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Scopolamine for preventing and treating motion sickness

This Cochrane Review summarises evidence from 14 randomised controlled studies evaluating the effectiveness and safety of scopolamine for motion sickness. The results show that scopolamine is more effective than placebo and scopolamine‐like derivatives in the prevention of nausea and vomiting associated with motion sickness. However, scopolamine was not shown to be superior to antihistamines and combinations of scopolamine and ephedrine. Scopolamine was less likely to cause drowsiness, blurred vision or dizziness when compared to these other agents.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Interventions to treat noisy breathing, or 'death rattle': the unpleasant, gurgling breathing occuring in many patients who are about to die

Approximately half of those relatives and friends who witness it, as well as hospital staff, find the noise of 'death rattle' distressing. For this reason, doctors and nurses try to eliminate the sound using a variety of methods, from changing the position of the patient to giving drugs to stop the noise. The aim of this review is to find out which treatment, if any, is best. Only four of 32 reports identified met the inclusion criteria for this review; none showed a convincing benefit of any single drug over any others. Some treatments may be worth trying but staff should watch carefully for any side effects of the treatment (e.g. agitation or excessively dry mouth). Anxious relatives need explanation, reassurance and discussion about any fears and concerns associated with the terminal phase and 'death rattle'. Research in this difficult area is necessary to understand the cause of the noise, its effect on the patient and those around them and the best ways of managing this condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Nonsteroidal anti‐inflammatory drugs are effective treatment for acute renal colic

Acute renal colic is the pain caused by the blockage of urine flow secondary to urinary stones. The prevalence of kidney stone is thought to be between 2% to 3%, and the incidence has been increasing in recent years due to changes in diet and lifestyle. The renal colic pain is usually a sudden intense pain located in the flank or abdominal areas. This usually happens when a urinary stone blocks the ureter (the tube connecting the kidneys to the bladder). Different types of pain killers are used to ease the discomfort. Nonsteroidal anti‐inflammatory drugs (NSAIDs) and antispasmodics (treatment that suppresses muscle spasms) are used commonly to relieve pain and discomfort. This review aimed to assess the effectiveness of commonly used non‐opioid pain killers in adult patients with acute renal colic pain. Fifty studies enrolling 5734 participants were included in this review. Treatments varied greatly and combining of studies was difficult. We found that overall NSAIDs were more effective than other non‐opioid pain killers including antispasmodics for pain reduction and need for additional medication. We also found that the combining NSAIDs with antispasmodics did not increase the efficacy. No serious adverse effects were reported by any of the included studies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Scopolamine as an antidepressant: a systematic review

OBJECTIVES: The cholinergic-adrenergic hypothesis of mania and depression states that depression is characterized by an increase in central cholinergic activity relative to noradrenergic tone. Scopolamine is a centrally acting competitive inhibitor of the muscarinic cholinergic receptor site. This review seeks to find all available data investigating scopolamine as an antidepressant.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Hyoscine vs glycopyrronium for drying respiratory secretions in dying patients

The author of this review concluded that there was no clear evidence to support the choice of hyoscine over glycopyrronium for drying up the secretions that cause the 'death rattle'. A thorough search identified only two relevant studies with conflicting results. The author's interpretation of the evidence was appropriate and the conclusion is likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Transdermal scopolamine for the prevention of postoperative nausea and vomiting: a systematic review and meta-analysis

The authors concluded that transdermal scopolamine compared with placebo was associated with significant reductions in postoperative nausea and vomiting during the first 24 hours post anaesthesia but there was a higher prevalence of visual disturbances at 24 to 48 hours after surgery. Due to the unknown quality of included studies, the reliability of the authors' conclusions is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Effect of hyoscine N-butylbromide on polyp detection during colonoscopy: a meta-analysis of randomized controlled trials

Bibliographic details: Li Y, Lian JJ, Ying J, Gao J, Luo TC, Zeng XQ, Chen SY.  Effect of hyoscine N-butylbromide on polyp detection during colonoscopy: a meta-analysis of randomized controlled trials. Journal of Gastroenterology and Hepatology Research 2014; 3(9): 1220-1226 Available from: http://www.ghrnet.org/index.php/joghr/article/view/852

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Systematic review of controlled clinical trials of gastric lavage in acute organophosphorus pesticide poisoning

This review assessed the effect of gastric lavage in acute organophosphorus pesticide poisoning. The authors concluded that there was no high quality evidence available to support the clinical effectiveness of single or multiple gastric lavages for organophosphorus pesticide poisoning. Given the methodological and reporting limitations of the primary study data, this conclusion appears appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Anticholinergic bronchodilators versus beta2‐sympathomimetic agents for acute exacerbations of chronic obstructive pulmonary disease

Shortness of breath is the main complaint of persons with chronic obstructive pulmonary disease (COPD). This symptom worsens during an exacerbation or 'flare' of COPD. Trials comparing ipratropium bromide versus beta‐agonists showed no significant difference in short‐term or long‐term effects (24 hours) on ease of breathing. Side effects of these drugs were reported by only a minority of patients and include dry mouth and tremor, and a 'strange feeling' after drug administration.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Anticholinergic therapy for acute asthma in children

Asthma is a condition that affects the airways (tubes carrying air in and out of the lungs). During an asthma exacerbation (attack), the airways narrow and drugs can be taken to dilate, or widen, the airways. Common bronchodilators (medicines used to widen the airways) are short‐acting beta2‐ agonists (e.g. salbutamol) or anticholinergics (e.g. ipratropium bromide). In this review, we examined if the use of anticholinergic inhalers during an asthma attack in children aged over two years is effective compared to either placebo or another bronchodilator. We also looked at combinations of anticholinergic plus a beta2‐agonist compared to an anticholinergic on its own.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Tiotropium for stable chronic obstructive pulmonary disease

Tiotropium (Spiriva) is a bronchodilator drug that has been developed to open the airways in the lungs effectively with once daily dosing. The main aims of therapy in COPD are to reduce exacerbations and related hospitalisations, improve quality of life, and reduce the rate of decline in lung function. The evidence from the trials in the review indicates that, compared with a placebo and ipratropium, tiotropium does reduce exacerbations and related hospitalisations and improves quality of life and symptoms in people with moderately severe COPD, although the evidence with regards to decline in lung function is less clear. Tiotropium caused dry mouth. Compared with other commonly used drugs in COPD, such as long‐acting beta agonists (including salmeterol), there is not enough evidence for us to draw reliable conclusions. In order to better understand the effects of this drug we need long‐term studies (over several years), studies conducted in mild and severe COPD, and additional studies that measure outcomes in relation to other agents used in the treatment of this condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Tiotropium versus long‐acting beta2‐agonists (LABAs) in the management of COPD

Tiotropium is an inhaled medication that helps open the airways (bronchodilator) and is used to manage persistent symptoms of COPD. We found seven studies including 12,223 participants that compared tiotropium with long‐acting beta2‐agonists (LABAs), which are another type of bronchodilator. This systematic review found that currently there is insufficient evidence to suggest which of these treatments provides greater long‐term benefit in quality of life. Furthermore, both treatments had similar effects on symptoms, lung function and death rates.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

For people with COPD, is it better to take a combination of tiotropium and long‐acting beta2‐agonists than either inhaler alone?

Chronic obstructive pulmonary disease (COPD) is a lung disease that includes the conditions chronic bronchitis and emphysema. The symptoms include breathlessness and a chronic cough. COPD is an irreversible disease that is usually brought on by airway irritants, such as smoking or inhaled dust.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

The effect of hyoscine N-butylbromide on adenoma detection rate: a meta-analysis of randomized clinical trials

BACKGROUND AND AIM: Anti-spasmodic drugs may facilitate mucosal inspection during colonoscopy. The impact of hyoscine N-butylbromide (HBB) on polyp detection rate (PDR) and adenoma detection rate (ADR) is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Combined beta‐agonists and anticholinergics compared to beta‐agonists alone for adults with asthma treated in emergency departments

We looked at if combined treatment of short‐acting beta‐agonists and anticholinergics were more effective to improve outcomes in adults with asthma who were treated in emergency departments compared to treatment with beta‐agonists alone.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Hyoscine for polyp detection during colonoscopy: a meta-analysis and systematic review

AIM: To assess the role of hyoscine for polyp detection during colonoscopy.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

The effect of adding inhaled corticosteroids to tiotropium and long‐acting beta2‐agonists for managing chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a lung disease which includes the conditions chronic bronchitis and emphysema. COPD is characterised by blockage or narrowing of the airways. The symptoms include breathlessness and a chronic cough. COPD is an irreversible disease that is usually brought on by airway irritants, such as smoking or inhaled dust.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Combined inhalers compared to tiotropium inhalers for the treatment of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a general term referring to chronic bronchitis and emphysema, or both. COPD occurs when airflow to the lungs is restricted. Symptoms include cough and breathlessness and inhalers are commonly used to prevent and relieve these symptoms. COPD is usually caused by smoking and the best way to improve symptoms is to give up smoking.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Tiotropium versus ipratropium bromide in the management of COPD

Chronic obstructive pulmonary disease (COPD) is a lung disease that includes the conditions chronic bronchitis and emphysema. COPD is mainly caused by smoking or inhaling dust, which leads to blockage or narrowing of the airways. The symptoms include breathlessness and a chronic cough. Tiotropium is an inhaled medication, taken once a day, to help widen the airways (bronchodilator) and is used in the management of COPD. Ipratropium bromide is also a bronchodilator but has a shorter duration of action and has to be taken several times a day.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Tiotropium for managing COPD

Chronic obstructive pulmonary disease (COPD) is a lung disease which includes the conditions, chronic bronchitis and emphysema. It is caused by smoking or inhaled dust, which leads to blockage or narrowing of the airways. The symptoms include breathlessness and a chronic cough. Tiotropium is an inhaled medication that helps widen the airways (bronchodilator) for up to 24 hours, and is used to manage persistent symptoms of COPD.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

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