Benzatropine

Class Anticholinergic
Chemistry

Tropane alkaloid

Routes of administration

Oral, IV, or as patches

Absorption

Oral bioavailability is about 29%, mostly because of poor and slow absorption

Solubility

pKa 9.54, highly water-soluble.

Distribution

VOD=12-30L/kg, highly protein bound (95%)

Metabolism

Undergoes minimal hepatic metabolism

Elimination

Excreted primarily through the urine and bile unchanged

Time course of action

Half life is 7 hours

Target receptor

Muscarinic receptors (M1-M5), which are mainly Gq-coupled receptors, but also targets antihistamine receptors. By a completely unrelated mechanism, it also acts as a potent inhibitor of presynaptic carrier-mediated dopamine transport.

Mechanism of action

By compettively blocking the effets of acetylcholine on Gq-coupled muscrinic receptors, benzatropine decreases the intracellular concentration of ioniased calcium and cAMP. This results in numerous downstream clinical effects. It also causes sedation by its antagonist effects on CNS histamine receptors, and it reverses the extrapyramidal effects of dopamine antagonists (eg. maxolon-induced dystonia) by increasing synaptic dopamine concentrations through inhibitoon of presynaptic dopamine transport.

Clinical effects

#NAME?

Literature reference

This Canadian monograph from Pendopharm

CICM details of understanding Not specifically listed in the CICM syllabus
Mentioned around Deranged Physiology
Related SAQs