ATROPINESULPHATE

Indications & Dose:

Bradycardia due to acute massive overdosage of betablockers BY INTRAVENOUS INJECTION Child: 40 micrograms/kg (max. per dose 3 mg)Adult: 3 mg Treatment of poisoning by organophosphorus insecticide or nerve agent (in combination with pralidoxime chloride)BY INTRAVENOUS INJECTION Child: 20 micrograms/kg every 5–10 minutes (max. per dose 2 mg) until the skin becomes flushed and dry, the pupils dilate, and bradycardia is abolished, frequency of administration dependent on the severity of poisoning Adult: 2 mg every 5–10 minutes until the skin becomes flushed and dry, the pupils dilate, and bradycardia is abolished, frequency of administration dependent on the severity of poisoning Symptomatic relief of gastro-intestinal disorders characterised by smooth muscle spasm l BY MOUTH Adult: 0.6–1.2 mg daily, dose to be taken at night Premedication BY INTRAVENOUS INJECTION Child 12–17 years: 300–600 micrograms, to be administered immediately before induction of anaesthesia Adult: 300–600 micrograms, to be administered immediately before induction of anaesthesia BY SUBCUTANEOUS INJECTION, OR BY INTRAMUSCULAR INJECTION Child 12–17 years: 300–600 micrograms, to be administered 30–60 minutes before induction of anaesthesia Adult: 300–600 micrograms, to be administered 30–60 minutes before induction of anaesthesia Intra-operative bradycardia BY INTRAVENOUS INJECTION Child 12–17 years: 300–600 micrograms, larger doses may be used in emergencies Adult: 300–600 micrograms, larger doses may be used in emergencies continued Control  of  muscarinic  side-effects  of neostigmine in reversal of competitive neuromuscular block BY INTRAVENOUS INJECTION Child 12–17 years: 0.6–1.2 mg Adult: 0.6–1.2 mg Excessive bradycardia associated with beta-blocker use BY INTRAVENOUS INJECTION Adult: 0.6–2.4 mg in divided doses (max. per dose 600 micrograms)Bradycardia following myocardial infarction(particularly if complicated by hypotension)BY INTRAVENOUS INJECTION Adult: 500 micrograms every 3–5 minutes;maximum 3 mg per course

Contraindications:

Narrow angle glaucoma,gastric and urinary retention, para-lytic ilius.Obstructive disease of GI tract, obstructive uropathy,unstable  cardiovascular  status  in  acute haemorrhage, intes-tinal atony of the elderly or debilitated   patient, thyrotoxicosis, tachycardia,hypersensitivity to belladonna alkaloids.

Side Effects:

Dry mouth with difficulty in swallowing and thirst,dilatation of the pupils with loss of accomodation and sensitivity to light, increased intra-ocular pressure, flushing, dry skin, bradycardia followed by tachycardia, palpitations and arrhythmias,difficulty with micturation and constipation; rarely fever, confusional states and rashes, decreased sweating, constipation, irritation at injection site,increased sensitivity to light, confusion, skin rash,orthostatic hypotension, loss of memory, headache,nausea, vomiting, ventricular fibrillation, palpitation,ataxia.

Cautions:

Elderly, urinary retention, prostatic enlargement, tachycardia, cardiac insufficiency,paralytic ileus, ulcerative colitis and pyloric stenosis;may  aggravate  gastro-oesophageal  reflux;pregnancy and breast-feeding.

Precautions:

Interaction:

Drugs Antihistamines, antipsycotics, antiparkinsonism medicine, mepridine, orphanadrine, nitrites, alkaline agents, primidone, MAO inhibitors

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

In children with spastic paralysis or brain damage. Prostate hypertrophy, congestive heart failure, cardiac arrhythmia, biliary tract disease, chronic lung disease. Heart prostration may occur in hot weather.PREGNANCY: Safety not established.BREAST-FEEDING: Caution,   use only if clearly indicated. Old age: May be used in reduced dose.MONITORING REQUIREMENTS Control of muscarinic side-effects of neostigmine in reversal of competitive neuromuscular block Since atropine has a shorter duration of action than neostigmine, late unopposed bradycardia may

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: