Atropine, Inj
Antispasmodic & Anticholinergic · Anticholinergic
Indications
See under dosage.
Dosage
Premedication: ORAL: For administration by mouth, injection solution may be given orally 1-2 hr before induction of anaesthesia. Children: Neonate, 20-40 mcg/kg. 1 mth-18 yr, 20-40 mcg/kg (max. 900 mcg). INJECTION: IV injection: Immediately before induction of anaesthesia: Children: Neonate, 10 mcg /kg. 1 mth-12 yr, 20 mcg /kg (minimum 100 mcg, max. 600 mcg). 12-18 yr, 300-600 mcg. Adults: 300-600 mcg. SC or IM injection: 30-60 minutes before induction of anaesthesia: Children: Neonate, 10 mcg /kg. 1 mth-12 yr, 10-30 mcg /kg (minimum 100 mcg, max. 600 mcg). 12-18 yr, 300-600 mcg. Adults: 300-600 mcg. Intra-operative bradycardia: IV injection: Children: Neonate, 10-20 mcg /kg. 1 mth-12 yr, 10-20 mcg /kg. 12-18 yr, 300-600 mcg (larger doses in emergencies). Adults: 300-600 mcg (larger doses in emergencies). Control of muscarinic side-effects of neostigmine 50 mcg /kg in reversal of…
Administration
Intratracheal: Dilute with NS to a volume of 3-5 mL followed by several positive-pressure ventilators. Parenteral: Administer undiluted by rapid IV inj; slow injection may result in paradoxical bradycardia. Compatibility: Incompatible with thiopental (Y-site administration), cimetidine/pentobarbital (in syringe), Compatibility when admixed: Incompatible with floxacillin, metaraminol, methohexital, norepinephrine. Stability: Store injection at controlled room temperature of 15°C-30°C. Protect from light.
Adverse Effects
Fatigue, delirium, headache, restlessness, ataxia. Dry hot skin. Impaired GI motility. Tremor. Blurred vision. Vomiting, fever, rashes, dizziness, confusion, hallucination, retrosternal pain. Muscarinic effects (e.g., dry mouth, mydriasis, cycloplegia, photophobia, flushing, bradycardia, tachycardia, palpitations and arrhythmias, difficult micturition, constipation, reduced bronchial secretions).
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Hypersensitivity to atropine, narrow angle glaucoma, tachycardia, thyrotoxicosis, obstructive disease of the GI tract, obstructive uropathy, prostatic enlargement, paralytic ileus or pyloric stenosis, severe ulcerative colitis, Myasthaenia gravis. Precautions: Use with caution in children with spastic paralysis or brain damage, diarrhoea, GORD, urinary retention, acute MI, hypertension, heart transplant patients, COPD, fever. Renal or hepatic impairment.
Interactions
Anticholinergic agents, may alter response to beta-adrenergic blockers. MAOIs, domperidone, metoclopramide, disopyramide, mexiletine, ketoconazole, sublingual preps (nitrates), propofol, parasympathomimetics.
Advice to Patient
Take oral form 30 to 60 minutes before meals. Contact prescriber if persistent or severe diarrhoea, constipation, difficulty in urination, difficulty in swallowing, chest pain, palpitations, rapid heartbeat, increased confusion, depression, loss of memory, muscle weakness or tremors, eye pain occur. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Void before taking medication. Avoid extreme heat.
Pharmacokinetics
Onset of action: Inhibition of salivation: IM: Within 30 min; max effect: 30-60 min. Increased heart rate: IM: Within 15-30 min; max effect: 45-60 min. IV: Immediate; max effect: 0.7-4 min. Duration: Inhibition of salivation: IM: =4 hrs. Absorption: Rapid and well absorbed from all dosage forms. Metabolism: Hepatic. Half-life elimination: Children <2 yrs: 6.9 ± 3 hrs. > 2yrs: 2.5 ± 1.2 hrs. Adults: 3 ± 0.9 hrs. Elderly 65-75 yrs: 10 ± 7.3 hrs. Time to peak: IM: Autoinjector: 3 min. Excretion: Urine.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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