OFTALMOLOSA CUSI CHLORAMPHENICOL 1% Price

Overview

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

Name

Atropine Sulphate 1%

Precaution

- Atropine sulphate 1% should be used with caution in patients with a history of glaucoma, especially narrow-angle glaucoma, as it can increase intraocular pressure, potentially exacerbating the condition. - Use carefully in patients with cardiac arrhythmias, particularly those with tachycardia, as atropine can increase heart rate, possibly worsening arrhythmias. - It should be used cautiously in individuals with hepatic or renal impairment, as the drug is metabolized by the liver and excreted by the kidneys, and impaired function may result in higher drug levels and increased risk of side effects. - In elderly patients, atropine 1% should be prescribed with care, as older adults are more sensitive to anticholinergic effects, leading to risks like confusion, urinary retention, and dry mouth. - Pregnant women should only use atropine 1% when necessary, as it can cross the placenta, and it is classified as pregnancy category C. - Caution should be exercised when using atropine 1% in individuals with myasthenia gravis, as it can worsen muscle weakness. - Atropine 1% should be used carefully in patients with gastrointestinal diseases, such as ulcerative colitis, as it can worsen symptoms such as constipation. - The medication should be avoided in infants, particularly neonates, due to the risk of increased heart rate and other severe side effects.

Indication

- **Ophthalmic use**: Atropine sulphate 1% is commonly used in ophthalmology to dilate the pupils (mydriasis) for diagnostic purposes, such as retinal examinations or to treat certain eye conditions like uveitis. - It is used to treat symptomatic bradycardia (slow heart rate) in emergency settings, although typically atropine is administered intravenously in such cases. - Atropine 1% is used in some eye surgeries to immobilize the eye and control intraocular pressure. - It can also be employed for its cycloplegic effect, which helps in the management of certain eye conditions that involve spasm of the eye muscles. - Atropine sulphate 1% may be used for controlling excessive salivation in patients undergoing surgery, though this is more common with injectable formulations.

Contra indication

- **Hypersensitivity**: Atropine sulphate 1% should not be used in individuals with known hypersensitivity or allergic reactions to atropine or any of its components. - It is contraindicated in patients with narrow-angle glaucoma, as it can exacerbate increased intraocular pressure, worsening the condition. - It should be avoided in individuals with a history of myasthenia gravis, as it can exacerbate muscle weakness and interfere with muscle function. - Atropine sulphate 1% is contraindicated in individuals with a history of hypersensitivity to belladonna alkaloids or any of its excipients. - Atropine 1% should not be used in cases of gastrointestinal obstruction, particularly in conditions such as paralytic ileus. - It is contraindicated in patients with severe tachyarrhythmias (rapid heart rhythms) or those with tachycardia. - The drug should be avoided in infants unless absolutely necessary, due to the risk of side effects such as tachycardia.

Side Effect

- **Ophthalmic side effects**: Common side effects of atropine 1% include photophobia (sensitivity to light), blurred vision, and difficulty with near vision (due to the cycloplegic effect). - **Dry mouth**: The anticholinergic properties of atropine may cause dry mouth, making swallowing difficult. - **Tachycardia**: Atropine can cause an increase in heart rate, which may lead to palpitations and potentially exacerbate existing cardiac arrhythmias. - **Urinary retention**: Atropine can inhibit bladder contraction, leading to difficulty urinating, especially in older males with prostate enlargement. - **Gastrointestinal issues**: Atropine can cause constipation due to reduced motility of the gastrointestinal tract. - **Confusion and cognitive effects**: Elderly patients, in particular, may experience confusion, memory disturbances, and delirium as a result of atropine’s central anticholinergic effects. - **Headache and dizziness**: Some patients may experience headaches or dizziness due to the systemic effects of atropine, particularly when used in high doses. - **Severe side effects**: Rarely, atropine can cause more severe effects such as seizures, hallucinations, arrhythmias, or anaphylaxis, particularly if there is an overdose.

Pregnancy Category ID

3

Mode of Action

- Atropine sulphate 1% is a muscarinic acetylcholine receptor antagonist. It works by blocking the action of acetylcholine, a neurotransmitter that binds to muscarinic receptors in the eye, heart, gastrointestinal tract, and other tissues. - In the eye, atropine 1% blocks muscarinic receptors in the iris sphincter muscle, resulting in pupil dilation (mydriasis) and paralysis of accommodation (cycloplegia). This is useful in diagnostic procedures and managing conditions like uveitis. - In the heart, atropine blocks the parasympathetic effects mediated by the vagus nerve, resulting in an increase in heart rate (tachycardia). This action is beneficial in treating bradycardia. - Atropine reduces gastrointestinal motility by blocking acetylcholine's action on smooth muscles, which can decrease secretions and help in managing gastrointestinal conditions like diarrhea. - It also reduces salivation and respiratory secretions, which is beneficial in pre-anesthetic or surgical settings. - Atropine’s central effects on the brain can cause alterations in cognition and memory, which are particularly problematic in older individuals.

Interaction

- **Anticholinergics**: Combining atropine sulphate 1% with other anticholinergic medications, such as antihistamines, tricyclic antidepressants, or certain antipsychotics, can lead to enhanced anticholinergic effects, increasing the risk of dry mouth, blurred vision, urinary retention, constipation, and confusion, especially in elderly patients. - **Digoxin**: Atropine may increase the risk of arrhythmias when used with digoxin, especially in patients with heart conditions, due to atropine's potential to elevate the heart rate. - **Beta-blockers**: The combined use of atropine with beta-blockers can counteract the heart rate-lowering effects of beta-blockers, possibly reducing the efficacy of either drug in controlling bradycardia. - **Cholinesterase inhibitors**: Atropine can block the effects of cholinesterase inhibitors used to treat Alzheimer's disease, potentially making these drugs less effective. - **Narcotic analgesics**: The combination of atropine with opioids may intensify the anticholinergic side effects, such as constipation and urinary retention, and could increase the risk of CNS depression. - **Alcohol**: Alcohol may potentiate the sedative and anticholinergic effects of atropine, leading to increased drowsiness, dizziness, and confusion. - **Antacids**: Certain antacids can reduce the absorption of atropine, particularly if they contain aluminum or magnesium, potentially decreasing its effectiveness when taken together.

Pregnancy Category Note

Information not available

Adult Dose

- **Ophthalmic Use**: The typical dose for atropine 1% ophthalmic solution is 1-2 drops in the affected eye(s) 1-2 hours before the examination or as prescribed by the healthcare provider. The frequency of administration may vary depending on the specific condition being treated. - **For Mydriasis**: 1-2 drops of atropine 1% may be instilled into the affected eye 1 hour before an eye examination. This may be repeated based on the clinician's assessment. - **For Cycloplegia**: A drop of atropine 1% can be administered to induce cycloplegia during procedures involving the eye muscles. - **Preoperative Use**: Atropine can also be used before surgery to reduce secretions. The usual dose is 0.4-0.6 mg intramuscularly or intravenously.

Child Dose

- **For Ophthalmic Use**: The pediatric dose for atropine 1% ophthalmic solution is generally 1-2 drops in the affected eye 1 hour before the examination, and additional doses may be administered as prescribed by a physician. - **For Cycloplegia**: Atropine 1% is commonly used in children to induce cycloplegia during eye examinations. Typically, 1-2 drops are instilled in the affected eye(s). - **For Bradycardia**: In children, atropine is often given intravenously for bradycardia, with the initial dose being 0.02 mg/kg IV, up to a maximum of 0.5 mg per dose. This dose may be repeated as needed every 3-5 minutes.

Renal Dose

- Atropine sulphate 1% is primarily used topically in the eyes, and renal function typically does not have a significant impact on dosing for this indication. However, caution should be exercised in patients with renal impairment when using systemic forms of atropine, as renal dysfunction could lead to prolonged drug effects. - There is no specific renal dose adjustment required for the ophthalmic 1% formulation, but patients with severe renal dysfunction should be monitored for signs of atropine accumulation if they receive systemic doses.

Administration

Information not available