ATROPINE- Introduction, brand name, pharmacological name, available forms, route of administeration , CNS, acetyl choline function, classification, pharmacodynamics, pharmacokinetics,indications, contraindications, precautions, side-effects, nursing responsibility and patient education

1. DRUG PRESENTATION
ATROPINE SULPHATE
Ms. Ritu Ahirwal

2. INTRODUCTION
Atropine is a medication used to treat certain
types of nerve agent and pesticide poisonings
as well as some types of slow heart rate and
to decrease saliva production during surgery. It
is typically given intravenously or by injection
into a muscle. Eye drops are also available
which are used to treat uveitis (inflammation of
the iris, choroid and sclera) and early
amblyopia (impaired or dim vision). The
intravenous solution usually begins working
within a minute and lasts half an hour to an
hour. Large doses may be required to treat
some poisonings.

3. BRAND NAME| GENERIC NAME: Atropen,
Daturin
PHARMACOLOGICAL NAME: Atropine
sulfate

4. AVAILABLE FORMS
Atropine sulfate is available in the form of:
 Injection form
 Tablet form
 Ophthalmic ointment
 Ophthalmic solution

5. ROUTEOF ADMINISTRATION:
Routes of administration are:
 Mouth
 Intravenous
 Intramuscular
 Rectal

6. CENTRLAL NERVOUS
SYSTSEM
NERVOUS
SYSYTEM
CENTRAL
NERVOUS
SYSTEM
SPINAL
CORD
BRAIN
PERIPHER
AL
NERVOUS
SYSTEM
AUTONOMI
C
NERVOUS
SYSYTEM
SYMPATHETI
C N.S.
PARA
SYMPATHAT
C N.S.
SOMATIC
NERVOUS
SYSTEM

7. Sympathetic Nervous
System
Fight or Flight
Epinephrine released from adrenal
gland
Increase in heart rate and cardiac
output, skeletal muscle vasodilation,
bronchial dilation, pupillary dilation

8. Parasympathetic Nervous
System
The parasympathetic nervous system
conserves energy as it slows the heart rate,
increases intestinal and gland activity, and
relaxes sphincter muscles in gastrointestinal
tract.

9. Acetylcholine Function
Acetylcholine is the chief
neurotransmitter of the parasympathetic
nervous system that contracts smooth
muscles, dilates blood vessels,
increases bodily secretions, and slows
heart rate.

10. CLASSIFICATION : Antimuscarinic
(Anticholinergic)
PHARMACODYANIMICS
Antiarrhythmic action: It blocks the effects
of acetylcholine on the SA and AV nodes,
thereby increasing SA and AV node
conduction velocity. These changes result in
an increased heart rate (both atrial and
ventricular).

11. Anticholinergic action: As a cholinergic
blocking agent, atropine decreases the
action of the parasympathetic nervous
system on certain glands (bronchial, salivary,
and sweat), resulting in decreased
secretions. It also decreases cholinergic
effects on the iris, ciliary body, and intestinal
and bronchial smooth muscle.

12. Respiratory system
Atropine causes relaxation of upper respiratory
tract muscles and inhibition of secretary function
of bronchi.
Atropine prevents bronchospasm.
Gastrointestinal tract
Atropine inhibits motor activity of GIT and
secretary function
Atropine significantly decreases salivation which
results in dryness of mouth, difficulties in
swallowing and speaking.
Atropine decreases tonus of intestine gall bladder,
stomach and inhibits peristalsis

13. Urogenital Tract
Atropine relaxes smooth muscles of urinary
bladder and prolongs the period urination
and can provoke development of urine
retention.
Eye
Atropine by blocking the circular muscles of
pupil, causes mydriasis(dilation of pupil).

14.  Antidote for cholinesterase
poisoning:
Atropine blocks the cholinomimetic effects
of these pesticides.

15. PHARMACOKINETICS:-
 Absorption: I.V. administration is the most
common route for bradyarrhythmia
treatment. With endotracheal
administration, atropine is well absorbed
from the bronchial tree; drug has been
used in 1-mg doses in acute
bradyarrhythmia when an I.V. line hasn’t
been established.
 Distribution: Well distributed throughout
the body, including the CNS. Only 18% of
drug binds with plasma protein (clinically
insignificant).

16.  Metabolism: Metabolized in the liver to
several metabolites. About 30% to 50% of a
dose is excreted by the kidneys as
unchanged drug.
 Excretion: Excreted primarily through the
kidneys; however, small amounts may be
excreted in the feces and expired air.

17. INDICATIONS:
 Symptomatic bradycardia
 Preoperatively for diminishing secretions
and blocking cardiac vagal reflexes.
 insecticide poisoning.
 Bronchospasm
 Acute iritis, uveitis.
 Cycloplegic refraction.

18. CONTRAINDICATIONS
 Hypersensitivity
 Glucoma
 Pyloric stenosis
 Thyrotoxicosis
 Fever
 Urinary tract obstruction

19. PRECAUTIONS
 Take this drug with food
 Avoid alcohol
 Keep the drug out of reach of children
 Store drug at 59° to 86° F (15° to 30° C)
and protect from heat, light, and air.
 Take some rest when taking this drug as
it may cause blurry vision, fainting and
disorientation.

20. SIDE- EFFECTS/ADVERSE
EFFECTS
 CNS: headache, restlessness,
disorientation, hallucinations, insomnia,
dizziness, excitement, confusion,
especially in geriatric patients
 CV: palpitations and bradycardia
following low-dose atropine, tachycardia
after higher doses

21. SIDE- EFFECTS/ADVERSE
EFFECTS
 EENT: photophobia, increased
intraocular pressure, blurred vision,
mydriasis, cycloplegia (paralysis of
ciliary muscles)
 GI: dry mouth, thirst, constipation,
nausea, vomiting
 GU: urine retention, impotence

22. SIDE- EFFECTS/ADVERSE
EFFECTS
 Hematologic: leukocytosis
 Skin: dryness
 Other: severe allergic reactions,
including anaphylaxis and urticaria

23. NURSING
RESPONSIBILITIES
 Start with a test dose.
 Monitor vital signs of the patient every 2
hourly
 Monitor patient’s fluid intake and output
as the drug causes urine retention. If
possible, patient should void before
taking drug.
 Watch closely for urine retention in
elderly men with BPH.

24. NURSING
RESPONSIBILITIES
 Assess the patient for adverse effects
after administration.
 Report side effects immediately to the
consultant if any.
 Give the drug with food.
 Monitor temperature in infants and
children for "atropine fever".

25. PATIENT EDUCATION
RELATED TO DRUG
 Avoid Alcohol consumption
 Take this drug with food
 Report serious adverse reactions
promptly.
 Avoid hazardous activities until blurry
vision subsides

26. PATIENT EDUCATION
RELATED TO DRUG
 Ease photophobia by wearing dark
glasses.
 If you think there has been an overdose,
call your poison control center or get
medical care right away.
 Avoid OTC drugs
 Take your medicine on time and as
advised by the doctor.

27. REFERENCES:
 http://www.PDR.net
 http://www.Rxlist.com
 http://www.drugs.com
 http://www.paediatriconcall.com
 http://www.glowm.com