৳ 5/unit
Pack: ৳ 5
৳ 5/unit
Pack: ৳ 5
At a glance
Atropine Sulphate is an anticholinergic agent used for bradycardia, organophosphorus poisoning, and as an anesthesia adjunct. As eye drops, it is used for mydriasis, cycloplegia, and controlling myopia progression in children.
Indications
- Sinus bradycardia (ACLS)
- Asystole / Pulseless Electrical Activity (ACLS)
- Organophosphorus poisoning
- Anesthesia premedication (antisialagogue)
- Bronchospasm (nebulization)
- Cycloplegia and mydriasis for eye examination
- Uveitis treatment
- Myopia progression control in children (0.01% solution)
Pharmacology
Atropine is a competitive muscarinic receptor antagonist. It blocks acetylcholine at muscarinic receptors, reducing parasympathetic effects.
At low doses, it increases heart rate (by reducing vagal tone), reduces glandular secretions, and causes bronchodilation. At higher doses, CNS stimulation may occur.
In the eye, it causes mydriasis (pupil dilation) and cycloplegia (paralysis of accommodation) by blocking the sphincter pupillae and ciliary muscles.
Dosage
Injection (IV/IM/SC):
- Anesthesia premedication: 0.4-0.6 mg, 30-60 min before anesthesia; repeat q4-6hr PRN
- Sinus bradycardia (ACLS): 0.5-1 mg or 0.04 mg/kg IV q5min; max 3 mg
- Asystole/PEA (ACLS): 1 mg IV q3-5min; up to 0.04 mg/kg
- Organophosphorus poisoning: 2 mg IV/IM, q10-30min until muscarinic effects resolve; maintain atropinization for at least 2 days
- Bronchospasm (nebulization): 0.025 mg/kg (max 2.5 mg/dose) in 2.5 mL NS, q6-8hr
Eye Drops (0.01% & 1%):
- Uveitis (1%): 1 drop three times daily
- Refraction (1%): 1 drop twice daily for 1-2 days before exam, and 1 hour before exam
- Myopia control (0.01%): 1 drop at night in each eye; continue for at least 2 years
Side effects
Common (Eye Drops):
- Blurred vision
- Photophobia
- Local irritation
- Follicular conjunctivitis
- Vascular congestion, edema, exudate
- Contact dermatitis, eczematous dermatitis
Common (Injection/Systemic):
- Dry mouth
- Dysphagia
- Constipation
- Flushing and dry skin
- Tachycardia, palpitations, arrhythmias
- Mydriasis, photophobia, cycloplegia
- Raised intraocular pressure
Toxic doses: Tachycardia, hyperpyrexia, restlessness, confusion, excitement, hallucinations, delirium, circulatory failure, respiratory depression.
Use in pregnancy
[CONSULT YOUR DOCTOR] Atropine may be systemically absorbed after ocular administration; however, significant fetal effects have not been reported. Use with caution during pregnancy. [citation:4]
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Precautions & warnings
Serious Precautions:
- Contraindicated in angle-closure glaucoma [citation:4]
- Total dose should not exceed 0.03-0.04 mg/kg in patients with coronary artery disease [citation:9]
- May cause viscid plugs in chronic lung disease
- May cause complete urinary retention in prostatic hypertrophy
- May convert partial pyloric stenosis to complete obstruction
- Extreme caution in Down's syndrome, spastic paralysis, or brain damage [citation:4]
- Caution in pregnancy and lactation
Overdose effects
Symptoms: Headache, fast heartbeat, dry mouth and skin, unusual drowsiness, flushing. [citation:4]
Management: Flush eye with water and seek emergency medical attention.
Storage conditions
Eye Drops: Store below 30°C, in a dry place, away from light. Do not use after 1 month of opening. [citation:4]
Injection: Store as per manufacturer's instructions.