Trade Names:AtroPen- Injection 0.5 mg- Injection 1 mg- Injection 2 mg
Trade Names:Atropine Sulfate- Ophthalmic solution 1%- Injection 0.05 mg/mL- Injection 0.1 mg/mL- Injection 0.4 mg/mL- Injection 0.8 mg/mL- Injection 1 mg/mL
Trade Names:Atropine Sulfate Ophthalmic- Ointment 1%
Trade Names:Isopto Atropine- Ophthalmic solution 1%
Trade Names:Sal-Tropine- Tablets 0.4 mgAtropine (Canada)Atropine Injection (Canada)Atropine Ointment (Canada)Minims Atropine (Canada)
Inhibits action of acetylcholine or other cholinergic stimuli at postganglionic cholinergic receptors, including smooth muscles, secretory glands, and CNS sites.
Rapidly absorbed after oral administration.
Readily crosses blood-brain barrier.
The t ½ is 3 h (IV). 94% of dose is eliminated through urine in 24 h.
Administration prior to anesthesia to reduce or prevent secretions of respiratory tract; to control rhinorrhea; treatment of parkinsonism; restoration of cardiac rate and arterial pressure in some situations; treatment of peptic ulcers; management of hypersecretion, irritation, or inflammation of stomach, intestines, or pancreas; treatment of diarrhea; relief of infant colic; management of spasms of bile tract; treatment of hypertonicity of small intestine and uterus; management of hypermotility of colon; prevention of spasm of pylorus, biliary tree, ureters, and bronchi; treatment of frequent urination and bed-wetting; therapy for certain bradycardias and heart blocks; treatment of closed head injury with acetylcholine release; reduction of laughing and crying associated with brain lesions; treatment of alcohol withdrawal symptoms; relief of motion sickness. Antidote for CV collapse in certain overdoses or poisonings (eg, organophosphorous nerve agents having cholinesterase activity, organophosphorous or carbamate insecticides, muscarinic symptoms of insecticide or nerve agent poisonings). Short-term treatment and prevention of bronchospasm associated with chronic bronchial asthma, bronchitis, and COPD.Ophthalmic
Production of cycloplegia and mydriasis.
In the face of life-threatening poisonings by organophosphorous nerve agents and insecticides, there are no absolute contraindications for atropine use. Hypersensitivity to anticholinergics; narrow-angle glaucoma; primary glaucoma or tendency toward glaucoma (ophthalmic); adhesions between iris and lens; prostatic hypertrophy; obstructive uropathy; myocardial ischemia; unstable cardiac status caused by hemorrhage; tachycardia; myasthenia gravis; pyloric or intestinal obstruction; asthma; hyperthyroidism; renal disease; hepatic disease; toxic megacolon; intestinal atony or paralytic ileus.
0.4 to 0.6 mg every 4 to 6 h.Children
PO Use lowest effective dose. The following doses may be exceeded in certain cases: 7 to 16 lb: 0.1 mg; 17 to 24 lb: 0.15 mg; 24 to 40 lb: 0.2 mg; 40 to 65 lb: 0.3 mg; 65 to 90 lb: 0.4 mg; over 90 lb: 0.4 mg.SurgeryAdults
Subcutaneous/IM/IV 0.4 to 0.6 mg every 4 to 6 h.Children
Subcutaneous/IM/IV 0.01 mg/kg to max of 0.4 mg every 4 to 6 h.Infants less than 5 kg
Subcutaneous/IM/IV 0.04 mg/kg.Infants over 5 kg
Subcutaneous/IM/IV 0.03 mg/kg.BradyarrhythmiasAdults
Subcutaneous/IM/IV 0.4 to 2 mg every 1 to 2 h as needed.Children
Subcutaneous/IV/IM 0.01 to 0.03 mg/kg, every 1 to 2 h as needed.Antidote (Insecticide Poisoning)Adults
Parenteral At least 2 to 3 mg, repeated until signs of poisoning subside or signs of intoxication appear.Children
0.02 to 0.05 mg/kg/dose every 10 to 20 min until signs of atropic effect are observed, then every 1 to 4 h for at least 24 h.AtroPen
It is recommended that 3 AtroPen auto-injectors be available for use in each person at risk of nerve agent or organophosphate insecticide poisoning: 1 for mild symptoms plus 2 for severe symptoms as described in package insert.Adults and Children weighing over 90 lb (41 kg) (generally older than 10 yr of age)
IM 2 mg.Children weighing 40 to 90 lb (18 to 41 kg) (generally 4 to 10 yr of age)
IM 1 mg.Children weighing 15 to 40 lb (7 to 18 kg) (generally 6 mo to 4 yr of age)
IM 0.5 mg.Children weighing less than 15 lb (7 kg) (generally younger than 6 mo of age)
IM 0.25 mg.OphthalmicUveitis Adults
1 to 2 drops 0.5% to 1% solution up to 4 times daily or ointment once or twice daily.Children
1 to 2 drops 0.5% solution 3 times daily.Refraction Adults
1 to 2 drops of 1% solution 1 h before refraction examination.Children
1 to 2 drops 0.5% solution twice daily 1 to 3 days before refraction examination.
Store at temperature below 86°F.Ophthalmic
Store at room temperature (less than 86°F). Protect from heat.Injection
Store vials, prefilled syringes, and auto-injector at controlled room temperature (68° to 77°F). Protect from light and freezing.
Worsened schizophrenic symptoms; decreased serum haloperidol concentrations.Other anticholinergic agents
Additive anticholinergic effects.Phenothiazines
Decreased antipsychotic effects and increased anticholinergic effects may occur.
None well documented.
Altered ST-T waves; systole; atrial arrhythmia; atrial ectopic beats; atrial fibrillation; bigeminal beats; bradycardia; cardiac dilation; cardiac syncope; decreased BP; flattening of T wave; increased BP; intermittent nodal rhythm (no P wave); labile BP; left ventricular failure; MI; nodal extrasystole; palpitations; prolongation of sinus node recovery time; prolonged P wave; prolonged QT interval; retrograde conduction; R on T phenomenon; shortened PR segment; shortened RT duration; supraventricular extrasystole; tachycardia (sinus, supraventricular, junctional); transient AV dissociation; trigeminal beats; ventricular arrhythmia; ventricular extrasystole; ventricular fibrillation; ventricular flutter; ventricular premature contractions; weak or impalpable pulses; widening and flattening of QRS complex.
Abnormal movements; agitation; amnesia; anxiety; ataxia; Babinski reflex/Chaddock reflex; behavioral changes; coma; confusion; delirium; depression; difficulty concentrating; diminished tendon reflex; dizziness; dysarthria; dysmetria; fatigue; hallucinations; headache; hyperreflexia; hypertonia; insomnia; lethargy; locomotor difficulties; loss of libido; mania; mental disorder; muscle clonus; muscle twitching; opisthotonos; paranoia; restlessness; seizures; sensation of intoxication; somnolence; stupor; tremor; vertigo; weakness; withdrawal behavior.
Cold skin; cyanosed skin; dermatitis; dry mucous membranes; dry warm skin; erythematous rash; flushing; macular rash; maculopapular rash; oral lesions; popular rash; petechiae rash; salivation; scarlatiniform rash; sweating/moist skin.
Acute angle-closure glaucoma; blepharitis; blindness; blurred vision; conjunctivitis; cyclophoria; cycloplegia; decreased accommodation; decreased contrast sensitivity; decreased visual acuity; dry conjunctiva; dry eyes; eyelid crusting; heterophoria; irritated eyes; keratoconjunctivitis; mydriasis; photophobia; pupils poorly reactive to light; sicca; strabismus; tearing.Ophthalmic solution/ointment
Eczematoid dermatitis; follicular conjunctivitis; vascular congestion, edema, and exudates.
Abdominal distention; abdominal pain; constipation; decreased bowel sounds; decreased food absorption; delayed gastric emptying; distended abdomen; dry mouth; dysphagia; nausea; paralytic ileus; vomiting.
Bed wetting; difficulty in micturition; distended urinary bladder; impotency; urinary hesitancy or retention; urinary urgency.
Alpha waves (EEG) blocked upon opening eyes; elevated BUN; elevated erythrocytes; elevated hemoglobin; hyperglycemia; hypoglycemia; hypokalemia; hyponatremia; increase in photic stimulation on EEG; leukocytosis; low hemoglobin; runs of alpha waves on EEG; signs of drowsiness on EEG.
Dehydration; failure to feed.
Breathing difficulty; inspiratory stridor; labored respirations; laryngospasm; pulmonary edema; respiratory failure; shallow respiration; slow respiration; subcostal recession; syncope; tachypnea.
Chest pain; excessive thirst; feeling hot; heat intolerance; hyperpyrexia; tongue chewing.
MonitorBaseline signs and symptoms
Identify baseline signs and symptoms, and monitor patients response to therapy according to indications for use: increased heart rate when used for bradycardia; decreased secretions for preanesthesia; decreased GI motility or decreased abdominal pain in GI disorders; pupil dilation in eye disorders; decreased tremor, rigidity and drooling in Parkinson disease. Notify health care provider if signs or symptoms do not improve or worsen.Eyelid inflammation
Monitor patient's response to therapy. Notify health care provider if eye or eyelid inflammation is noted or if symptoms do not improve or worsen (ophthalmic).Poisoning
Ensure that patient with moderate to severe poisoning is closely monitored for at least 48 h after emergency treatment has been provided (auto-injector).Respiratory status
Monitor patients respiratory status. Be prepared to provide artificial respiration if severe breathing difficulty is noted (auto-injector).
Category C .
Excreted in breast milk. If possible, do not use.
Use cautiously in infants.
Use with caution in the elderly, in patients with Down syndrome, brain damage, spastic paralysis, disorders of heart rhythm (eg, atrial flutter), severe narrow-angle glaucoma, pyloric stenosis, prostatic hypertrophy, significant renal failure, or a recent MI.
Has occurred in sensitive patients.
May be an early symptom of incomplete intestinal obstruction.
May delay gastric emptying time and complicate therapy.
Determine IOP and depth of angle of anterior chamber before and during ophthalmic use to avoid glaucoma attacks.
May occur at high ambient temperature.
Dry mouth, thirst, vomiting, nausea, abdominal distention, CNS stimulation, delirium, drowsiness, restlessness, stupor, fever, seizures, hallucinations, convulsions, coma, circulatory failure, tachycardia, weak pulse, hypertension, hypotension, respiratory depression, palpitations, urinary urgency, blurred vision, dilated pupils, photophobia, rash, dry and hot skin.
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