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Back to Drug index
Name: Atropine Sulfate
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The FDA approved Xolair?, the first in a new class of asthma therapies that
are bioengineered to target IgE.
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Pregnancy Category C
Drug classes
- Anticholinergic
- Antimuscarinic
- Parasympatholytic
- Antiparkinsonism drug
- Antidote
- Diagnostic agent (ophthalmic preparations)
- Belladonna alkaloid
Mechanisms of action
Competitively blocks the effects of acetylcholine at muscarinic cholinergic
receptors that mediate the effects of parasympathetic postganglionic impulses,
thus depressing salivary and bronchial secretions, dilating the bronchi,
inhibiting vagal influences on the heart, relaxing the GI and GU tracts,
inhibiting gastric acid secretion (high doses), relaxing the pupil of the
eye (mydriatic effect), and preventing accommodation for near vision (cycloplegic
effect); also blocks the effects of acetylcholine in the CNS.
Indications
- Systemic administration: Antisialogogue for preanesthetic medication
to prevent or reduce respiratory tract secretions
- Treatment of parkinsonism; relieves tremor and rigidity
- Restoration of cardiac rate and arterial pressure during anesthesia
when vagal stimulation produced by intra-abdominal traction causes a decrease
in pulse rate, lessening the degree of AV block when increased vagal tone
is a factor (eg, some cases due to digitalis)
- Relief of bradycardia and syncope due to hyperactive carotid sinus
reflex
- Relief of pylorospasm, hypertonicity of the small intestine, and hypermotility
of the colon
- Relaxation of the spasm of biliary and ureteral colic and bronchospasm
- Relaxation of the tone of the detrusor muscle of the urinary bladder
in the treatment of urinary tract disorders
- Control of crying and laughing episodes in patients with brain lesions
- Treatment of closed head injuries that cause acetylcholine release
into CSF, EEG abnormalities, stupor, neurologic signs
- Relaxation of uterine hypertonicity
- Management of peptic ulcer
- Control of rhinorrhea of acute rhinitis or hay fever
- Antidote (with external cardiac massage) for cardiovascular collapse
from overdose of parasympathomimetic (cholinergic) drugs (choline esters,
pilocarpine), or cholinesterase inhibitors (eg, physostigmine, isoflurophate,
organophosphorus insecticides)
- Antidote for poisoning by certain species of mushroom (eg, Amanita
muscaria)
- Ophthalmic preparations: diagnostically to produce mydriasis and cycloplegiapupillary
dilation in acute inflammatory conditions of the iris and uveal tract
Contraindications/cautions
- Contraindicated in the presence of hypersensitivity to anticholinergic
drugs.
- Systemic administration: Contraindicated in the presence of glaucoma,
adhesions between iris and lens, stenosing peptic ulcer, pyloroduodenal
obstruction, paralytic ileus, intestinal atony, severe ulcerative colitis,
toxic megacolon, symptomatic prostatic hypertrophy, bladder neck
obstruction, bronchial asthma, COPD, cardiac arrhythmias, tachycardia,
myocardial ischemia, impaired metabolic, liver or kidney function, myasthenia
gravis.
- Use caution in the presence of Down syndrome, brain damage, spasticity,
hypertension, hyperthyroidism, lactation.
- Ophthalmic solution: Contraindicated with glaucoma or tendency to
glaucoma.
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Adverse effects Systemic Administration
- CNS: Blurred vision, mydriasis,
cycloplegia, photophobia, increased intraocular pressure, headache, flushing,
nervousness, weakness, dizziness, insomnia, mental confusion or excitement
(after even small doses in the elderly), nasal congestion
- GI: Dry mouth, altered taste perception,
nausea, vomiting, dysphagia, heartburn, constipation, bloated feeling,
paralytic ileus, gastroesophageal reflux
- CV: Palpitations, bradycardia
(low doses), tachycardia (higher doses)
- GU: Urinary hesitancy and retention;
impotence
- Other: Decreased sweating and
predisposition to heat prostration, suppression of lactation
Ophthalmic Preparations
- Local: Transient stinging
- Systemic: Systemic adverse effects,
depending on amount absorbed
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