Classes
DEA Class; Rx
Common Brand Names; Enlon Plus
- Antidotes, Systemic
Description
Combined cholinesterase inhibitor, edrophonium, and antimuscarinic agent, atropine
Used IV to reverse the effects of nondepolarizing neuromuscular blocking agents (e.g., curare type)
Edrophonium exerts the primary actions, while atropine decreases the adverse reactions associated with edrophonium
Indications
For use in nondepolarizing neuromuscular blockade reversal or antagonism, or as an adjunctive treatment of respiratory depression due to curare overdosage.
Contraindications
Atropine; edrophonium is contraindicated in patients with glaucoma, synechia, or posterior synechiae, pyloric stenosis and GI obstruction
Patients who have sulfite hypersensitivity should be monitored carefully when using atropine; edrophonium.
Adverse Effects
- AV block
Bradycardia
Arrhythmia exacerbation
Respiratory arrest
Laryngospasm
Seizures
Scarlatiniform Exanthema - Premature ventricular Contractions (PVCs)
Sinus tachycardia
Dysphonia
Dysarthria
Dysphagia
Conjunctival hyperemia
Photophobia
Blurred vision
Urinary retention
Warnings
Atropine may alter the heart rate causing tachycardia or potentiating arrhythmia. Edrophonium induces vagal stimulation. Thus, use atropine; edrophonium cautiously in patients with known cardiac disease, including cardiac arrhythmias, AV block, bradycardia, congestive heart failure, coronary artery disease, angina, hypotension, or other cardiac instability where an increase in heart rate could be detrimental. Atropine-containing products should be used cautiously in patients with recent or acute myocardial infarction, as the atropine-induced increased heart rate increases the oxygen demand on the heart and can exacerbate myocardial ischemia. In patients receiving beta-adrenergic blocking agents, there is an increased risk for excessive bradycardia from unopposed parasympathetic vagal tone. Such patients should receive atropine alone prior to atropine; edrophonium.
Pregnancy and Lactation
Atropine; edrophonium is classified as FDA pregnancy risk category C.
According to the manufacturer, the safety and efficacy of atropine; edrophonium during breast-feeding has not been established
Maximum Dosage
0.014 mg atropine; 1 mg edrophonium per kg IV per dose.
0.014 mg atropine; 1 mg edrophonium per kg IV per dose.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.