemetics; D003692:Delayed-Action Preparations; D018727:Muscarinic Antagonists; D012601:Scopolamine