INTRODUCTION

ATROPINE SULPHATE contains Atropine which belongs to the group of medicines called Anti-cholinergic drugs. It is used to restore normal heartbeat during an event of cardiac arrest (heart stops working suddenly). It is often used as a preanesthetic medication to prevent the risk of sudden decrease in heartbeat and to reduce saliva secretions during surgical procedures. It can also be used in the treatment of poisoning caused due to certain substances like insecticides or mushrooms. It is used in combination with other medicines to reverse the effects of certain muscle relaxants (like vecuronium, rocuronium) given during surgery. It can also reduce the overactivity of certain medicines (muscle relaxants) used in the treatment of severe muscle disorders like myasthenia gravis.

Atropine is an antimuscarinic agent. It works by blocking the effects of a neurotransmitter called acetylcholine, which is responsible for causing contraction of muscles, increase in body secretions, and decrease in heart rate. As a result, it leads to stimulation of muscles, increase in heart rate, and decrease in body secretions.

ATROPINE SULPHATE is not recommended for use in patients suffering from closed-angle glaucoma (increased eye pressure), an enlarged prostate, myasthenia gravis, or any obstruction of gut. If you are pregnant or breastfeeding, consult your doctor for advice before receiving ATROPINE SULPHATE. The most common side effects of ATROPINE SULPHATE are dry mouth, reduced sweating, blurred vision, constipation, increased heart rate and confusion. Consult your doctor if any of the symptom worsens.

USES OF ATROPINE SULPHATE

Used:

• to restore normal heartbeat during emergency conditions like cardiac arrest
• as a preanesthetic medication to reduce salivary secretions
• to reverse the effect of muscle relaxants given during surgery
• to reduce the overactivity of certain medicines used in the treatment of severe muscle disorders like myasthenia gravis
• as an antidote for insecticides and mushroom poisoning

HOW ATROPINE SULPHATE WORKS

ATROPINE SULPHATE is an antimuscarinic agent. It effectively restores cardiac activity and body function by blocking the effects of a neurotransmitter called acetylcholine in the body which is responsible for various physiological functions (such as contraction of skeletal or smooth muscles, increase in body secretions or bowel movements, and decrease in heart rate). As a result, ATROPINE SULPHATE stimulates skeletal muscles, increases heart rate and reduces body secretions (such saliva, sweat, bronchial and intestinal secretion) and bowel movements. This helps in restoring cardiac activity during fatal conditions like cardiac arrest or poisoning, reduces salivary secretion during surgical procedures and stimulates muscle movements by counteracting the effects of muscle relaxants.

DIRECTIONS FOR USE

ATROPINE SULPHATE will be given to you only by a doctor or a nurse either into the vein (intravenously), muscle (intramuscularly), under the skin (subcutaneously) or into the trachea (via endotracheal tube). Your doctor will decide the correct dose and duration for you depending upon your age, body weight, and disease condition.

SIDE EFFECTS OF ATROPINE SULPHATE

HOW TO MANAGE SIDE EFFECTS

Dryness of mouth:

Drink plenty of water and fruit juices. Consume soft foods with higher water and fiber content. Artificial saliva can also be used in case of extreme dryness of mouth. Consult your doctor if you experience dryness of mouth for prolonged period.

Constipation:

Eat plenty of fiber rich foods such as fresh fruits, vegetables, and cereals and drink plenty of water. Try to exercise more regularly. If you still feel constipated, consult your doctor for advice.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug-Drug interactions:

Before receiving ATROPINE SULPHATE, inform your doctor if you are taking any of the following medicines such as:

• medicines used to treat abnormal heartbeat (Ex. mexiletine, digoxin, disopyramide)
• antihistamines (used to reduce allergic reactions) Ex. diphenhydramine, chlorpheniramine
• medicines used to treat depression such as tricyclic antidepressants (Ex. amitriptyline, nortriptyline, doxepin)
• anticholinesterase (used to reduce the activity of acetylcholine) Ex. neostigmine or pyridostigmine)
• medicines used to treat mental illness (Ex. chlorpromazine, promethazine, haloperidol and droperidol)
• amantadine (used to treat Parkinsonism or viral infections)
• general anesthetics (used to induce loss of consciousness or sensation before surgery) Ex. propofol
• medicines used to treat nausea and vomiting (Ex. domperidone)
• ketoconazole (used to treat fungal infections)
• medicines that dissolve slowly in your mouth Ex. sublingual tablets, chewable tablets or throat lozenges)

Overdosage:

ATROPINE SULPHATE will be administered to you only by a doctor or a nurse in a hospital, and so it is unlikely to receive an overdose. However, consult your doctor or nurse if you experience any unpleasant symptoms such as dry mouth or burning sensation in mouth, difficulty in swallowing, nausea, vomiting, skin rash, dry or red skin, feeling sleepy, intolerance of light, high body temperature, high blood pressure, irregular heart rate, breathing difficulties, restlessness, hallucinations, severe confusion, excitement (delirium), or convulsions.

SYNOPSIS

MORE INFORMATION

• Keep ATROPINE SULPHATE out of the sight and reach of children.
• Store at room temperature

FAQs ABOUT ATROPINE SULPHATE

Can ATROPINE SULPHATE be used to treat emergency conditions?

Yes. [GBNKEYWORD can be used during emergency conditions like cardiac arrest to restore normal heartbeat. It can also be used treat poisoning caused due to insecticides or mushrooms.

What precautions do I need to follow while taking ATROPINE SULPHATE?

Patients receiving ATROPINE SULPHATE must inform their doctor about their pre-existing disease conditions such as high blood pressure, coronary artery disease, angina, chronic heart failure glaucoma, inflammation of the stomach and intestines or blockade in the gut. Drink plenty of water or fluid after receiving ATROPINE SULPHATE, as it may lead to increased dryness of mouth. Avoid concomitant use of other heart medicines with ATROPINE SULPHATE without consulting your as it may increase the risk of side effects.

Can ATROPINE SULPHATE be given via tracheal route?

Yes. ATROPINE SULPHATE can be given into the trachea (via an endotracheal tube) if necessary. It must be administrated only the doctor or nurse and cannot be self-administered. Your doctor will decide the correct dose and suitable route of administration for you depending upon the severity of your condition.

Can ATROPINE SULPHATE cause an increase in heart rate?

Yes. ATROPINE SULPHATE is known to increase heart rate and is used to restore your heart rate during emergency conditions like cardiac failure. ATROPINE SULPHATE should be used with caution in patients with high blood pressure, coronary artery disease, and angina. Consult your doctor before receiving.

Can ATROPINE SULPHATE cause high blood pressure?

Yes. ATROPINE SULPHATE restores normal heartbeat by increasing the blood pressure and so, it must be used with caution among patients having heart diseases like high blood pressure, chest pain or heart attack. Consult your doctor before receiving.

Can ATROPINE SULPHATE be used on infants?

ATROPINE SULPHATE is generally not recommended for use in very young children. Your doctor might suggest a low dose depending upon the child’s age and body weight. Therefore, consult your doctor for advice.

Can ATROPINE SULPHATE cause dry skin?

Yes. ATROPINE SULPHATE can cause dry skin in some individuals. It is caused due to decreased secretion of sweat (anhidrosis). Patients who received ATROPINE SULPHATE are advised to keep their skin hydrated always. Apply moisturizer generously to affected dry areas of the skin. Drink plenty of water to keep yourself hydrated. Consult your doctor for advice if you experience excessive skin dryness.

Does ATROPINE SULPHATE make your mouth dry?

Yes. ATROPINE SULPHATE can cause dry mouth in some individuals. Drink plenty of water and fruit juices. Consume soft foods with higher water and fiber content. Artificial saliva can also be used in case of extreme dryness of mouth. Consult your doctor if you experience dryness of mouth for prolonged period.

REFERENCES

1. KD. Tripathi. Anticholinergic Drugs and Drugs Acting on Autonomic Ganglia. Essentials of medical pharmacology. Seventh edition. 2013. Page – 113-121.

2. Mohammed Joynal Abedin, Abdullah Abu Sayeed, Ariful Basher, Richard J Maude, Gofranul Hoque and M. A. Faiz. Open-Label Randomized Clinical Trial of Atropine Bolus Injection Versus Incremental Boluses Plus Infusion for Organophosphate Poisoning in Bangladesh. SpringerLink. February 2012. [Accessed on 22nd April 2022] https://link.springer.com/article/10.1007/s13181-012-0214-6

3. Panagiotis V S Vasileiou, Evangelia Kouskouni and Theodoros Xanthos. Atropine in cardiac arrest. ResearchGate. October 2012. [Accessed on 22nd April 2022] https://www.researchgate.net/publication/281739601_Atropine_in_cardiac_arrest

4. Mercury Pharmaceuticals. Health Products Regulatory Authority. [Revised in March 2021] [Accessed on 22nd April 2022] https://www.hpra.ie/img/uploaded/swedocuments/ef800ad6-da9e-4437-93f0-8a80329b96a5.pdf

5. Macarthys Laboratories Ltd, T/A Martindale Pharma. Electronic Medicines Compendium (EMC). [Revised in September 2018] [Accessed on 22nd April 2022] https://www.medicines.org.uk/emc/files/pil.3587.pdf

6. Macarthys Laboratories Ltd, T/A Martindale Pharma. Electronic Medicines Compendium (EMC). [Revised in September 2018] [Accessed on 22nd April 2022] https://www.medicines.org.uk/emc/files/pil.3695.pdf

7. Hospira, Inc. U.S. Food & Drug Administration. [Revised in October 2015] Accessed on 22nd April 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/021146s015lbl.pdf

USEFUL DIAGNOSTIC TESTS

• Electrolyte profile test