Atropine Sulfate(a’ troe peen)
Parenteral and oral
preparations: AtroPen
Ophthalmic solution: Atropine Sulfate Ophthalmic, Isopto Atropine Ophthalmic
PREGNANCY CATEGORY C
Drug Classes
Anticholinergic
Antidote
Antimuscarinic
Antiparkinsonian
Belladonna alkaloid
Diagnostic agent (ophthalmic preparations)
Parasympatholytic
Therapeutic Actions
Competitively blocks the effects of acetylcholine at muscarinic cholinergic receptors that mediate the effects of parasympathetic postganglionic impulses, 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
Antisialagogue for preanesthetic medication to prevent or reduce respiratory tract secretions
Treatment of parkinsonism; relieves tremor and rigidity (injection)
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 cardiac glycosides)
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 (injection)
Treatment of closed head injuries that cause acetylcholine release into CSF, EEG abnormalities, stupor, neurologic signs
Relaxation of uterine hypertonicity
Management of peptic ulcer (injection)
Control of rhinorrhea of acute rhinitis or hay fever
Antidote (with external cardiac massage) for CV 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) (injection)
Initial treatment of muscarinic symptoms of insecticide or nerve agent poisoning
Ophthalmic preparations
Diagnostically to produce mydriasis and cycloplegia-pupillary dilation in acute inflammatory conditions of the iris and uveal tract
Contraindications and Cautions
Contraindicated with hypersensitivity to anticholinergic drugs.
Systemic administration
Contraindicated with 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, hepatic, or renal function; myasthenia gravis.
Use cautiously with Down syndrome, brain damage, spasticity, hypertension, hyperthyroidism, pregnancy, lactation.
Ophthalmic solution
Contraindicated with glaucoma or tendency to glaucoma.
Available Forms
Tablets—0.4 mg; injection—0.05, 0.1, 0.3, 0.4, 0.5, 0.8, 1, 2 mg/mL; ophthalmic ointment—1%; ophthalmic solution—0.5%, 1%, 2%; auto-injector—0.25, 0.5, 1, 2 mg
