ATROPINE SULFATE AGUETTANT Price

Overview

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This medicine contains an important and useful components, as it consists of
Atropine sulfateis available in the market in concentration

Name

Atropine Sulphate

Precaution

- Atropine sulphate should be used with caution in individuals with a history of glaucoma, especially narrow-angle glaucoma, as it can exacerbate the condition by increasing intraocular pressure. - Patients with a history of cardiac arrhythmias, particularly those with tachycardia, should be monitored carefully, as atropine can exacerbate these conditions by increasing heart rate. - Use with caution in individuals with renal or hepatic impairment as the clearance of atropine may be reduced, leading to an increased risk of side effects. - Atropine should be used carefully in patients with gastrointestinal diseases, such as ulcerative colitis, as it may exacerbate symptoms like constipation and bloating. - In elderly patients, atropine should be prescribed at lower doses due to increased sensitivity to the drug, which can lead to anticholinergic side effects like confusion, dry mouth, and urinary retention. - Pregnant women should use atropine only if clearly needed, as it crosses the placental barrier. It is classified as a pregnancy category C drug, meaning it should be used only if the potential benefits justify the potential risks. - Caution is needed when atropine is used alongside other anticholinergic drugs to avoid cumulative effects, which can increase the risk of anticholinergic toxicity, leading to symptoms such as confusion, hallucinations, or severe dry mouth. - It should be avoided in patients with myasthenia gravis, as atropine may worsen muscle weakness.

Indication

- Atropine sulphate is primarily used to treat bradycardia (slow heart rate), particularly when the heart rate drops below 40-50 beats per minute, leading to hemodynamic instability. - It is used as a pre-anesthetic medication to reduce salivation and respiratory secretions during surgery or diagnostic procedures. - Atropine is indicated in the treatment of organophosphate poisoning, where it counteracts the effects of acetylcholinesterase inhibitors, which can lead to excessive acetylcholine accumulation. - Atropine is also used to manage poisoning from certain nerve agents by reversing the muscarinic effects such as excessive salivation, bronchoconstriction, and bradycardia. - It is used to treat symptomatic bradyarrhythmias in emergency settings, including in cases of heart block or sinus node dysfunction. - In some cases, atropine may be used in ophthalmology to dilate the pupils for diagnostic purposes or during retinal examination. - Atropine is also employed as part of the treatment regimen for acute cholinergic toxicity from substances like insecticides or chemical warfare agents.

Contra indication

- Atropine sulphate is contraindicated in individuals with known hypersensitivity or allergy to atropine or any of its components. - It is contraindicated in patients with narrow-angle glaucoma, as it can increase intraocular pressure and worsen the condition. - It should not be used in individuals with myasthenia gravis due to the risk of exacerbating muscle weakness. - Atropine is contraindicated in individuals with paralytic ileus or any condition that involves gastrointestinal obstruction, as it can impair normal bowel motility. - It is also contraindicated in patients with severe tachyarrhythmias, as atropine may worsen the condition by further increasing the heart rate. - Atropine should not be administered in cases of pheochromocytoma, a rare adrenal gland tumor, due to the risk of precipitating a hypertensive crisis. - It should be avoided in newborns and infants unless absolutely necessary, as the drug can increase the risk of tachycardia and other severe side effects.

Side Effect

- Common side effects include dry mouth, thirst, and difficulty swallowing due to atropine’s anticholinergic properties. - Blurred vision and sensitivity to light (photophobia) can occur as atropine causes pupil dilation and reduces accommodation. - Tachycardia (increased heart rate) is frequently observed, which can be problematic in patients with pre-existing cardiac conditions. - Constipation is a common side effect because atropine decreases gastrointestinal motility. - Urinary retention, particularly in males with prostate enlargement, can occur as atropine inhibits bladder contractions. - Confusion, memory disturbances, and delirium may occur, especially in elderly patients who are more sensitive to anticholinergic drugs. - In some cases, it may cause skin flushing, dizziness, or headaches. - Rarely, atropine can cause more severe side effects like arrhythmias, seizures, or anaphylaxis (severe allergic reactions). - Overdose symptoms include increased body temperature (hyperthermia), dry and flushed skin, rapid heart rate, and CNS disturbances such as agitation or hallucinations.

Pregnancy Category ID

3

Mode of Action

- Atropine is a muscarinic acetylcholine receptor antagonist, meaning it blocks the action of acetylcholine, a neurotransmitter that normally binds to muscarinic receptors in various tissues such as the heart, smooth muscles, and glands. - In the heart, atropine specifically blocks the muscarinic receptors of the parasympathetic nervous system, resulting in an increase in heart rate (tachycardia). This is particularly useful in treating bradycardia. - In the gastrointestinal system, atropine decreases smooth muscle activity, which results in reduced motility, making it useful for decreasing gastrointestinal secretions and controlling diarrhea in certain cases. - In the eye, atropine induces pupil dilation (mydriasis) by blocking the muscarinic receptors in the iris sphincter muscle, leading to a widening of the pupil, which is useful during ophthalmic examinations. - In the respiratory system, atropine inhibits secretions in the airway and reduces bronchial constriction, helping to prevent excessive saliva and mucus production during surgery or in patients with respiratory diseases. - It also acts centrally in the brain to modulate various functions such as memory and cognition, although the drug's central nervous system effects are often associated with adverse reactions like confusion or delirium in elderly patients.

Interaction

- **Anticholinergics**: Concurrent use of atropine with other anticholinergic drugs, such as antihistamines, tricyclic antidepressants, or certain antipsychotics, can result in enhanced anticholinergic effects, leading to increased risks of dry mouth, blurred vision, urinary retention, constipation, and confusion, particularly in elderly patients. - **Digoxin**: Atropine may increase the risk of arrhythmias when used with digoxin. The combination may lead to excessive heart rate elevation, particularly in patients with pre-existing heart conditions. Close monitoring is recommended. - **Beta-blockers**: When used in combination with atropine, beta-blockers may reduce the heart rate-lowering effects of beta-blockers, potentially making atropine less effective in controlling bradycardia. This could lead to an imbalance in heart rate regulation. - **Lithium**: The use of atropine with lithium may enhance the risk of toxicity, particularly in the central nervous system. Atropine can exacerbate some of the sedative effects of lithium, increasing the risk of confusion or delirium. - **Cholinesterase inhibitors**: Atropine can counteract the effects of cholinesterase inhibitors, such as donepezil or rivastigmine, used to treat Alzheimer's disease. This could make these medications less effective in managing symptoms of dementia. - **Narcotic analgesics**: The combination of atropine with opioid pain relievers, such as morphine or oxycodone, may enhance the narcotic’s anticholinergic side effects, including constipation and urinary retention. Additionally, atropine could exacerbate the CNS depressant effects of opioids, increasing the risk of sedation or respiratory depression. - **Alcohol**: Alcohol may amplify the sedative and anticholinergic effects of atropine, increasing the likelihood of dizziness, confusion, and difficulty with coordination, especially in elderly patients. - **Antacids**: Some antacids may reduce the absorption of atropine, particularly if they contain aluminum or magnesium. This interaction might lead to a decrease in the drug's effectiveness when taken simultaneously. - **Phenothiazines**: The use of atropine with phenothiazine drugs, like chlorpromazine, may increase the likelihood of anticholinergic side effects, such as dry mouth, blurred vision, and constipation. This combination should be used cautiously.

Pregnancy Category Note

Information not available

Adult Dose

- For bradycardia: An intravenous dose of 1 mg is usually administered as an initial dose. If necessary, this can be repeated every 3-5 minutes until the desired heart rate is achieved, with a maximum dose of 3 mg. - For pre-anesthesia medication: Typically, 0.4 to 0.6 mg is administered intramuscularly or intravenously 30 to 60 minutes before surgery to reduce salivation and respiratory secretions. - For organophosphate poisoning: An initial dose of 2 to 5 mg IV is recommended, and repeated doses may be given every 5-15 minutes depending on the severity of symptoms. - For eye examinations: A 1% atropine solution may be used, with 1-2 drops instilled into the affected eye 1-2 hours before the examination. - For symptomatic bradyarrhythmias: A typical intravenous dose is 1 mg every 3-5 minutes as required, up to a maximum of 3 mg.

Child Dose

- For bradycardia in children, the recommended initial dose is 0.02 mg/kg IV, with a minimum dose of 0.1 mg and a maximum dose of 0.5 mg per administration. This can be repeated every 3-5 minutes if needed. - For pre-anesthesia medication in children, 0.01 to 0.02 mg/kg can be administered intramuscularly or intravenously 30-60 minutes before the procedure. - For organophosphate poisoning in children, the initial dose is typically 0.05 mg/kg IV, which may be repeated every 10-15 minutes as necessary. - In ophthalmology, atropine is used to dilate the pupil in pediatric patients, typically by instilling 1-2 drops of a 1% solution in the affected eye prior to the examination.

Renal Dose

- Atropine is primarily metabolized in the liver, but since it is excreted via the kidneys, renal function may influence its clearance. - In patients with mild renal impairment, no dose adjustment is generally necessary, but monitoring for side effects is recommended. - For those with moderate to severe renal dysfunction, it may be advisable to lower the dose or increase the dosing interval to minimize the risk of atropine accumulation. - Renal failure patients should be monitored carefully for signs of atropine toxicity, especially in the elderly population where renal function may be compromised.

Administration

Information not available