Classes
DEA Class; Rx
Common Brand Names; Atreza, Atropine PO, SalTropine, IsoptoAtropine
- Anticholinergic, Antispasmodic Agents
- Ophthalmic
Description
Natural tertiary amine extracted from belladonna alkaloid
Used for symptomatic bradycardia, secretion reduction prior to surgery, organophosphate toxicity, to produce mydriasis and cycloplegia, and treatment of amblyopia.
Consists of a racemic mixture of both d- and l-hyoscyamine
Indications
Indicated for Sialorrhea, Pylorospasm & Other Spastic Conditions of the Gastrointestinal Tract
Contraindications
Hypersensitivity to anticholinergic drugs
Narrow-angle glaucoma, synechia (adhesions) between iris and eye lens, myasthenia gravis, obstructive uropathy, paralytic ileus, severe ulcerative colitis, toxic megacolon, acute hemorrhage with cardiovascular instability, thyrotoxicosis
Adverse Effects
- Ataxia
- Coma
- Confusion
- Delirium
- Dizziness
- Drowsiness
- Hallucinations
- Headache
- Insomnia
- Nervousness
- Arrhythmia
- Flushing
- Hypotension
- Palpitation
- Tachycardia
- Dyspnea
- Laryngospasm
- Pulmonary edema
- Bloating
- Constipation
- Delayed gastric emptying
- Loss of taste
- Nausea
- Paralytic ileus
- Vomiting
- Xerostomia
- Nasal dryness
- Fever
- Anhidrosis
- Urticaria
- Rash
Warnings
Use caution in open-angle glaucoma, hyperthyroidism, BPH, CVD, autonomic neuropathy, HTN, partial obstructive uropathy, toxin-mediated diarrhea, hepatic/renal impairment, tachyarrhythmia, Down syndrome, brain damage in children, salivary secretion disorder, hiatal hernia, reflex esophagitis
Restrict dose to 2-3 mg (0.03-0.04 mg/kg) in patients with ischemic heart disease, to avoid atropine-induced tachycardia, increased myocardial oxygen demand and potential for worsening cardiac ischemia or increasing infarction size
Therapy may precipitate acute glaucoma
Treatment may convert partial organic pyloric stenosis into complete obstruction
May lead to complete urinary retention in patients with prostatic hypertrophy
May cause thickening of bronchial secretions and formation of viscid plugs in patients with chronic lung disease
Pregnancy and Lactation
Pregnancy
Drug readily crosses the placental barrier and enters fetal circulation; there are no adequate data on developmental risk associated with use of atropine in pregnant women; adequate animal reproduction studies have not been conducted with atropine
Lactation
Drug reported to be excreted in human milk; there are no data on effects of atropine on breastfed infant or effects on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from therapy or from underlying maternal condition