Section 1 - CHEMICAL PRODUCT AND COMPANY IDENTIFICATION

PRODUCT NAME

HYOSCINE HYDROBROMIDE

NFPA

PRODUCT USE

An anticholinergic agent with central and peripheral actions. Hyoscine hydrobromide has
been used with morphine in acute mania and delirium, including delirium tremens. Also has
been used for the relief of withdrawal symptoms in various treatments of morphine
dependence. As a pre- operative medication hyoscine hydromide calms the patient, reduces
secretions, diminishes certain anaesthetic side- effects and assists the induction
process. Used also to prevent and treat travel- sickness, and in the eye for its mydriatic
(dilation of the pupil) and cycloplegic actions (paralysis of the ciliary muscle).
CAUTION: Hyoscine may cause drowsiness and dulling of mental alertness. Patients
undergoing treatment with hyoscine should not take charge of vehicles, other means of
transport where loss of attention may lead to accidents. Patients should abstain from
alcohol.

SYNONYMS

C17-H21-NO4.HBr, "1-alpha-H, 5-alpha-H-tropan-3-alpha-ol, 6-beta, 7-beta-epoxy-, (-)-
tropate", "1-alpha-H, 5-alpha-H-tropan-3-alpha-ol, 6-beta, 7-beta-epoxy-, (-)-tropate",
"(ester), hydrobromide", "hyoscini hydrobromidum", "hyoscine bromide", "(-)-hyoscine
hydrobromide", "L-hyoscine hydrobromide", "L-hyoscine hydrobromide", "hyoscine F
hydrobromide", "hyoscyine hydrobromide", "scopolamini hydrobromidum", "scopalamine
bromide", "(-)-scopolamine bromide", "scopolamine hydrobromide", "scopolaminium bromide",
"scopolammonium bromide", "(-)-(1S, 3s, 5R, 6R, 7S)-6, 7-epoxytropan-3-yl (S)-tropate
hydrobromide", "(-)-(1S, 3s, 5R, 6R, 7S)-6, 7-epoxytropan-3-yl (S)-tropate hydrobromide",
Beldavrin, Euscopol, Hysco, Isoscopil, Kwells, Scopamin, Scopos, Sereen, Triptone,
"quartenary ammonium anticholinergic alkaloid"

Section 2 - HAZARDS IDENTIFICATION

CANADIAN WHMIS SYMBOLS

EMERGENCY OVERVIEW

RISK

Very toxic by inhalation, in contact with skin and if swallowed.

POTENTIAL HEALTH EFFECTS

ACUTE HEALTH EFFECTS

SWALLOWED

  Severely toxic effects may result from the accidental ingestion of the material; animal experiments indicate that ingestion of less than 5 gram may be fatal or may produce serious damage to the health of the individual.  Anticholinergics can cause loss of vision. Effects associated with their use include increased heart rate, decreased saliva production and other secretions and reduction in bowel movements. Adverse effects include dry mouth, difficulty swallowing and speaking, thirst, dilated pupils, loss of focus, sensitivity to light, skin flushing and dryness, a temporary slowing of heart rate followed by rapid heart rate with palpitations and irregularities in rhythm. There may be vomiting, pain in the chest and dizziness. Toxicity due to overdose may result in rapid breathing, high fever, restlessness, confusion, excitement, paranoia, psychosis, hallucinations, delirium, seizures and convulsions. A rash may occur on the face or upper trunk. Severe intoxication can depress the central nervous system, causing inco-ordination, drowsiness, stupor, unconsciousness, coma, stoppage of circulation and breathing, and death.  Quaternary ammonium anticholinergic agents, in high doses, can cause postural hypotension and impotence. Paralysis may occur at very high doses.  

EYE

  There is some evidence to suggest that this material can causeeye irritation and damage in some persons.  Anticholinergic eye drops can cause stinging, dryness, redness, itch, dilated pupils, and loss of focus with blurred vision. Pupil Reflexes may be lost or diminished for 3 days.  

SKIN

  Skin contact with the material may produce severely toxic effects; systemic effects may result following absorption and these may be fatal.  The material is not thought to be a skin irritant (as classified using animal models). Abrasive damage however, may result from prolonged exposures. Good hygiene practice requires that exposure be kept to a minimum and that suitable gloves be used in an occupational setting.  Entry into the blood-stream, through, for example, cuts, abrasions or lesions, may produce systemic injury with harmful effects. Examine the skin prior to the use of the material and ensure that any external damage is suitably protected.  

INHALED

  Inhalation of dusts, generated by the material, during the course of normal handling, may produce severely toxic effects; these may be fatal.  The material is not thought to produce respiratory irritation (as classified using animal models). Nevertheless inhalation of dusts, or fume, especially for prolonged periods, may produce respiratory discomfort and occasionally, distress.  

CHRONIC HEALTH EFFECTS

  Long term exposure to high dust concentrations may cause changes in lung function i.e. pneumoconiosis; caused by particles less than 0.5 micron penetrating and remaining in the lung. Prime symptom is breathlessness; lung shadows show on X-ray.  Limited evidence suggests that repeated or long-term occupational exposure may produce cumulative health effects involving organs or biochemical systems.  There is some evidence that human exposure to the material may result in developmental toxicity. This evidence is based on animal studies where effects have been observed in the absence of marked maternal toxicity, or at around the same dose levels as other toxic effects but which are not secondary non-specific consequences of the other toxic effects.  Prolonged exposure to anticholinergic agents may irritate the eyes, causing allergic lid reactions, conjunctivitis, swelling, excess blood flow to the eyes, and sensitivity to light. Increase in eye pressure may lead to closed angle glaucoma. There may be hypersensitivity shown by conjunctivitis, rash and eczema. Anticholinergics can also cause chronic constipation with blockage of the intestine by feces.  Chronic intoxication with ionic bromides, historically, has resulted from medical use of bromides but not from environmental or occupational exposure; depression, hallucinosis, and schizophreniform psychosis can be seen in the absence of other signs of intoxication. Bromides may also induce sedation, irritability, agitation, delirium, memory loss, confusion, disorientation, forgetfulness (aphasias), dysarthria, weakness, fatigue, vertigo, stupor, coma, decreased appetite, nausea and vomiting, diarrhoea, hallucinations,  an acne like rash on the face, legs and trunk, known as bronchoderma (seen in 25-30% of case involving bromide ion), and a profuse discharge from the nostrils (coryza). Ataxia and generalised hyperreflexia have also been observed. Correlation of neurologic symptoms with blood levels of bromide is inexact. The use of substances such as brompheniramine, as antihistamines, largely reflect current day usage of bromides; ionic bromides have been largely withdrawn from therapeutic use due to their toxicity. Several cases of foetal abnormalities have been described in mothers who took large doses of bromides during pregnancy.  Hyoscine produces depression of the  cerebral cortex especially in the  motor areas and acts as a powerful hypnotic.  Under the conditions of a 2-year gavage study there was no evidence that  the material produced carcinogenic activity in male or female rats mice.  National Toxicological Program Technical Report Series No. 445, March 1997