Details About Generic Salt ::  Atropine

Main Medicine Class:: Anticholinergic,antispasmodic   

(AT-troe-peen)
Atropine-1, Atropine Care, Atropisol, Isopto Atropine, Sal-Tropine,  Atropisol, Dioptic’s Atropine, Isopto Atropine, Minims Atropine
Class: Anticholinergic/antispasmodic

 

Drugs Class ::

 Action Inhibits action of acetylcholine or other cholinergic stimuli at postganglionic cholinergic receptors, including smooth muscles, secretory glands and CNS sites.

Indications for Drugs ::

 Indications 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 bedwetting; 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 with drawal symptoms; relief of motion sickness. Antidote for cardiovascular collapse in certain overdoses or poisonings. Short-term treatment and prevention of bronchospasm associated with chronic bronchial asthma, bronchitis and COPD. Ophthalmic preparation: Production of cycloplegia and mydriasis.

Drug Dose ::

 Route/Dosage

ADULTS: 0.4 to 0.6 mg q 4 to 6 hr. CHILDREN: PO Use lowest effective dose beginning at 0.01 mg/kg q 4 to 6 hr not to exceed 0.4 mg q 4 to 6 hr.

Surgery

ADULTS: SC/IM/IV 0.4 to 0.6 mg q 4 to 6 hr. CHILDREN: SC/IM/IV 0.01 mg/kg to max of 0.4 mg q 4 to 6 hr. INFANTS < 5 KG: SC/IM/IV 0.04 mg/kg. INFANTS > 5 KG: SC/IM/IV 0.03 mg/kg.

Bradyarrhythmias

ADULTS: SC/IM/IV 0.4 to 2 mg q 1 to 2 hr prn. CHILDREN: SC/IV/IM 0.01 to 0.03 mg/kg, q 1 to 2 hr prn.

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 q 10 to 20 min until signs of atropic effect are observed, then q 1 to 4 hr for at least 24 hr.

Ophthalmic

Uveitis

ADULT: 1 to 2 drops 0.5% to 1% solution qid or ointment tid. CHILDREN: 1 to 2 drops 0.5% solution tid.

Refraction

ADULT: 1 to 2 drops of 1% solution 1 hr before refraction examination. CHILDREN: 1 to 2 drops 0.5% solution bid 1 to 3 days before refraction examination.

Contraindication ::

 Contraindications Hypersensitivity to anticholinergics; narrow-angle glaucoma; 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.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: If possible, do not use. Infants: Use cautiously. Special-risk patients: Use cautiously in elderly patients and in patients with Down’s syndrome, brain damage or spastic paralysis. Anticholinergic psychosis: Has occurred in sensitive patients. Diarrhea: May be an early symptom of incomplete intestinal obstruction. Gastric ulcer: May delay gastric emptying time and complicate therapy. Glaucoma: Determine intraocular IOP and depth of angle of anterior chamber before and during ophthalmic use to avoid glaucoma attacks. Heat prostration: May occur at high ambient temperature.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Palpitations; bradycardia; tachycardia; orthostatic hypotension. CNS: Headache; nervousness; drowsiness; weakness; dizziness; confusion; insomnia; fever; excitability; restlessness; tremor. DERM: Allergic reactions; urticaria; rash; flushing. EENT: Nasal congestion; altered taste. GI: Xerostomia; nausea; vomiting; dysphagia; heartburn; constipation; bloated feeling; paralytic ileus. GU: Urinary hesitancy and retention; impotence. RESP: Bronchospasm. OTHER: Suppression of lactation; decreased sweating.

Drug Mode of Action ::  

 Action Inhibits action of acetylcholine or other cholinergic stimuli at postganglionic cholinergic receptors, including smooth muscles, secretory glands and CNS sites.

Drug Interactions ::

 Interactions

Haloperidol: Worsened schizophrenic symptoms; decreased serum haloperidol concentrations. Phenothiazines: Decreased antipsychotic effects and increased anticholinergic effects may occur. Other anticholinergic agents: Additive anticholinergic effects.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Identify baseline signs and symptoms, and monitor patient according to indications for use: Increased heart rate when used for bradycardia (notify physician of paradoxical 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’s disease.
  • Monitor elderly patient for agitation or drowsiness.
  • Monitor vital signs. Remember that pulse rate is particularly sensitive to atropine.
  • Assess for urinary retention, particularly in elderly male patients and in those with pre-existing prostatic hypertrophy and other obstructive/retentive disorders.
  • Dim room lighting to comfort level or provide sunglasses if necessary.
  • Keep room cool and provide adequate hydration to prevent hyperpyrexia.
  • Institute safety precautions if visual or CNS disturbances occur.
  • Provide frequent oral hygiene, skin care, and lubricating eye drops if dry mouth/skin/eyes occur.
  • Notify physician immediately if eye pain, diarrhea, or significant tachycardia or bradycardia occurs.
OVERDOSAGE: SIGNS & SYMPTOMS
  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

Drug Storage/Management ::

 Administration/Storage

Oral

  • Administer 30 min before meals and at bedtime for GI disorders.
  • Store in airtight, light-resistant container at room temperature.

IM/SC

  • Draw solution carefully into syringe. Accidental eye exposure results in blurred vision.
  • Administer 30 to 60 min before surgery if used for preanesthesia.
  • Give after patient has voided.

IV

  • Do not add to IV solutions.

Ophthalmic

  • Compress inner canthus gently for 1 to 3 min after installation.
  • Wash hands after administration to avoid accidental eye exposure.

Drug Notes ::

 Patient/Family Education

  • Warn patient that temporary mild stinging and blurred vision may occur with ophthalmic preparations.
  • Instruct patient to withhold ophthalmic preparations if eye pain, redness, or rapid, irregular pulse occurs and to notify physician immediately.
  • Instruct patient in and observe return demonstration of patient’s technique for installation of ophthalmic preparations.
  • Instruct patient to take oral dose 30 min before meals and at bedtime.
  • Caution patient to avoid hazardous activities until vision clears.
  • Advise patients that eyes may be more sensitive to light and to wear sunglasses, as needed.
  • Tell patients to increase dietary fiber and fluids, unless contraindicated, to reduce constipation.
  • Explain importance of frequent oral hygiene and regular dental care when mouth is dry. Explain that chewing sugarless gum or sucking on ice chips or hard candy may relieve dry mouth.
  • Caution patient to avoid vigorous exercise in warm environment and to avoid hot baths or saunas.
  • Advise male patients that if impotence occurs, it may be a result of drug therapy and to notify physician.
  • Tell patient to notify physician immediately if the following symptoms occur: Rapid, irregular pulse; headaches; hot, dry skin; difficulty swallowing; urinary retention; constipation; difficulty breathing; loss of coordination; restlessness; tremors; disorientation; hallucinations.
  • If patient is taking drug for symptoms of Parkinson’s disease, warn patient that drug should not be discontinued abruptly, because withdrawal-like symptoms may occur.

Disclaimer ::

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