Anticholinergic antiemetic
Scopolamine patch
Transderm Scōp Anticholinergic — green 1 mg over 72 h (1.5 mg patch)
Transdermal PONV prophylaxis for high-risk patients.
Typical adult doses
| Indication | Dose | Onset | Duration |
|---|---|---|---|
| PONV prophylaxis | 1 patch behind the ear the evening before or ≥ 2 h pre-op | — | — |
Mechanism
Muscarinic antagonist (vestibular pathway).
Key effects
- Antiemetic
Watch out for
- Confusion in the elderly
- Dry mouth, blurred vision
- Mydriasis if hand-to-eye contact — wash hands
Pimp questions
Pimp question
A patient has one dilated pupil after surgery and a scopolamine patch. What happened?
Answer
Likely anisocoria from touching the patch then the eye — wash hands after applying. Still tell the team.