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Drug Details

Atropine SO4 600mcg injection

• Presentation
  Clear, colourless, sterile, aqueous solution intended for parenteral administration to human beings.
• Description
  Each 1ml of solution contains 600 micrograms of Atropine Sulphate B.P.
• Indications
  

  1) In anaesthesia, to reduce the risk of vagal inhibition of the heart and to reduce salivary and bronchial secretions.

  2) In the treatment of cholinergic crisis of myasthenia gravis.

  3) In conjunction with neostigmine used to reverse the effects of non-depolarising muscle relaxants.

  4) In the treatment of poisoning by certain cholinesterase inhibitors e.g. organo-phosphorous compounds.

  5) During cardiopulmonary resuscitation to counteract excessive vagal tone on the heart.

• Adult Dosage
  

  1) Use in Anaesthesia

  Adults (including the elderly): The usual dose is 0.3 to 0.6mg (300 micrograms to 600 micrograms)

  Childern:

  Premature Infants: 65 micrograms

  Full-term Infants: 100 micrograms

  6 months – 1 year: 200 micrograms

  Over one year: 10-20 micrograms/kg bodyweight

  2) Treatment of cholinergic crisis of myasthenia gravis

  Adults: The usual does is 0.4 to 2.0 mg intravenously, which may be increased according to patients response.

  3) In conjunction with neostigmine used to reverse the effects of non-depolarising muscle relaxants

  Adults: The usual dose is 0.6 to 1.2mg given by slow intravenous injection.

  Atropine should be administered before neostigmine.

  4) Treatment of poisoning by certain cholinesterase inhibitors

  Adults: From 1.2mg, increased according to patient's response.

  5) Use during Cardiopulmonary Resuscitation

  Adults: A dose of 0.2 to 0.5mg may be given intravenously and repeated if necessary. Persistent bradycardia should be controlled by the insertion of a pacemaker as soon as possible.

  Route of administration: By subcutaneous, intramuscular or intravenous injection.

• Contra Indications
  

  Use in patients hypersensitive to anticholinergic agents.

  Use in paralytic ileus or pyloric stenosis.

  Use in patients with closed-angle glaucoma or prostatic hypertrophy.

• Special Precautions
  

  Atropine should be used with caution in conditions characterised by tachycardia such as thyrotoxicosis, cardiac insufficiency or failure and in cardiac surgery.

  Atropine should be used only with extreme caution in toxic pyrexial children, or in high ambient temperatures, because of the danger of hyperpyrexia.

  When used to treat a cholinergic crisis in myasthenia gravis, all anti-cholinesterase medication should be withdrawn, if necessary for several days.

  Doses of atropine up to 1mg are mildly stimulant to the central nervous system. Higher doses may induce mental disturbances and depression of the central nervous system. Children and elderly people are particularly susceptible.

  Care is required when using atropine in the presence of acute myocardial ischaemia or infarction as the ischaemia or infarction may be worsened.

• Interactions
  

  The effects of the atropine may be enhanced by the concomitant administration of other drugs with anticholinergic properties e.g. some anti-histamines, phenothiazines, tricyclic anti-depressants, amantadine, butyrophenones.

  Atropine should be used cautiously during ether anaesthesia since the sympathomimetic effects of this agent are likely to be potentiated.

• Adverse Drug Reactions
  

  Side effects include dry mouth, dysphagia, dry skin, thirst, dilated pupils with loss of accommodation and photophobia, increased intraocular pressure, palpitation, arrhythmias, constipation and urinary retention.