Methods of using atropine. Atropine - indications for use Release form and composition

Gross formula

C 17 H 23 N 03

Pharmacological group of the substance Atropine

Nosological classification (ICD-10)

CAS code

51-55-8

Characteristics of the substance Atropine

Atropine sulfate is a white crystalline or granular powder, odorless. Easily soluble in water and ethanol, practically insoluble in chloroform and ether.

Pharmacology

pharmachologic effect- anticholinergic.

Blocks m-cholinergic receptors. Causes mydriasis, paralysis of accommodation, increased intraocular pressure, tachycardia, xerostomia. Inhibits the secretion of bronchial and gastric, sweat glands. Relaxes the smooth muscles of the bronchi, gastrointestinal tract, bile and urinary systems - antispasmodic effect. Stimulates (large doses) the central nervous system. After intravenous administration, the maximum effect appears after 2-4 minutes, after oral administration (in the form of drops) after 30 minutes. In the blood, it is 18% bound to plasma proteins. Passes through the BBB. Excreted by the kidneys (50% unchanged).

Use of the substance Atropine

Peptic ulcer of the stomach and duodenum, pylorospasm, cholelithiasis, cholecystitis, acute pancreatitis, hypersalivation (parkinsonism, poisoning with heavy metal salts, during dental procedures), irritable bowel syndrome, intestinal colic, biliary colic, renal colic, symptomatic bradycardia (sinus, sinoatrial blockade, proximal AV blockade, electrical activity of the ventricles without pulse, asystole), for preoperative sedation; poisoning with m-cholinergic stimulants and anticholinesterase drugs (reversible and irreversible action), incl. organophosphorus compounds; for X-ray studies of the gastrointestinal tract (if necessary to reduce the tone of the stomach and intestines), bronchial asthma, bronchitis with hyperproduction of mucus, bronchospasm, laryngospasm (prevention).

In ophthalmology. To dilate the pupil and achieve paralysis of accommodation (determining the true refraction of the eye, examining the fundus), creating functional rest in inflammatory diseases and injuries of the eye (iritis, iridocyclitis, choroiditis, keratitis, thromboembolism and spasm of the central retinal artery).

Contraindications

Hypersensitivity, for ophthalmic forms - closed-angle glaucoma (including if it is suspected), open-angle glaucoma, keratoconus, children (1% solution - up to 7 years).

Restrictions on use

Diseases of the cardiovascular system in which an increase in heart rate may be undesirable: atrial fibrillation, tachycardia, chronic heart failure, coronary heart disease, mitral stenosis, arterial hypertension, acute bleeding; thyrotoxicosis (possibly increased tachycardia); increased body temperature (further increase is possible due to suppression of the activity of the sweat glands); reflux esophagitis, hiatal hernia, combined with reflux esophagitis (decreased motility of the esophagus and stomach and relaxation of the lower esophageal sphincter can slow down gastric emptying and increase gastroesophageal reflux through the sphincter with impaired function); gastrointestinal diseases accompanied by obstruction: achalasia of the esophagus, pyloric stenosis (possibly decreased motility and tone, leading to obstruction and delayed evacuation of gastric contents); intestinal atony in elderly or debilitated patients (possible development of obstruction), paralytic intestinal obstruction (possible development of obstruction); diseases with increased intraocular pressure: closed-angle (mydriatic effect, leading to an increase in intraocular pressure, can cause an acute attack) and open-angle glaucoma (mydriatic effect can cause a slight increase in intraocular pressure; adjustment of therapy may be required); nonspecific ulcerative colitis (high doses can inhibit intestinal motility, increasing the likelihood of paralytic ileus; in addition, the manifestation or exacerbation of such a severe complication as toxic megacolon is possible); dry mouth (long-term use may further increase the severity of xerostomia); liver failure (decreased metabolism) and renal failure (risk of side effects due to decreased excretion); chronic lung diseases, especially in young children and weakened patients (a decrease in bronchial secretion can lead to thickening of secretions and the formation of plugs in the bronchi); myasthenia gravis (the condition may worsen due to inhibition of the action of acetylcholine); prostatic hypertrophy without urinary tract obstruction, urinary retention or predisposition to it, or diseases accompanied by urinary tract obstruction (including bladder neck due to prostatic hypertrophy); gestosis (possibly increased arterial hypertension); brain damage in children, cerebral palsy, Down's disease (response to anticholinergic drugs increases). For ophthalmological forms (additionally) - age over 40 years (risk of undiagnosed glaucoma), synechia of the iris.

Use during pregnancy and breastfeeding

Side effects of the substance Atropine

Systemic effects

From the nervous system and sensory organs: headache, dizziness, insomnia, confusion, euphoria, hallucinations, mydriasis, paralysis of accommodation, impaired tactile perception.

From the cardiovascular system and blood (hematopoiesis, hemostasis): sinus tachycardia, worsening myocardial ischemia due to excessive tachycardia, ventricular tachycardia and ventricular fibrillation.

From the gastrointestinal tract: xerostomia, constipation.

Others: fever, intestinal and bladder atony, urinary retention, photophobia.

Local effects: transient tingling and increased intraocular pressure; with prolonged use - irritation, hyperemia of the skin of the eyelids; hyperemia and swelling of the conjunctiva, the development of conjunctivitis, mydriasis and paralysis of accommodation.

When administered in single doses<0,5 мг возможна парадоксальная реакция, связанная с активацией парасимпатического отдела вегетативной нервной системы (брадикардия, замедление AV проводимости).

Interaction

Weakens the effect of m-cholinomimetics and anticholinesterase drugs. Drugs with anticholinergic activity enhance the effect of atropine. When taken simultaneously with antacids containing Al 3+ or Ca 2+, the absorption of atropine from the gastrointestinal tract is reduced. Diphenhydramine and promethazine enhance the effect of atropine. The likelihood of developing systemic side effects is increased by tricyclic antidepressants, phenothiazines, amantadine, quinidine, antihistamines and other drugs with m-anticholinergic properties. Nitrates increase the likelihood of increased intraocular pressure. Atropine changes the absorption parameters of mexiletine and levodopa.

Routes of administration

Inside, intravenously, intramuscularly, PC, conjunctivally, subconjunctival or parabulbar, by electrophoresis. The ointment is placed behind the eyelids.

Precautions for the substance Atropine

For distal AV block (with wide QRS complexes), atropine is ineffective and is not recommended.

When instilling into the conjunctival sac, it is necessary to press the lower lacrimal opening to prevent the solution from entering the nasopharynx. With subconjunctival or parabulbar administration, it is advisable to prescribe validol to reduce tachycardia.

An intensely pigmented iris is more resistant to dilatation and to achieve an effect it may be necessary to increase the concentration or frequency of administration, so one should be wary of an overdose of mydriatics.

Pupil dilation can trigger an acute attack of glaucoma in people over 60 years of age and people with hyperopia, who are predisposed to glaucoma due to the fact that they have a shallow anterior chamber.

The drug contains the main substance atropine sulfate and additional components depending on its shape.

Release form

The main form of release of Atropine: injection solution and eye drops. The solution is packaged in 1 ml ampoules, and eye drops in 5 ml dropper bottles.

pharmachologic effect

The drug has anticholinergic action that can block M-cholinergic receptors.

Pharmacodynamics and pharmacokinetics

Atropine is an alkaloid that is also found in some plants, such as belladonna, datura, henbane and others. In medicine, a substance called . It should be noted that the release form of this component is a granular or crystalline white powder that is odorless. It is easily soluble in water or ethanol and is resistant to chloroform and ether.

The pharmacological group that this drug belongs to is anticholinergic. In this case, the mechanism of action includes blocking m-cholinergic receptors.

The use of this substance leads to amidriasis, paralysis of accommodation, increased intraocular pressure, and xerostomia. Inhibition of the secretion of bronchial, sweat and other glands was also noted. Relaxation occurs in the smooth muscles of the bronchi, biliary or urinary organs, and gastrointestinal tract, that is, the substance acts as an antagonist and exhibits an antispasmodic effect.

In large dosages, stimulation of the nervous system is possible. When Atropine is administered intravenously, the maximum effect is observed after 2-4 minutes, and if eye drops are used, then after 30 minutes.

Combination with antacids that contain Al3+ or Ca2+ may reduce the absorption of the main substance from the gastrointestinal tract. Some tricyclic antidepressants , phenothiazines , Quinidine, antihistamines and other drugs with m-anticholinergic properties can enhance the development of systemic undesirable effects.

Nitrates can cause an increase in intraocular pressure, and Atropine can change absorption parameters And Mexiletina .

special instructions

The use of Atropine for distal AV block accompanied by wide QRS complexes is ineffective and, in general, is not recommended.

When the solution is dripped into the conjunctival sac, the lower lacrimal punctum should be gently pressed to avoid drops entering the nasopharynx. Subconjunctival or parabulbar administration is recommended with simultaneous administration to reduce tachycardia.

Terms of sale

On prescription.

Storage conditions

To store any form of the drug, a dark, cool place is required, out of reach of children.

Best before date

For injection solution – 5 years, for eye drops – 3 years.

Atropine analogs

Level 4 ATX code matches:

Main analogues: , And .

Formula: C17H23NO3, chemical name: 8-Methyl-8-azabicyclooct-3-yl endo-(±)-alpha-(hydroxymethyl)benzeneacetic acid ester (and as sulfate).
Pharmacological group: vegetotropic agents / anticholinergic agents / m-anticholinergics.
Pharmachologic effect: anticholinergic.

Pharmacological properties

Atropine blocks m-cholinergic receptors, which leads to paralysis of accommodation, mydriasis, increased intraocular pressure, xerostomia, tachycardia, inhibition of the secretion of sweat, gastric and bronchial glands, relaxation of the smooth muscles of the gastrointestinal tract, bronchi, urinary and biliary tract. Large doses of atropine have a stimulating effect on the central nervous system. The maximum effect develops 2–4 minutes after intravenous administration, half an hour after oral administration. 18% in the blood is bound to plasma proteins. Penetrates through the blood-brain barrier. It is excreted by the kidneys, about 50% unchanged.

Indications

Peptic ulcer of the duodenum and stomach; cholelithiasis; pylorospasm; cholecystitis; hypersalivation (in case of poisoning with salts of heavy metals, parkinsonism, during dental interventions); renal colic; acute pancreatitis; intestinal colic; irritable bowel syndrome; biliary colic; symptomatic bradycardia (sinus, proximal AV block, sinoatrial block, asystole, pulseless ventricular electrical activity); poisoning with anticholinesterase drugs and m-cholinergic stimulants, including organophosphorus compounds; for preoperative sedation; for X-ray studies of the gastrointestinal tract (to reduce the tone of the intestines and stomach); bronchitis with hyperproduction of mucus; bronchial asthma; laryngospasm (for prevention); bronchospasm; in ophthalmology, to dilate the pupil and achieve paralysis of accommodation (to determine the true refraction of the eye and to examine the fundus), to create functional rest in case of injuries and inflammatory diseases of the eye (iridocyclitis, iritis, keratitis, choroiditis, thromboembolism, spasms of the central retinal artery).

Method of administration of atropine and dose

Atropine is taken orally before meals by adults 1–3 times a day, 0.25–1 mg; for children, depending on age, 0.05–0.5 mg 1–2 times a day. The maximum single dose is 1 mg, daily dose is 3 mg. Intravenously, subcutaneously or intramuscularly 1–2 times a day, 0.25–1 mg. For the treatment of bradyarrhythmias, adults: intravenous bolus under the control of blood pressure and ECG - 0.5–1 mg, if necessary, the administration is repeated after 3–5 minutes; maximum dose 0.04 mg/kg (3 mg). Children - 10 mcg/kg. In ophthalmology, 2–3 times a day, 1–2 drops of a 1% solution are instilled into the affected eye. Children under 7 years of age are allowed to use an atropine solution in a concentration of ≤0.5%. Sometimes a 0.1% atropine solution is administered parabulbarly - 0.3–0.5 ml or subconjunctivally 0.2–0.5 ml, as well as by electrophoresis - a 0.5% solution from the anode through the eyelids or an eye bath. The ointment is applied behind the eyelids 1–2 times a day.
If you miss your next dose of atropine, you should contact your doctor.
In case of distal type of AV block (when the QRS complexes are wide on the ECG), atropine is not recommended, as it is ineffective. When introduced into the conjunctival sac, the lacrimal punctum (lower) must be pressed to avoid the solution entering the nasopharynx. With parabulbar or subconjunctival administration, it is advisable to take validol to reduce tachycardia. The more strongly pigmented iris is resistant to dilatation and, in order to achieve an effect, it is necessary to increase the frequency of administration or the concentration of the drug, so you should be wary of an overdose of atropine. Pupil dilation can cause an acute attack of glaucoma in patients over 60 years of age and in hyperopic patients who are predisposed to glaucoma because their anterior chamber is less deep. Patients should be warned that driving is prohibited for at least 2 hours after an ophthalmological examination. Atropine should be used with caution in patients with diseases of the circulatory system in which an increase in heart rate is undesirable (tachycardia, atrial fibrillation, coronary artery disease, chronic heart failure, mitral stenosis, hypertension, acute bleeding); with hyperthermia (it may increase due to decreased activity of the sweat glands); with thyrotoxicosis (tachycardia may increase); with a hiatal hernia, reflux esophagitis (due to decreased gastric motility and relaxation of the esophageal sphincter, gastric emptying may slow down and gastroesophageal reflux may increase); for diseases of the gastrointestinal tract that are accompanied by obstruction (pyloric stenosis, achalasia of the esophagus, intestinal atony in weakened or elderly patients), ulcerative colitis (tone and motility may decrease, which will lead to retention and obstruction of the contents of the stomach or intestines); with hepatic (metabolism decreases) and renal (the possibility of side effects increases due to decreased excretion of the drug) failure; with chronic lung diseases (secretion in the bronchi decreases, which can lead to thickening of secretions and the formation of plugs in the bronchi); with myasthenia gravis, cerebral palsy, brain damage in children, Down's disease (the condition may worsen due to the effect on acetylcholine); with gestosis (possibly increased arterial hypertension).

Contraindications and restrictions for use

Hypersensitivity, in ophthalmology: closed-angle glaucoma (including if it is suspected), keratoconus, open-angle glaucoma, children's age (1% solution - up to 7 years).

Use during pregnancy and breastfeeding

Atropine crosses the placental barrier. There have been no strictly controlled and adequate clinical studies of the safety of atropine use during pregnancy. When administered intravenously during pregnancy, tachycardia may develop in the fetus. Atropine is also found in breast milk in small concentrations. Therefore, the use of atropine during pregnancy and breastfeeding is not recommended.

Side effects of atropine

Systemic effects: sensory organs and nervous system: dizziness, insomnia, headache, euphoria, confusion, paralysis of accommodation, mydriasis, hallucinations, tactile perception disorders; circulatory system: sinus tachycardia and, because of this, worsening myocardial ischemia, ventricular fibrillation; digestive system: constipation, xerostomia; others: atony of the bladder and intestines, fever, photophobia, urinary retention. Local effects: increased intraocular pressure and transient tingling, hyperemia and irritation of the skin of the eyelids, swelling and hyperemia of the conjunctiva, paralysis of accommodation, conjunctivitis. When administered in single doses

Interaction of atropine with other substances

Reduces the effect of anticholinesterase drugs and m-cholinomimetics. Drugs that have anticholinergic activity enhance the effects of atropine. When taken together with antacids that contain Ca2+ or Al3+ ions, the absorption of atropine from the gastrointestinal tract is reduced. Promethazine and diphenhydramine increase the effects of atropine. The risk of developing systemic side effects is higher when used together with tricyclic antidepressants, phenothiazines, amantadine, quinidine, antihistamines and other drugs that have m-anticholinergic properties. Nitrates increase the possibility of increasing intraocular pressure. Atropine changes the absorption parameters of levodopa and mexiletine.

Overdose

With a slight overdose of atropine, dry mouth, impaired accommodation, dilated pupils, intestinal atony, difficulty urinating, tachycardia, and dizziness appear. In case of atropine poisoning, dilated pupils, dry skin and mucous membranes, increased intraocular pressure and body temperature, urinary retention, headache, tachycardia, dizziness, complete loss of orientation, hallucinations, and severe psychomotor agitation appear; Hypotension, convulsions with loss of consciousness, and coma may develop. It is necessary to administer the antidote proserin or physostigmine and symptomatic treatment.

Composition and release form of the drug

Injection in the form of a colorless or slightly colored, transparent liquid.

Excipients: hydrochloric acid solution 1M - up to pH 3.0-4.5, water for injection - up to 1 ml.

2 ml - glass syringes (1) - contour cell packaging (1) - cardboard packs.

pharmachologic effect

M-cholinergic receptor blocker is a natural tertiary amine. It is believed that atropine binds equally to the m 1 -, m 2 - and m 3 -subtypes of muscarinic receptors. Affects both central and peripheral m-cholinergic receptors.

Reduces the secretion of salivary, gastric, bronchial, and sweat glands. Reduces the tone of smooth muscles of internal organs (including bronchi, digestive system organs, urethra, bladder), reduces gastrointestinal motility. Has virtually no effect on the secretion of bile and pancreas. Causes mydriasis, paralysis of accommodation, reduces the secretion of tear fluid.

In average therapeutic doses, atropine has a moderate stimulating effect on the central nervous system and a delayed but long-lasting sedative effect. The central anticholinergic effect explains the ability of atropine to eliminate tremor in Parkinson's disease. In toxic doses, atropine causes agitation, hallucinations, and coma.

Atropine reduces the tone of the vagus nerve, which leads to an increase in heart rate (with a slight change in blood pressure) and an increase in conductivity in the His bundle.

In therapeutic doses, atropine does not have a significant effect on peripheral vessels, but with an overdose, vasodilation is observed.

When applied topically in ophthalmology, maximum pupil dilation occurs after 30-40 minutes and disappears after 7-10 days. Mydriasis caused by atropine is not eliminated by instillation of cholinomimetic drugs.

Pharmacokinetics

Well absorbed from the gastrointestinal tract or through the conjunctival membrane. After systemic administration, it is widely distributed in the body. Penetrates through the BBB. A significant concentration in the central nervous system is achieved within 0.5-1 hour. Protein binding is moderate.

T1/2 is 2 hours. Excreted in the urine; about 60% is unchanged, the remaining part is in the form of hydrolysis and conjugation products.

Indications

Systemic use: spasm of smooth muscle organs of the gastrointestinal tract, bile ducts, bronchi; peptic ulcer of the stomach and duodenum, acute pancreatitis, hypersalivation (parkinsonism, poisoning with heavy metal salts, during dental procedures), irritable bowel syndrome, intestinal colic, renal colic, bronchitis with hypersecretion, bronchospasm, laryngospasm (prevention); premedication before surgery; AV block, bradycardia; poisoning with m-cholinomimetics and anticholinesterase substances (reversible and irreversible effects); X-ray examination of the gastrointestinal tract (if necessary to reduce the tone of the stomach and intestines).

Local use in ophthalmology: for examining the fundus of the eye, for dilating the pupil and achieving accommodation paralysis in order to determine the true refraction of the eye; for the treatment of iritis, iridocyclitis, choroiditis, keratitis, embolism and spasm of the central retinal artery and some eye injuries.

Contraindications

Hypersensitivity to atropine.

Dosage

Orally - 300 mcg every 4-6 hours.

To eliminate bradycardia intravenously in adults - 0.5-1 mg; if necessary, the administration can be repeated after 5 minutes; children - 10 mcg/kg.

For the purpose of intramuscular premedication for adults - 400-600 mcg 45-60 minutes before anesthesia; children - 10 mcg/kg 45-60 minutes before anesthesia.

When applied topically in ophthalmology, 1-2 drops of a 1% solution are instilled (in children a solution of lower concentration is used) into the affected eye, the frequency of use is up to 3 times with an interval of 5-6 hours, depending on the indications. In some cases, a 0.1% solution is administered subconjunctivally 0.2-0.5 ml or parabulbar - 0.3-0.5 ml. Using electrophoresis, a 0.5% solution is injected from the anode through the eyelids or an eye bath.

Side effects

For systemic use: dry mouth, tachycardia, constipation, difficulty urinating, mydriasis, photophobia, paralysis of accommodation, dizziness, impaired tactile perception.

For local use in ophthalmology: hyperemia of the skin of the eyelids, hyperemia and swelling of the conjunctiva of the eyelids and eyeball, photophobia, dry mouth, tachycardia.

Drug interactions

When taken orally with drugs containing aluminum or calcium carbonate, the absorption of atropine from the gastrointestinal tract is reduced.

When used simultaneously with anticholinergic drugs and drugs with anticholinergic activity, the anticholinergic effect is enhanced.

When used simultaneously with atropine, it is possible to slow down the absorption of mexiletine, reduce the absorption of nitrofurantoin and its excretion by the kidneys. The therapeutic and side effects of nitrofurantoin are likely to increase.

When used simultaneously with phenylephrine, blood pressure may increase.

Under the influence of guanethidine, the hyposecretory effect of atropine may be reduced.

Nitrates increase the likelihood of increased intraocular pressure.

Procainamide enhances the anticholinergic effect of atropine.

Atropine reduces the concentration of levodopa in the blood plasma.

special instructions

Use with caution in patients with diseases of the cardiovascular system, in which an increase in heart rate may be undesirable: atrial fibrillation, tachycardia, chronic failure, coronary artery disease, mitral stenosis, arterial hypertension, acute bleeding; with thyrotoxicosis (possible increased tachycardia); at elevated temperatures (may further increase due to suppression of the activity of the sweat glands); with reflux esophagitis, hiatal hernia, combined with reflux esophagitis (decreased motility of the esophagus and stomach and relaxation of the lower esophageal sphincter can slow down gastric emptying and increase gastroesophageal reflux through the sphincter with impaired function); for gastrointestinal diseases accompanied by obstruction - achalasia of the esophagus, pyloric stenosis (possibly decreased motility and tone, leading to obstruction and retention of gastric contents), intestinal atony in elderly or debilitated patients (possible development of obstruction), paralytic ileus; with an increase in intraocular pressure - closed-angle (mydriatic effect, leading to an increase in intraocular pressure, can cause an acute attack) and open-angle glaucoma (mydriatic effect can cause a slight increase in intraocular pressure; adjustment of therapy may be required); with nonspecific ulcerative colitis (high doses can inhibit intestinal motility, increasing the likelihood of paralytic intestinal obstruction, in addition, the manifestation or exacerbation of such a severe complication as toxic megacolon is possible); with dry mouth (long-term use may cause further increase in the severity of xerostomia); with liver failure (decreased metabolism) and renal failure (risk of side effects due to decreased excretion); for chronic lung diseases, especially in young children and weakened patients (a decrease in bronchial secretion can lead to thickening of secretions and the formation of plugs in the bronchi); with myasthenia gravis (the condition may worsen due to inhibition of the action of acetylcholine); prostatic hypertrophy without urinary tract obstruction, urinary retention or predisposition to it, or diseases accompanied by urinary tract obstruction (including bladder neck due to prostatic hypertrophy); with gestosis (possibly increased arterial hypertension); brain damage in children, cerebral palsy, Down's disease (reaction to anticholinergic drugs increases).

The interval between doses of atropine and antacids containing aluminum or calcium carbonate should be at least 1 hour.

With subconjunctival or parabulbar administration of atropine, the patient must be given a tablet under the tongue to reduce tachycardia.

Impact on the ability to drive vehicles and machinery

During the treatment period, the patient must be careful when driving vehicles and engaging in other potentially hazardous activities that require increased concentration, speed of psychomotor reactions and good vision.

Pregnancy and lactation

Atropine penetrates the placental barrier. Adequate and strictly controlled clinical studies of the safety of atropine during pregnancy have not been conducted.

When administered intravenously during pregnancy or shortly before birth, tachycardia may develop in the fetus.

For liver dysfunction

Use with caution in case of liver failure (decreased metabolism).

Use in old age

Use with caution in patients with diseases of the cardiovascular system, in which an increase in heart rate may be undesirable; with intestinal atony in elderly or debilitated patients (possible development of obstruction), with prostatic hypertrophy without urinary tract obstruction, urinary retention or predisposition to it, or diseases accompanied by urinary tract obstruction (including bladder neck due to prostatic hypertrophy glands).

Atropine is an anticholinergic and antispasmodic agent.

The active substance of this drug is Atropine, which is a poisonous alkaloid found in the leaves and seeds of plants of the nightshade family, such as henbane, belladonna, and dope. The main chemical feature of Atropine is its ability to block the body's M-cholinoreactive systems, which are located in the heart muscle, organs with smooth muscles, the central nervous system and secretory glands. As a result of this blocking, M-cholinergic receptors become insensitive to the mediator of nerve impulses (acetylcholine).

The use of Atropine helps to reduce the secretory function of the glands, relax the tone of the smooth muscle organs, dilate the pupil, increase intraocular pressure and paralysis of accommodation (the ability of the eye to change the focal length). The acceleration and stimulation of cardiac activity after the use of Atropine is explained by its ability to relieve the inhibitory influences of the vagus nerve. The effect of Atropine on the central nervous system occurs in the form of stimulation of the respiratory center, and when using toxic doses, motor and mental agitation (convulsions, visual hallucinations) is possible.

Atropine quickly penetrates the bloodstream from the site of application and is then distributed throughout the body in a short period of time.. The maximum effect of the drug after intravenous administration occurs after 2-4 minutes, after oral administration - after half an hour. Plasma protein binding occurs by 18%. The drug is able to pass through the placental and blood-brain barriers. Excreted by the kidneys, excreted in the urine both in the form of metabolites and unchanged. Traces of the drug can be found in breast milk.

Indications for use of Atropine

This drug is actively used to treat the following diseases:

• spasm of the bile ducts, smooth muscle organs of the gastrointestinal tract;
• acute pancreatitis, peptic ulcer of the stomach and duodenum;
• renal colic, intestinal colic, irritable bowel syndrome;
• laryngospasm, bronchospasm, bronchitis with hypersecretion, bronchial asthma;
• urinary incontinence due to increased excitability of the bladder muscles;
• pulmonary hemorrhage;
• poisoning with asphyxiants, morphine, cholinomimetic substances, poisonous mushrooms (fly agarics), anticholinesterase drugs.

According to the instructions, Atropine can be used as a premedication before surgery, as well as during radiological studies of the intestine.

In ophthalmology, Atropine drops are used to dilate the pupil of the eye and achieve paralysis of accommodation to examine the fundus and determine the true refraction of the eye. Atropine drops are also used to create functional rest in case of inflammatory diseases and eye injuries.

How to use Atropine

According to the instructions, Atropine can be used orally, administered intravenously, intramuscularly, or subcutaneously. With these methods of administration, depending on the expected effect, the doctor prescribes a single dose, which usually corresponds to 0.25 - 1 mg or the same number of milliliters and is taken once or twice a day.

During induction of anesthesia, Atropine (0.3-0.6 mg) is used intramuscularly or subcutaneously half an hour to an hour before anesthesia, and in combination with morphine - 60 minutes before anesthesia.

The use of Atropine in case of poisoning with anticholyesterase drugs is 2 mg as an intramuscular injection every half hour.

The maximum single dose of the drug should not exceed 2 mg, and the daily dose should not exceed 3 mg. For children, the daily dose of Atropine is prescribed in two doses and should not exceed 0.02 mg (for children under 6 months), 0.05 mg (6 months - 1 year), 0.2 mg (1-2 years), 0 .25 mg (3-4 years), 0.3 mg (5-6 years), 0.4 mg (7-9 years), 0.5 mg (10-14 years).

In ophthalmology, Atropine drops, ointment or solution are used. 1-2 drops of 1% (adults), 0.5%, 0.25%, 0.125% (children) solution are instilled into the sore eye, or 1% ointment is placed over the edge of the eyelid. Atropine drops and ointment should be used no more than three times a day at 5-6 hour intervals. In some cases, the drug in the form of a 1% solution is administered subconjunctivally (instilled into the eye) at a dose of 0.2-0.5% or parabulbarly (injections under the eyeball) - 0.3-0.5 ml.

Side effects

The instructions for Atropine indicate the following negative effects that can be caused by the use of this drug:

• dizziness, insomnia, headache, euphoria, confusion, impaired tactile perception;
• ventricular tachycardia, ventricular fibrillation, aggravation of myocardial infarction due to excessive tachycardia, sinus tachycardia;
• constipation, xerostomia;
• urinary retention, intestinal and bladder atony, photophobia, fever;
• increased intraocular pressure, development of conjunctivitis, hyperemia and swelling of the conjunctiva, paralysis of accommodation, mydriasis.

Contraindications to the use of Atropine

This drug is not prescribed for hypersensitivity to it, as well as keratoconus, closed-angle glaucoma, open-angle glaucoma,

The instructions for Atropine indicate a number of diseases for which this drug should be prescribed with extreme caution:

Diseases of the cardiovascular system, in which an increase in the number of heartbeats is undesirable;

Increased body temperature;

Reflux esophagitis or associated hiatal hernia;

Diseases of the gastrointestinal tract, which are accompanied by obstruction;

Intestinal atony, especially in weakened or elderly patients;

Diseases with increased intraocular pressure;

Nonspecific ulcerative colitis;

Liver failure;

Dry mouth;

Kidney failure;

Chronic lung diseases;

Myasthenia;

Diseases that accompany urinary tract obstruction;

Down's disease, cerebral palsy, brain damage in children;

Synechia of the iris and age over 40 years - in ophthalmology.

Pregnancy and lactation are also reasons for careful use of Atropine.

Additional Information

The shelf life of Atropine is 5 years; the manufacturer indicates the end date of use on the packaging. The drug should be stored in a dark place out of reach of children.

Atropine sulfate

Atropine sulfate is an analogue of Atropine, in this regard, the characteristics of Atropine sulfate correspond to the characteristics of Atropine. The drugs Atropine sulfate and Atropine should be taken only as prescribed by a doctor and under his constant supervision.

Sincerely,