Atropine Edrophonium

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

  1. abdominal pain
  2. arrhythmia exacerbation
  3. asthenia
  4. AV block
  5. blurred vision
  6. bradycardia
  7. bronchial secretions
  8. conjunctival hyperemia
  9. diaphoresis
  10. diarrhea
  11. diplopia
  12. dysarthria
  13. dysphagia
  14. dysphonia
  15. fever
  16. flushing
  17. increased urinary frequency
  18. lacrimation
  19. laryngospasm
  20. miosis
  21. mydriasis
  22. nasal dryness
  23. nausea
  24. photophobia
  25. premature ventricular contractions (PVCs)
  26. respiratory arrest
  27. restlessness
  28. scarlatiniform exanthema
  29. seizures
  30. sinus tachycardia
  31. urinary retention
  32. vomiting
  33. weakness
  34. xerosis
  35. 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
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  • Amoxapine
  • Antacids
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  • 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
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  • 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
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