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a drug used to relieve or prevent spasms (especially of the smooth muscles) (同)spasmolytic, antispasmodic_agent

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/11/26 09:14:18」(JST)

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An antispasmodic (synonym: spasmolytic) is a drug or a herb that suppresses muscle spasms.^[1]^[2]

Smooth muscle spasm[edit]

One type of antispasmodics is used for smooth muscle contraction, especially in tubular organs of the gastrointestinal tract. The effect is to prevent spasms of the stomach, intestine or urinary bladder. Both dicyclomine and hyoscyamine are antispasmodic due to their anticholinergic action. Both of these drugs have general side effects and can worsen gastroesophageal reflux disease.^[3]

Mebeverine is a muscolotropic spasmolytic with a strong and selective action on the smooth muscle spasm of the gastrointestinal tract, particularly of the colon. It does not have the acetylecholine side effect commonly seen in an anticholinergic antispasmodic.

Papaverine is an opium alkaloid used to treat visceral spasms, erectile dysfunction and investigated as antipsychotic drug due to its potency to inhibit phosphodiesterase PDE10A.

Peppermint oil has been traditionally used as an antispasmodic, and a review of studies on the topic found that it "could be efficacious for symptom relief in IBS"^[4] (as an antispasmodic) although more carefully controlled studies are needed. A later study showed it is an effective antispasmodic when test-applied topically to the intestine during endoscopy.^[5]

Bamboo shoots have been used for gastrointestinal and antispasmodic symptoms. Anisotropine, Atropine, Cindinium Cap are also the most commonly used modern antispasmodics.

Skeletal muscle spasm[edit]

Pharmacotherapy may be used for acute musculoskeletal conditions when physical therapy is unavailable or has not been fully successful. Another class of antispasmodics for such treatment includes cyclobenzaprine, carisoprodol, orphenadrine, and tizanidine.^[6] Effectiveness has not been clearly shown for metaxalone, methocarbamol, chlorzoxazone, baclofen, or dantrolene.^[6] Applicable conditions include acute back or neck pain, or pain after an injury.

Spasm may also be seen in movement disorders featuring spasticity in neurologic conditions such as cerebral palsy, multiple sclerosis, and spinal cord disease. Medications are commonly used for spastic movement disorders, but research has not shown functional benefit for some drugs.^[7]^[8] Some studies have shown that medications have been effective in decreasing spasticity, but that this has not been accompanied by functional benefits.^[7] Medications such as baclofen, tizanidine, and dantrolene have been used.^[6]

References[edit]

^ Antispasmodic at eMedicine Dictionary
^ "Antispasmodic". Dorland's Medical Dictionary.
^ "Treatment of Irritable Bowel Syndrome - December 15, 2005 -- American Family Physician". Retrieved 2007-08-14.
^ Pittler MH, Ernst E (1998). "Peppermint oil for irritable bowel syndrome: a critical review and metaanalysis". Am. J. Gastroenterol. 93 (7): 1131–1135. doi:10.1111/j.1572-0241.1998.00343.x. PMID 9672344.
^ Hiki N, Kurosaka H, Tatsutomi Y et al. (2003). "Peppermint oil reduces gastric spasm during upper endoscopy: a randomized, double-blind, double-dummy controlled trial". Gastrointest. Endosc. 57 (4): 475–482. doi:10.1067/mge.2003.156. PMID 12665756.
^ ^a ^b ^c Chou R, Peterson K, Helfand M (2004). "Comparative efficacy and safety of skeletal muscle relaxants for spasticity and musculoskeletal conditions: a systematic review". Journal of Pain Symptom Management 28 (2): 140–175. doi:10.1016/j.jpainsymman.2004.05.002. PMID 15276195.
^ ^a ^b Taricco M, Adone R, Pagliacci C, Telaro E. Pharmacological interventions for spasticity following spinal cord injury. Cochrane Database of Systematic Reviews 2000, Issue 2. Art. No.: CD001131 Taricco, M.; Adone, R.; Pagliacci, C.; Telaro, E. (2000). "Pharmacological interventions for spasticity following spinal cord injury". In Taricco, Mariangela. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD001131. edit.
^ Shakespeare D, Boggild M, Young CA. Anti-spasticity agents for multiple sclerosis. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD001332 Shakespeare, D.; Boggild, M.; Young, C. A. (2003). "Anti-spasticity agents for multiple sclerosis". In Shakespeare, David. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD001332. edit.

External links[edit]

Antispasmodics at the US National Library of Medicine Medical Subject Headings (MeSH)

UpToDate Contents

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1. 成人における過敏性腸症候群の治療 treatment of irritable bowel syndrome in adults
2. 慢性疼痛の治療の概要 overview of the treatment of chronic pain
3. 過敏性腸症候群に対するアロセトロン塩酸塩（Lotronex） alosetron hydrochloride lotronex for irritable bowel syndrome
4. 一過性直腸痛 proctalgia fugax
5. オッディ括約筋機能不全の臨床症状よび診断 clinical manifestations and diagnosis of sphincter of oddi dysfunction

English Journal

Review: Antispasmodics and antidepressants were each effective in the irritable bowel syndrome; bulking agents were not.

[No authors listed]
Annals of internal medicine.Ann Intern Med.2011 Dec 20;155(12):JC607.
PMID 22184708

Japanese Journal

Colonic Distention at Screening CT Colonography: Role of Spasmolytic Agents and Body Habitus

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The Kurume Medical Journal 61(1.2), 9-15, 2014
… We investigated the effect of antispasmodic agents and the patient body habitus on the degree of colonic dilation in screening CTC.<BR>We assessed the effect of clinical characteristics [age, gender, body mass index (BMI), and the presence of diverticula] and the use of antispasmodics on colonic distention in 140 patients who underwent CTC for colorectal cancer screening. … Seventy patients received antispasmodics prior to CT examination and the other 70 did not. …
NAID 130004775771

Colonic Distention at Screening CT Colonography: Role of Spasmolytic Agents and Body Habitus

, , , , , , , ,
The Kurume Medical Journal, 2014
… <BR>We assessed the effect of clinical characteristics (age, gender, body mass index [BMI], and the presence of diverticula) and the use of antispasmodics on colonic distention in 140 patients who underwent CTC for colorectal cancer screening. … Seventy patients received antispasmodics prior to CT examination and the other 70 did not. …
NAID 130004705782

しゅく薬甘草湯を用いた胃Ｘ線検査法の検討

徳留一博
日本東洋医学雑誌 44(2), 159-166, 1993
鎮痙剤を用いる胃X線検査では尿閉, 動悸, 散瞳などの副作用が起こり, 高齢者や心疾患, 喘息などの患者の検査の際は苦慮することが多い。そこで胃運動と胃液分泌の抑制を目的とする鎮痙剤筋注使用の代わりに布薬甘草湯エキス剤を用い, 胃X線検査を行い, そのX線写真の画質を調べ, その診断能を検討した。そして, 日常臨床でこの方法が帯有用であることがわかったので報告する。
NAID 130001416994

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リンク元	「spasmolytic」「antispasmodic agent」「antispasmodic drug」「parasympatholytics」「antispastic drug」
関連記事	「antispasmodic」