Question

You plan to prescribe scopolamine, as a transdermal drug delivery system (skin patch), for a patient who will be leaving for an expensive cruise and is very susceptible to motion sickness. What comorbidity would weigh against prescribing the drug because it is most likely to pose adverse effects-or be truly contraindicated?

a. Angle-closure (narrow-angle) glaucoma
b. Bradycardia
c. History of allergic reactions to uncooked shellfish
d. Resting blood pressure of 112/70
e. Hypothyroidism, mild
f. Parkinson disease (early onset, not currently treated)

Answer 1

Angle-closure (narrow-angle) glaucoma would be the comorbidity contraindicating the use of a scopolamine patch due its potential to increase intraocular pressure, thereby worsening glaucoma.

Step-by-step explanation:

When prescribing scopolamine as a transdermal patch to prevent motion sickness during a cruise, certain comorbidities should be considered due to the risk of adverse effects or contraindications. The comorbidity that would weigh against prescribing scopolamine is angle-closure (narrow-angle) glaucoma. Scopolamine is a muscarinic antagonist which can increase intraocular pressure, thus potentially exacerbating glaucoma. As an autonomic drug, scopolamine's mild anticholinergic effects are usually well tolerated since the patch delivers a regulated, low concentration of the drug to minimize systemic toxicity.