G-Atropine

Generic name: Atropine Sulfate (Injection)

0.6 mg/ml

Manufactured by: Gonoshasthaya Pharma Ltd.

1 ml ampoule: ৳ 6.00 (10's pack: ৳ 60.00)

Indication

Atropine Sulfate Injection is indicated in-

Cardiovascular disorders: It is used in a variety of disorders or circumstances in which bradyarrhythmias occur. It is frequently used in sudden onset bradyarrhythmias and although it may also be employed for the initial treatment of chronic arrhythmias, cardiac pacing is generally preferred for long-term control. Examples of acute use include the prevention and treatment of arrhythmias associated with anaesthesia, the treatment of other drug-induced arrhythmias, and in cardiac arrest due to asystole. It has been used in the management of bradycardia of acute myocardial infarction; however, caution is required, as it may exacerbate ischaemia or infarction in these patients.

Anaesthetic premedication: It is given before the induction of general anaesthesia to diminish the risk of vagal inhibition of the heart and to reduce the salivary and bronchial secretions.

Anticholinesterase and mushroom poisoning.

For control of muscarinic side-effects of neostigmine in reversal of competitive neuromuscular block.

Pharmacology

Atropine binds to and inhibit muscarinic acetylcholine receptors, producing a wide range of anticholinergic effects. Atropine is an anticholinergic agent which competitively blocks the muscarinic receptors in peripheral tissues such as the heart, intestines, bronchial muscles, iris and secretory glands. Some central stimulation may occur. Atropine abolishes bradycardia and reduces heart block due to vagal activity. Smooth muscles in the bronchi and gut are relaxed while glandular secretions are reduced. It also has mydriatic and cycloplegic effect.

Dosage & Administration

Interaction

Peripheral and central nervous system anticholinergic action is additive with other drugs which have anticholinergic activity for example, tricyclic antidepressants, other antispasmodics and antiparkinsonian drugs, some antihistamines, phenothiazines, disopyramide and quinidine. By delaying gastric emptying, atropine may delay the onset of action of other drugs and in some cases increase absorption. Addition of metoclopramide accentuates the reduction of lower oesophageal pressure produced by atropine premedication, and may thus protect against aspiration of gastric contents.

Side Effects

Dryness of the mouth with difficulty in swallowing and talking, thirst, reduced bronchial secretions, dilatation of the pupils (mydriasis) with loss of accomodation (cycloplegia) and photophobia, flushing, dryness of skin, transient bradycardia followed by tachycardia with palpitations and arrhythmias, difficulty in micturition, as well as reduction in the tone and motility of GIT leading to constipation. Occasionally vomiting may also occur.

Pregnancy & Lactation

It has negligible effects on the human uterus and is not teratogenic. Small quantities of atropine appears in breast milk when the drug is given to lactating mothers. It has also been reported to impair milk production, although this is not conclusively documented.

Precautions & Warnings

It should be used with caution in children, and in geriatric patients, who may be more susceptible to its adverse effects. It is generally advisable to be cautious in giving atropine to any patient with diarrhoea. Due to the risk of provoking hyperpyrexia atropine should not be given to patients, especially children when the ambient temperature is high. It should also be used cautiously in patients with fever. Persons with Down’s syndrome appear to have an increased susceptibility to the actions of atropine. It should be used with caution in conditions characterised by tachycardia such as thyrotoxicosis, heart failure, and in cardiac surgery, where it may further accelerate the heart rate. Care is required in patients with acute myocardial infarction as ischaemia and infarction may be made worse. It should be given with care to patients with hypertension.

Atropine may cause mental confusion, especially in the elderly. Reduced bronchial secretion caused by systemic administration of atropine may be associated with the formation of mucous plugs.

In the treatment of parkinsonism, increases in dosage and transfer to other forms of treatment should be gradual and antimuscarinic agents should not be withdrawn abruptly. Minor reactions may be controlled by reducing the dose until tolerance has developed.

Use in Special Populations

Therapeutic Class

Anticholinergics (antimuscarinics)/ Anti-spasmodics

Overdose Effects

Storage Conditions

Keep below 25°C temperature, away from light & moisture. Keep out of the reach of children.