Atropine is a tropane alkaloid obtained from Atropa belladonna or deadly nightshade, Datura stramonium or jimsonweed, Mandragora officinarum or mandrake, and other plants of the family Solanaceae. This versatile, all-purpose drug thats a secondary metabolite of the above plants provides a wide variety of effects and uses. Classified as an anticholinergic drug, it even serves as a competitive antagonist for the muscarinic acetylcholine receptor.
Because of atropine's potential deadliness, the drug derives its name from one of the three Fates Atropos who, according to Greek mythology, chose how a person would die. The World Health Organization even considers it as a core medicine for the association's Essential Drugs List, which is a list of minimum medical requirements for a basic healthcare system.
Initial single adult doses range from around half a milligram to one milligram or five to ten milliliters of the 0.1 milligram/milliliter solution for antisialagogue and other antivagal effects, plus two to three milligrams or twenty to thirty milliliters of the 0.1 milligram/milliliter solution as an antidote for organophosporous muscarinic mushroom poisoning.
For patients without IV access, the endotracheal administration of atropine should suffice because it doesn't need intravenous medication routes. The advised adult dose of atropine for endotracheal administration is one to two milligrams diluted to a total not exceeding ten milliliters of normal saline or sterile water. Titration intervals of one or two hours are most suitable in cases that are not serious or critical.
Atropine Sulfate Injection (USP) should be administered with care and due consideration in all individuals over forty years of age. Acute glaucoma in susceptible patients may also occur during atropine treatment. Furthermore, conventional systemic doses may lead to complete urinary retention in patients with prostatic hypertrophy, convert partial organic pyloric stenosis into complete obstruction, or cause inspissation of bronchial secretions and formation of dangerous viscid plugs in patients with chronic lung disease. As such, informing your doctor of your medical history before starting treatment is of the utmost importance.
Even though the recurrent use of atropine is crucial in patients suffering from coronary artery disease, the total dose of the medicine should be restricted to two to three (maximum 0.03 to 0.04 milligrams/kilograms) to prevent the harmful side effects of atropine-caused tachycardia on myocardial oxygen demand.
As for sufferers of bradyasystolic cardiac arrest, a single milligram dose of atropine should be taken intravenously and repeated every three to five minutes if asystole persists. Three milligrams (0.04 milligrams/kilograms) given intravenously is a completely vagolytic dose in most patients. In addition, the administration of less than 0.05 milligrams can produce a paradoxical bradycardia because of the peripheral or central parasympathomimatic effects of low dose atropine in adults.
As an antidote, atropine's two to three milligram dose should be repeated no less often than every twenty to thirty minutes until symptoms of poisoning are significantly reduced or signs of atropine poisoning occur. Dosing information in children hasn't been well researched. Usage history of initial dose has been around 0.01 to 0.03 milligrams/kilograms body weight.
Side effects directly related to atropine's antimuscarinic action include tachycardia, photophobia, blurred vision, and dryness of mouth. These symptoms commonly happen with chronic administration of therapeutic doses. Anhidrosis, heat intolerance, and impaired temperature regulation may also occur to patients living in a hot environment. Elderly patients may also suffer urination difficulties and constipation. Occasional hypersensitivity, skin rashes, and exfoliation have also been reported.
Atropine poisoning side effects due to excessive dosage include ataxia, fatigue, tremor, restlessness, dizziness, thirst, hot and dry skin, difficulty in swallowing, dilated pupils, and palpitation. Toxic doses may lead to coma, delirium, hallucinations, restlessness and excitement, and marked palpitation. Severe intoxication while undergoing atropine treatment can also lead to circulatory collapse and depression. Consult your doctor if any of these symptoms occur or persist.
Atropine has the following structural formula:
• Molecular formula of atropine is C17H23NO3
• Chemical IUPAC Name is (8-methyl-8-azabicyclo[3.2.1]oct-3-yl) 3-hydroxy-2-phenyl-propanoate
• Molecular weight is 289.369 g/mol
• Atropine available : 5ml 1% bottles
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