Atropine Uses and Side Effects

Atropine Uses and Side makeAtropine is a competitive antagonist of acetylcholine which binds to the muscarinic sensory receptor in order to inhibit the parasympathetic neuronic system. It ca subroutines a reversible blockade of the action of acetylcholine and it basis be oercome by increase the concentration of acetylcholine at receptor sites of the effectors organ (e.g. by use the anticholinesterase agents which inhibit the destruction of acetylcholine). Atropine is an alkaloid or an extremely poisonous drug derived from a plant called atropia belladonna, also cognize as deadly nightshade. Belladonna is Italian word which means beautiful woman. In the Renaissance, woman use the juice of berries of atropia belladonna to dilate bookmans as it was perceived as more attractive.Eye Atropine acts in the center to block the action of acetylcholine, relaxing the cholinergically innervated sphincter muscles of the iris. This results in dilation of the pupil (mydriasis). The choliner gic stimulation of concerted ciliary muscle of the lens in the affection is also blocked. This results in paralysis of accommodation (cycloplegia). Besides, the superlative degree of intraocular pressure (IOP) occurs when the anterior chamber is narrow. It will further raise IOP in glaucoma patients because it will obstruct liquidation of aqueous humor by the Schlemm channel. Atropine is so contraindicated in these patients. A nonher effect of antimuscarinic drugs is to passinguce lacrimal discrimination which produces dryness in eye.Atropine has a slower bombardment and more prolonged effect in eye as maximum mydriatic effect occurs around 30 to 40 minutes and maximum cycloplegia takes several(prenominal) hours. Mydriasis usually lasts 7 to 12 days and cycloplegia may persist for 14 days or longer.cardiovascular system The vagus (parasympathetic) nerves that innervate the gist release acetylcholine (ACh) as their primary neurotransmitter to slow the nervus rate. ACh bind s to muscarinic receptors (M2) that argon found on cells comprising the sinoatrial (SA) and atrioventricular (AV) nodes.Atropine has a potent and prolonged effect on the eye muscle. It inhibits the effect of excessive vagal nerve activation on the amount like venous sinus bradycardia and AV nodal block (delay in the conduction of electrical impulses at the AV node of the heart) by binding to muscarinic receptors in order to prevent ACh from binding to and activating the receptor. Thus, atropine speeds up the heart rate and increases conduction velocity as it very effectively blocks the effects of parasympathetic nerve activity on the heart. There are minute effects on blood pressure since most resistance blood vessels do not cause cholinergic innervations. Small dosages of atropine used may decrease the heart rate, yet, large doses used definitely causes increasing of the heart rate.Central nervous system Atropine has minimal stimulant effects on the central nervous system, especially medullary centers, and a slower, longer-lasting sedative effect on the brain. Low doses atropine may produce flaccid restlessness and higher doses may produce agitation and hallucination. With still larger doses, stimulation is followed by mental picture leading to circulatory collapse and respiratory failure after a period of paralysis and coma.respiratory tract The parasympathetic nervous system regulate bronchomotor tone and secretionary glands of the airway. Since atropine is an antagonist muscarinic drug, it inhibits the secretion of nose, mouth, pharynx and bronchi, and thus dries the mucose membranes of the respiratory tract. And it also relaxes bronchial silent muscle, producing bronchodilation and change magnitude airway resistance. The effect is more classical in patients with airway disease like asthma.Gastrointestinal tract Motility and secretions of gastrointestinal tract are declined by atropine. GI smooth muscle motility is affected from the stomach to the colon by decreasing tone, amplitude and frequency of the peristaltic contractions. However, the gastric secretion is only slenderly reduced.Genitourinary tract The antimuscarinic action of atropine relaxes smooth muscle of the ureters and bladder wall in order to decrease the normal tone and amplitude of contractions of the ureters and bladder. Atropine has not signifi apprizet effect on the uterus.Sweat glands Small doses of atropine inhibit the activity of sweat glands, producing hot and dry on the skin. Sweating may be sufficiently corrupted and this will elevate the body temperature if utilise the larger doses in adult or at high environmental temperatures. For the infant or children who are administered large doses or even ordinary doses may cause atropine fever.Atropine is rapidly and well absorbed from the gastrointestinal tract, mucosal membrane, conjunctival membranes, and to some extent through intact skin when given by vocal route, solution, ointment or inje ction route (directly goes into muscle or vein). Pharmacological activity of paranteral administration is 2-3 time greater than enteral route.DistributionAtropine is rapidly cleared from the blood and is distributed throughout the body. It crosses the blood-brain barrier and placenta. Peak blood plasma concentrations of atropine are reached within 30 minutes. The duration of action of atropine administered by general route would be close to 4 -6 hours.MetabolismAfter administration, atropine disappears rapidly from the blood with a half-life of 2 hours. The half-life of atropine is slightly shorter in females than males. Then it is metabolized in the liver by oxidation and conjugation to give inactive metabolites. emptyingThe drugs effect on parasympathetic function declines rapidly in all organs except the eye. Effects on the iris and ciliary muscle persist for more than 3 days. About 50% of the dose is excreted within 4 hours and 90% in 24 hours in the urine, about 30 to 50% as unchanged drug.Therapeutic usesAs preanaesthetic medicationtsAtropine is used to block two effects in particular during anaesthesia, secretions in the respiratory tract in response to the irritating nature of some inhalant anaesthetics, and bradycardia (slowing of the heart) which accompanies most anaesthetics collectible to the block of muscarinic receptors in the heart. Overall, atropine can reduce the risk of airway obstruction and increase the heart release when anaesthetic drug is going to be used.Ophthalmological usesTopical atropine is used as a cycloplegic (temporarily paralyze the accommodation) and as a mydriatic (dilate the pupils) for accurate measurement of refractive error in patients. A second use is to prevent synechiae (adhesion) formation in uveitis and iritis. After local administration in the form of ophthalmic solution, the onset of atropine is around 30 minutes and it effects last very long dilation of pupil can persist several days.Cardiovascular disordersI njection of atropine is used in the handling of bradycardia (an extremely low heart rate) due to excessive vagal tone on the SA and AV node. It accelerates the cardiac rate by step-down of vagal tone and seizeion of reflex bradycardia during arterial hypertension. In addition, atropine is also used primary for sinus node dysfunction (inappropriate atrial rates) and symptomatic second-degree heart block (irregularities in the electrical conduction system of the heart).Respiratory disordersParenteral atropine can be used as a preoperative medication to suppress bronchiolar secretions when anaesthetics are used. It can be used to treat asthma, chronic bronchitis and chronic obstructive pulmonary disease.Gastrointestinal disordersAtropine is seldom used to treat pepti-ulcer nowadays. Atropine can provide some relief in the treatment of common travelers diarrhea (irritable bowel movement). It is often combined with an opioid antidiarrheal drug in order to reject abuse of the opioid ag ent.Urinary disordersAtropine is used to relieve bladder spasm after urologic surgery and for treating urinary want caused by minor inflammatory bladder disorder.HyperhidrosisIt is an excessive and profuse perspiration. Atropine can reduce the secretion of sweat glands by inhibiting the Ach binds to the muscarinic receptors.Cholinergic poisoningBy city block the action of ACh, atropine also can be used as an antidote for organophosphate poisoning caused by inhibition of cholinesterase and nerve gases. The atropine serves as an effective blocking agent for the excess ACh but does nothing to reverse the inhibition of cholinesterase. Troops, who are likely to be attacked with chemical weapons often carry autoinjectiors with atropine and obidoxime which can be quickly injected into the thigh. It is the only known antidote for VX nerve gas. both(prenominal) of the nerve gases attack and destroy acetycholinesterase (an enzyme hydrolyzes ACh to give choline), so the action of acetylcho line becomes prolonged. Therefore, atropine can be used to depress the effect of ACh.Parkinsons diseaseAtropine is used to treat the symptom of Parkinson such as drooling sweating rigidity and tremors. However, with the dewy-eyed array of uses and side effects that atropine has, it has been replaced by several other medicines that are more effectively in treating Parkinsons.Adverse effectAtropine and its possible side effect can affect individual people in various ways. The following are some of the side effects that are known to be associated with atropine. non all the patients using this antimuscarinic drug will experience the same effects. These effects are intensified as the dosages are increased.General chest pain, excessive thirst, weakness, dehydration, feeling hot, injection site reaction, fever.Eye dilation pupil, pupil poorly reactive to light, photophobia, blurred vision, decreased accommodation, decreased contrast sensitivity, decreased visual acuity, dry eyes or dry conjunctiva, acute angle closure glaucoma, irritated eyes, allergic conjunctivitis or blepharoconjunctivitis, heterophoria, red eye due to excess blood supply (hyperaemia).Psychiatric hallucination, mental confusion, agitation, restlessness, anxiety, excitement especially in elderly, fatigue.Central nervous system headache, nervousness, dizziness, drowsiness, muscle twitching, abnormal movement, coma, difficult concentrating, insomnia, amnesia, ataxia (loss of the ability to coordinate potent movement).Cardiovascular tachycardia (increasing in heartbeat), acute myocardial infarction, cardiac dilation, atrial arrhythmias, paradoxical Bradycardia (if low does Atropine used), asystole (absence of heart beat), increased blood pressure or decreased blood pressure.Respiratory slow respiration, breathing difficulty, pulmonary edema, respiratory failure.Gastrointestinal nausea, abdomen pain, vomiting, decreased bowel sounds, decreased food absorption, delayed gastric emptying, reduci ng of salivary secretions, loss of taste, bloated feeling.Genitourinary urinary retention, urine urgency, bed-wetting, difficult in micturation.Dermatologic dry mucous membrane, dry warm skin, flushed skin, oral lesion, anhidrosis (absence of sweating), dermatitis, rash, hyperthermia (elevated of body temperature)Overdose and Treatment widespread paralysis of parasympathetically innervated organs can characterize serious over dosage with atropine. Dry mucous membranes, astray dilated and nonresponsive pupils, tachycardia, fever, hallucination and flushed skin are mental and neurological symptoms which may last 48 hours or longer. Severe intoxication, respiratory depression, blood pressure declines, coma, circulatory collapse and death may occur with over dosage of atropine.