Atropine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult: PO Diverticular disease; Irritable bowel syndrome; Non-ulcer dyspepsia 0.6-1.2 mg at bedtime as a single dose. IV Bradycardia Initial: 0.5 mg repeated every 3-5 minutes. Max: 3 mg. IV/IM Organophosphorus poisoning In mild poisoning: Initial: 1-2 mg via IV inj every 5-60 minutes followed by subsequent 2 mg dose via IV/IM inj every 5-60 minutes until muscarinic signs and symptoms subside. In moderate-severe poisoning: Initial: 2-6 mg via IV inj followed by subsequent 2-6 mg dose via IV/IM inj every 5-60 minutes until muscarinic signs and symptoms subside. Max: 50 mg/day. IV/IM/SC Pre-anaesthetic medicine 0.3-0.6 mg via IM/SC inj 30-60 minutes prior to anaesthesia induction. Alternatively, 0.3-0.6 mg via IV inj immediately before anaesthesia induction. Ophthalmic Iritis; Uveitis As 1% solution: Instill 1-2 drops up to 4 times/day. Mydriasis and cycloplegia for refraction As 1% solution: Instill 1-2 drop(s) 40 minutes to 1 hour prior to procedure. May be repeated bid as necessary. As 1% ointment: Apply 0.3-0.5 cm into the conjunctival sac up to 3 times/day.
Administration
May be taken with or without food. Take w/ food or water.
Contraindications
Angle-closure glaucoma, narrow angle between the iris and cornea, 2nd or 3rd degree AV block, achalasia of oesophagus, paralytic ileus, severe ulcerative colitis, intestinal atony, toxic megacolon, pyloric stenosis, prostatic hypertrophy, obstructive uropathy, myasthenia gravis. Lactation (IV).
Special Precautions
Patients with Down's syndrome, brain damage, autonomic neuropathy, increased intraocular pressure, spastic paralysis, hiatal hernia, hyperthyroidism, gastric ulcers, GERD, diarrhoea, COPD, heart failure, myocardial ischaemia, hypertension, and cardiac surgery. Patients with fever or those exposed to high ambient temperature. Hepatic and renal impairment. Children. Pregnancy and lactation. Patient Counselling This drug may cause confusion, dizziness or blurred vision, if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure, pulse rate, heart rate, and ECG. Check for signs and symptoms of atropine toxicity (e.g. fever, muscle fasciculations, delirium, and mental status).
Adverse Reactions
Significant: Tachycardia, transient bradycardia, pulmonary oedema, urinary retention, delirium, agitation, amnesia; photophobia, blurred vision (ophthalmic). Rarely, hypertensive crisis and seizures. Cardiac disorders: Palpitations, chest pain. Eye disorders: Decreased lacrimation. Gastrointestinal disorders: Dry mouth, dysphagia, constipation, nausea, vomiting. General disorders and administration site conditions: Fever, irritability, asthenia, ataxia. Investigations: Irregular pulse, increased intraocular pressure, abnormal EEG, ECG changes. Metabolism and nutrition disorders: Increased thirst, hypokalaemia, hyperglycaemia. Nervous system disorders: Dysgeusia, restlessness, dizziness, headache. Psychiatric disorders: Confusion, hallucination, disorientation, insomnia. Renal and urinary disorders: Difficulty in micturition, urinary urgency. Respiratory, thoracic and mediastinal disorders: Dyspnoea, reduced bronchial secretion, laryngitis. Skin and subcutaneous tissue disorders: Anhidrosis, hot and dry skin, rash, dermatitis. Vascular disorders: Flushing.
Potentially Fatal: Asystole, MI, atrioventricular arrhythmia, atrial fibrillation, AV dissociation, ventricular tachycardia, respiratory depression, coma. Rarely, angioedema.
Drug Interactions
Additive antimuscarinic effect with amantadine, antiarrhythmics (e.g. disopyramide, quinidine), anticholinergics, TCA, MAOIs, antipsychotics (e.g. phenothiazine, clozapine, haloperidol), antiparkinsonian drugs, antispasmodics (e.g. domperidone), and some antihistamines (e.g. promethazine). Reduces absorption of ketoconazole and mexiletine. Antagonises therapeutic effects of synthetic choline esters (e.g. bethanechol, carbachol), anticholinesterase drugs (e.g. physostigmine, neostigmine, pyridostigmine), and cholinomimetic alkaloids (e.g. pilocarpine). May increase risk of severe constipation with opioid analgesics. Antagonises miotic actions of ophthalmic long-acting cholinergic antiglaucoma agents (e.g. echothiopate). May increase toxic effects of antimyasthenics, K citrate, K supplements. May antagonise gastrointestinal motility effects of cisapride, domperidone and metoclopramide.
ATC Classification
A03BA01 - atropine ; Belongs to the class of belladonna alkaloids, tertiary amines. Used in the treatment of functional gastrointestinal disorders.
S01FA01 - atropine ; Belongs to the class of anticholinergics used as mydriatics and cycloplegics.
Disclaimer: This information is independently developed by CIMS based on atropine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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