Atropine Edrophonium Brand Name– Enlon Plus
What is Atropine Edrophonium
Atropine edrophonium are used together in a parenteral preparation to reverse the effects of nondepolarizing neuromuscular blocking agents (e.g., curare type).
Atropine edrophonium is not effective in reversing depolarizing neuromuscular blocking agents (e.g., succinylcholine). Edrophonium is a cholinesterase inhibitor that competitively inhibits the hydrolysis of acetylcholine resulting in acetylcholine accumulation.
The increase in acetylcholine improves the transmission of impulses across the myoneural junction.
Acetylcholine accumulation also occurs at parasympathetic postganglionic receptors of the autonomic nervous system and can lead to parasympathetic adverse reactions.
Atropine is an antimuscarinic agent that decreases the adverse reactions associated with edrophonium.
When an edrophonium dose of 0.5—1 mg/kg is administered intravenously, the effects of the nondepolarizing neuromuscular blocking agents are antagonized quickly, with maximum antagonism reached within 1.2 minutes.
Antagonism is sustained for approximately 70 minutes. Atropine; edrophonium was approved for use by the FDA in November 1991.
Indications
- neuromuscular blockade reversal
For use in nondepolarizing neuromuscular blockade reversal or antagonism, or as an adjunctive treatment of respiratory depression due to curare overdosage
Side Effects
- abdominal pain
- arrhythmia exacerbation
- asthenia
- AV block
- blurred vision
- bradycardia
- bronchial secretions
- conjunctival hyperemia
- diaphoresis
- diarrhea
- diplopia
- dysarthria
- dysphagia
- dysphonia
- fever
- flushing
- increased urinary frequency
- lacrimation
- laryngospasm
- miosis
- mydriasis
- nasal dryness
- nausea
- photophobia
- premature ventricular contractions (PVCs)
- respiratory arrest
- restlessness
- scarlatiniform exanthema
- seizures
- sinus tachycardia
- urinary retention
- vomiting
- weakness
- xerosis
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- acute myocardial infarction
- angina
- asthma
- AV block
- bladder obstruction
- bradycardia
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- children
- chronic lung disease (CLD)
- coronary artery disease
- geriatric
- GI obstruction
- glaucoma
- heart failure
- hypotension
- infants
- myasthenia gravis
- myocardial infarction
- neonates
- posterior synechiae
- pregnancy
- prostatic hypertrophy
- pyloric stenosis
- sulfite hypersensitivity
- synechia
- toxic megacolon
- 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
- Amifampridine
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amoxapine
- Antacids
- Articaine; Epinephrine
- 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; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Belladonna; Opium
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benztropine
- Botulinum Toxins
- Brompheniramine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Bupivacaine
- Bupivacaine Liposomal
- Bupivacaine; Lidocaine
- 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
- Chloroprocaine
- 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
- Clomipramine
- Clozapine
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colesevelam
- COMT inhibitors
- Crofelemer
- Cyclizine
- Cyclobenzaprine
- Cyproheptadine
- Desipramine
- Desloratadine; Pseudoephedrine
- Dexchlorpheniramine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Dicyclomine
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Disopyramide
- Donepezil
- Donepezil; Memantine
- Doxepin
- Doxylamine
- Doxylamine; Pyridoxine
- Dronabinol
- Edrophonium
- Eluxadoline
- Ephedrine
- Erythromycin
- Erythromycin; Sulfisoxazole
- Esketamine
- Etomidate
- Ezogabine
- Fentanyl
- Fexofenadine; Pseudoephedrine
- Fluoxetine; Olanzapine
- Fluphenazine
- Fluticasone; Umeclidinium; Vilanterol
- food
- Fospropofol
- Gabapentin
- Galantamine
- Glucagon
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Glycopyrronium
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Halogenated Anesthetics
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hydroxyzine
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Imipramine
- Indacaterol; Glycopyrrolate
- Ipratropium
- Itraconazole
- Ketamine
- Lasmiditan
- Lemborexant
- Levobupivacaine
- Levocetirizine
- Levodopa
- Levorphanol
- Lidocaine
- Lidocaine; Prilocaine
- Linaclotide
- Lofexidine
- Loperamide
- Loperamide; Simethicone
- Loratadine; Pseudoephedrine
- Loxapine
- Lubiprostone
- Lumateperone
- Lurasidone
- Macimorelin
- Magnesium Hydroxide
- Maprotiline
- Meclizine
- Memantine
- Meperidine
- Meperidine; Promethazine
- Mepivacaine
- Mepivacaine; Levonordefrin
- Methacholine
- Methadone
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methocarbamol
- Methscopolamine
- Metoclopramide
- Mirtazapine
- Molindone
- Morphine
- Morphine; Naltrexone
- Nabilone
- Nalbuphine
- Naproxen; Pseudoephedrine
- Neostigmine
- Nitrofurantoin
- Nonsteroidal antiinflammatory drugs
- Norepinephrine
- Nortriptyline
- Olanzapine
- Omeprazole; Sodium Bicarbonate
- Orphenadrine
- Oxybutynin
- Oxycodone
- Oxymorphone
- Paroxetine
- Pentazocine
- Pentazocine; Naloxone
- Perphenazine
- Perphenazine; Amitriptyline
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Physostigmine
- Potassium
- Pramlintide
- Pregabalin
- Prilocaine
- Prilocaine; Epinephrine
- Procainamide
- Procaine
- Prochlorperazine
- Promethazine
- Propantheline
- Propofol
- Proton pump inhibitors
- Protriptyline
- Pseudoephedrine
- Pyridostigmine
- Quetiapine
- Quinidine
- Quinine
- Rasagiline
- Remifentanil
- Revefenacin
- Ritodrine
- Rivastigmine
- Ropivacaine
- Scopolamine
- Secretin
- Sedating H1-blockers
- Sincalide
- Sodium Bicarbonate
- Solifenacin
- Sufentanil
- Tacrine
- Tapentadol
- Tegaserod
- Tetracaine
- Thiazide diuretics
- Thioridazine
- Thiothixene
- Tiotropium
- Tiotropium; Olodaterol
- Tolterodine
- Topiramate
- Tramadol
- Tricyclic antidepressants
- Trifluoperazine
- Trihexyphenidyl
- Trimethobenzamide
- Trimipramine
- Triprolidine
- Trospium
- Umeclidinium
- Umeclidinium; Vilanterol
- Zonisamide