Atropine Sulfate
Indications
Atropine is indicated for Non ulcer
dyspepsia, Irritable bowel syndrome, Diverticular disease, Bradycardia,
Organophosphorus poisoning, Premedication in anesthesia, Poisoning or
overdosage with compound having muscarinic actions, Ophthalmic
Inflammatory eye disorders, Eye refraction.
Pharmacology
Atropine binds to and inhibit muscarinic
acetylcholine receptors, producing a wide range of anticholinergic
effects. Atropine is an anticholinergic agent which competitively blocks
the muscarinic receptors in peripheral tissues such as the heart,
intestines, bronchial muscles, iris and secretory glands. Some central
stimulation may occur. Atropine abolishes bradycardia and reduces heart
block due to vagal activity. Smooth muscles in the bronchi and gut are
relaxed while glandular secretions are reduced. It also has mydriatic
and cycloplegic effect.
Dosage & Administration
Adult:
- IV: Bradycardia: 500 mcg every 3-5 mins. Total: 3 mg.
- IV/IM: Organophosphorus poisoning: 2 mg every 10-30 mins until muscarinic effects disappear or atropine toxicity appears.
- IM/SC: Premedication in anesthesia: 300-600 mcg 30-60 mins before anesthesia.
- IV/IM/SC: Poisoning or overdosage with compound having muscarinic actions: 0.6-1 mg, repeat 2 hrly.
- Ophthalmic: Inflammatory eye disorders: As 0.5-1% solution: 1-2 drops 4 times/day.
- Ophthalmic: refraction: 1% solution 1 drop twice daily for 1-2 days before procedure.
- Oral: Non ulcer dyspepsia, Irritable bowel syndrome, Diverticular disease: 0.6-1.2 mg as a single dose at bedtime.
- 7 to 16 pounds: 0.1 mg, IV, IM, or subcutaneously
- 17 to 24 pounds: 0.15 mg, IV, IM, or subcutaneously
- 24 to 40 pounds: 0.2 mg, IV, IM, or subcutaneously
- 40 to 65 pounds: 0.3 mg, IV, IM, or subcutaneously
- 65 to 90 pounds: 0.4 mg, IV, IM, or subcutaneously
- Over 90 pounds: 0.4 to 0.6 mg, IV, IM, or subcutaneously
Interaction
Additive anticholinergic effects with quinidine, antidepressants and some antihistamines.
Contraindications
Glaucoma, chronic respiratory disease, sick
sinus syndrome, thyrotoxicosis, cardiac failure, pyloric stenosis,
prostatic hypertrophy.
Side Effects
Injection: Dry mouth,
dysphagia, constipation, flushing and dryness of skin, tachycardia,
palpitations, arrhythmias, mydriasis, photophobia, cycloplegia, raised
intraocular pressure. Toxic doses cause tachycardia, hyperpyrexia,
restlessness, confusion, excitement, hallucinations, delirium and may
progress to circulatory failure and resp depression.
Eye drops or ointment: Systemic toxicity esp in children, on prolonged use may lead to irritation, hyperaemia, oedema and conjunctivitis. Increased intraocular pressure.
Eye drops or ointment: Systemic toxicity esp in children, on prolonged use may lead to irritation, hyperaemia, oedema and conjunctivitis. Increased intraocular pressure.
Pregnancy & Lactation
Pregnancy Category C. Animal reproduction
studies have not been conducted with atropine. It also is not known
whether atropine can cause fetal harm when given to a pregnant woman or
can affect reproduction capacity. Atropine should be given to a pregnant
woman only if clearly needed.
Precautions & Warnings
Reflux oesophagitis; elderly; infants and children; Pregnancy.
Overdose Effects
May cause hyperthermia, hypertension,
increased respiratory rate, nausea and vomiting. May also lead to CNS
stimulation. Severe intoxication may lead to CNS depression, coma,
respiratory failure and death.
Therapeutic Class
Anticholinergics (antimuscarinics)/ Anti-spasmodics, Mydriatic and Cycloplegic agents
Storage Conditions
Store atropine at room temperature between
20 to 25° C. Store away from heat, moisture, and light. Keep atropine
out of the reach of children.
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