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Atropine Brand Names
Atreza | Atropine Care | Atropisol | Isopto Atropine | Ocu-Tropine | Sal-Tropine
What is Atropine
Atropine is a naturally occurring tertiary amine extracted from belladonna alkaloid that consists of a racemic mixture of both d- and l-hyoscyamine, which differ in their antimuscarinic potencies.
Atropine is the prototype antimuscarinic from which other antimuscarinic agents were developed. Atropine counteracts cholinergic-mediated reductions in heart rate, vascular resistance, and blood pressure.
It has many applications in clinical medicine but most commonly is used systemically to treat symptomatic bradycardia and as a preoperative agent to reduce secretions prior to surgery.
Atropine is recommended as a first-line therapy for acute symptomatic bradycardia, including atrioventricular block; it is more likely to be useful for atrioventricular block at the atrioventricular nodal level and bradycardia attributable to excess vagal tone.
Atropine is also used to produce mydriasis during ophthalmic examination.
It decreases the muscarinic cholinergic adverse reactions associated with organophosphate toxicity (e.g., lacrimation, sweating, breathing problems, bradycardia) and is well known as a useful adjunct in nerve agent and insecticide poisoning.
Indications
- amblyopia
- aspiration prophylaxis
- beta-blocker toxicity
- bradycardia
- calcium-channel blocker toxicity
- cardiac arrest
- cholinesterase inhibitor-induced muscarinic effects prophylaxis
- cycloplegia induction
- irinotecan-induced diarrhea
- iritis
- irritable bowel syndrome
- mydriasis induction
- organophosphate insecticide toxicity
- rapid-sequence intubation
- uveitis
- Patients with known coronary artery disease dosing: limit the total dose of parenteral atropine to 0.03 to 0.04 mg/kg.
Side Effects
- abdominal pain
- agitation
- amnesia
- anaphylactic shock
- angina
- anxiety
- asystole
- ataxia
- atopic dermatitis
- atrial fibrillation
- blepharitis
- blurred vision
- bradycardia
- coma
- confusion
- constipation
- cycloplegia
- dehydration
- delirium
- dizziness
- drowsiness
- dysarthria
- dysphagia
- fever
- flushing
- hallucinations
- headache
- hyperreflexia
- hypersalivation
- hypertension
- hypertonia
- hypotension
- ileus
- injection site reaction
- insomnia
- laryngitis
- laryngospasm
- leukocytosis
- maculopapular rash
- mania
- mydriasis
- nasal dryness
- nausea
- oral ulceration
- palpitations
- paranoia
- petechiae
- photophobia
- premature ventricular contractions (PVCs)
- pulmonary edema
- QT prolongation
- respiratory arrest
- respiratory depression
- restlessness
- seizures
- sinus tachycardia
- ST-T wave changes
- Stevens-Johnson syndrome
- supraventricular tachycardia (SVT)
- syncope
- tachypnea
- urinary incontinence
- urinary retention
- urinary urgency
- urticaria
- ventricular fibrillation
- vertigo
- vomiting
- weakness
- xerophthalmia
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- achalasia
- acute myocardial infarction
- ambient temperature increase
- angina
- anticholinergic medications
- asthma
- autonomic neuropathy
- bladder obstruction
- bleeding
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- children
- chronic lung disease (CLD)
- chronic obstructive pulmonary disease (COPD)
- closed-angle glaucoma
- colostomy
- contact lenses
- coronary artery disease
- dehydration
- dental disease
- diarrhea
- driving or operating machinery
- esophagitis
- fever
- gastroesophageal reflux disease (GERD)
- geriatric
- GI disease
- GI obstruction
- glaucoma
- heart failure
- heart transplant
- hepatic disease
- hiatal hernia
- hypertension
- hyperthyroidism
- ileostomy
- ileus
- increased intraocular pressure
- infants
- mitral stenosis
- myasthenia gravis
- myocardial infarction
- neonates
- peptic ulcer disease
- pregnancy
- prostatic hypertrophy
- pseudomembranous colitis
- pyloric stenosis
- renal failure
- renal impairment
- respiratory infection
- strenuous exercise
- synechia
- tachycardia
- thyrotoxicosis
- toxic megacolon
- ulcerative colitis
- urinary retention
- urinary tract obstruction
Interactions
- Abatacept
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Diphenhydramine
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Aclidinium
- Aclidinium; Formoterol
- Acrivastine; Pseudoephedrine
- Albuterol; Ipratropium
- Alfentanil
- Alosetron
- Aluminum Hydroxide
- Aluminum Hydroxide; Magnesium Carbonate
- Aluminum Hydroxide; Magnesium Hydroxide
- Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
- Aluminum Hydroxide; Magnesium Trisilicate
- Amantadine
- Ambenonium Chloride
- Amoxapine
- Antacids
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Oxycodone
- Atomoxetine
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Belladonna; Opium
- Benzhydrocodone; Acetaminophen
- Botulinum Toxins
- Brompheniramine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Butorphanol
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Cannabidiol
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbetapentane; Pyrilamine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Cenobamate
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexbrompheniramine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chlorcyclizine
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Cholinergic agonists
- Cisapride
- Clemastine
- Clozapine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colesevelam
- Crofelemer
- Cyclizine
- Cyclobenzaprine
- Cyproheptadine
- Desloratadine; Pseudoephedrine
- Dexchlorpheniramine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Disopyramide
- Donepezil
- Donepezil; Memantine
- Doxylamine
- Doxylamine; Pyridoxine
- Dronabinol
- Edrophonium
- Eluxadoline
- Ephedrine
- Erythromycin
- Erythromycin; Sulfisoxazole
- Esketamine
- Ezogabine
- Fentanyl
- Fexofenadine; Pseudoephedrine
- Fluoxetine; Olanzapine
- Fluphenazine
- Fluticasone; Umeclidinium; Vilanterol
- food
- Gabapentin
- Galantamine
- Glucagon
- Glycopyrronium
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hydroxyzine
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Ipratropium
- Itraconazole
- Lasmiditan
- Levocetirizine
- Levodopa
- Levorphanol
- Linaclotide
- Lofexidine
- Loperamide
- Loperamide; Simethicone
- Loratadine; Pseudoephedrine
- Loxapine
- Lubiprostone
- Lumateperone
- Lurasidone
- Macimorelin
- Magnesium Hydroxide
- Maprotiline
- Meclizine
- Memantine
- Meperidine
- Meperidine; Promethazine
- Methacholine
- Methadone
- Metoclopramide
- Mirtazapine
- Molindone
- Morphine
- Morphine; Naltrexone
- Nabilone
- Nalbuphine
- Naproxen; Pseudoephedrine
- Neostigmine
- Nitrofurantoin
- Norepinephrine
- Olanzapine
- Omeprazole; Sodium Bicarbonate
- Orphenadrine
- Oxycodone
- Oxymorphone
- Paroxetine
- Pentazocine
- Pentazocine; Naloxone
- Perphenazine
- Perphenazine; Amitriptyline
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Physostigmine
- Potassium
- Pramlintide
- Pregabalin
- Procainamide
- Prochlorperazine
- Promethazine
- Proton pump inhibitors
- Pseudoephedrine
- Pyridostigmine
- Quetiapine
- Quinidine
- Rasagiline
- Remifentanil
- Revefenacin
- Ritodrine
- Rivastigmine
- Secretin
- Sedating H1-blockers
- Sincalide
- Sodium Bicarbonate
- Solifenacin
- Sufentanil
- Tacrine
- Tapentadol
- Tegaserod
- Thiazide diuretics
- Thioridazine
- Thiothixene
- Tiotropium
- Tiotropium; Olodaterol
- Tolterodine
- Topiramate
- Tramadol
- Tricyclic antidepressants
- Trifluoperazine
- Trimethobenzamide
- Triprolidine
- Trospium
- Umeclidinium
- Umeclidinium; Vilanterol
- Zonisamide
