Atropine sulfate

[AH-troh-peen] Pregnancy Category: C

Atropair, Atropine-1 Ophthalmic, Atropine Sulfate Ophthalmic, Atropine-Care Ophthalmic, Atropisol Ophthalmic, Dioptic's Atropine M, Isopto Atropine Ophthalmic, Minims Atropine M [Rx]

Classification: Cholinergic blocking agent

See also Cholinergic Blocking Agents.

Action/Kinetics: Atropine blocks the action of acetylcholine on post-ganglionic cholinergic receptors in smooth muscle, cardiac muscle, exocrine glands, urinary bladder, and the AV and SA nodes in the heart. Ophthalmologically, atropine blocks the effect of acetylcholine on the sphincter muscle of the iris and the accommodative muscle of the ciliary body. This results in dilation of the pupil (mydriasis) and paralysis of the muscles required to accommodate for close vision (cycloplegia). Peak effect: Mydriasis, 30-40 min; cycloplegia, 1-3 hr. Recovery: Up to 12 days. Duration, PO: 4-6 hr. tV2: 2.5 hr. Metabolized by the liver although 30%-50% is excreted through the kidneys unchanged. Uses: PO: Adjunct in peptic ulcer treatment. Irritable bowel syndrome. Adjunct in treatment of spastic disorders of the biliary tract. Urologic disorders, urinary incontinence. During anesthesia to control salivation and bronchial secretions. Has been used for parkinsonism but more effective drugs are available.

Parenteral: Antiarrhythmic, adjunct in GI radiography. Prophylaxis of arrhythmias induced by succinyl-

D choline or surgical procedures. Reduce sinus bradycardia (severe) and syncope in hyperactive carotid sinus reflex. Prophylaxis and treatment of toxicity due to cholinesterase inhibitors, including organophosphate pesticides. Treatment of curariform block. As a preanesthetic or in dentistry to decrease secretions.

Ophthalmologic: Cycloplegic refraction or pupillary dilation in acute inflammatory conditions of the iris and uveal tract. Non-FDA Approved Uses: Treatment and prophylaxis of posterior synechiae; pre- and postoperative mydriasis; treatment of malignant glaucoma.

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