Atropine

Pregnancy Pregnancy: The use of Atropine during breastfeeding is contraindicated. Breastfeeding Breastfeeding: No problems have been described in humans regarding the administration of atropine during breastfeeding.‍‍‍‍‍‍​​​‍​​​​​​ However, the risk-benefit ratio should be considered since traces of atropine are found in breast milk and children are particularly sensitive to these drugs. Antimuscarinics inhibit lactation. Driving Driving: Application of this eye drop may cause blurred vision (visual disturbance). In such cases, driving vehicles or operating machinery is not advisable. Injectable route: Talk to your doctor, pharmacist, or nurse before use. Atropine should be administered with caution to children and elderly patients as they are more susceptible to its adverse effects. The same caution should be exercised in cases of pseudomembranous colitis, diarrhea, hyperthyroidism, gastrointestinal infection (e.g., dysentery), hepatic or renal disease, and hypertension. Systemic administration of antimuscarinic agents to debilitated patients with chronic pulmonary disease may lead to the formation of bronchial plugs due to decreased bronchial secretions. In the treatment of Parkinsonism, increasing the dose of atropine to be administered as well as switching to other types of treatment should be gradual (antimuscarinic therapy should not be discontinued abruptly). Individuals with Down syndrome apparently exhibit increased susceptibility to the actions of atropine. Conversely, albino individuals show some resistance to this drug. Administration of small doses may cause paroxysmal bradycardia. Since antimuscarinics may delay gastric emptying, they may lead to stasis in patients with gastric ulcer. Precautionary measures are also necessary in patients with esophageal reflux problems or who present hiatal hernia associated with reflux esophagitis, as antimuscarinics decrease gastric motility and lower esophageal sphincter pressure. Prolonged use of antimuscarinics may decrease or inhibit salivary secretion, contributing to the development of dental caries, periodontal disease, oral candidiasis, and discomfort. Regarding laboratory test results, antimuscarinics interfere with the gastric acid secretion test. Administration of antimuscarinics is not recommended during the 24 hours prior to the test, as these drugs antagonize the effect of pentagastrin and histamine in the evaluation of gastric acid secretory function. Antimuscarinics, and atropine in particular, interfere with the phenolsulfonphthalein (PSP) excretion test. Atropine uses the same tubular secretion mechanism as phenolsulfonphthalein (PSP), producing a decrease in urinary PSP excretion. In patients undergoing this test, simultaneous administration of atropine is not recommended. Since antimuscarinics may increase intraocular pressure, it is advisable in some patients, depending on their condition, to monitor this parameter. Inform your doctor, pharmacist, or nurse if you are taking, have recently taken, or might take other medicines. a) With drugs having anticholinergic properties Patients receiving antimuscarinic agents concomitantly with amantadine, certain antihistamines, antiparkinsonian agents, butyrophenones or phenothiazines, tricyclic antidepressants, or antiarrhythmic agents with anticholinergic properties (e.g., procainamide) are at increased risk of developing adverse anticholinergic effects. b) Effects on gastrointestinal drug absorption The reduction in gastric motility caused by antimuscarinic agents may affect the absorption of some drugs. For example, simultaneous administration of an antimuscarinic and levodopa may decrease the absorption of the latter in the intestine as it increases its metabolism in the stomach. If the antimuscarinic is discontinued without a simultaneous reduction of the levodopa dose, toxic effects may occur as a result of increased levodopa absorption. Patients receiving concomitant therapy with an antimuscarinic and digoxin should be monitored as they may develop digitalis toxicity. Since antimuscarinic agents may decrease hydrochloric acid production in the stomach and/or increase gastric pH, they may decrease the gastrointestinal absorption of ketoconazole. If concomitant therapy is necessary, the antimuscarinic agent should be administered at least two hours after ketoconazole administration. Potentially, antimuscarinic agents may delay the onset of therapeutic effect (e.g., analgesia, antipyretic action) of acetaminophen. c) With glucocorticoids, corticotropin (ACTH), or haloperidol Long-term concomitant therapy with antimuscarinics may result in increased intraocular pressure. Furthermore, the antipsychotic efficacy of haloperidol may be decreased in schizophrenic patients. d) With urinary alkalinizers (antacids containing calcium and/or magnesium, carbonic anhydrase inhibitors, citrates, and sodium bicarbonate) Urinary excretion of antimuscarinics may be delayed due to urine alkalinization, resulting in potentiation of the therapeutic and/or adverse effects of these drugs. e) With antacids or adsorbent antidiarrheals Simultaneous administration may decrease absorption of antimuscarinics, resulting in decreased therapeutic efficacy. Therefore, these drugs should be administered at least one hour apart. f) With cyclopropane Simultaneous intravenous administration of antimuscarinics with the anesthetic cyclopropane may trigger ventricular arrhythmias. g) With guanadrel, guanethidine, or reserpine Simultaneous administration may antagonize the inhibitory action of antimuscarinics on gastric hydrochloric acid secretion. h) With monoamine oxidase (MAO) inhibitors, including furazolidone, procarbazine, and pargyline Simultaneous administration may intensify adverse muscarinic effects due to the secondary antimuscarinic activity of these drugs. Furthermore, MAO inhibitors may block the detoxification of antimuscarinics, thus potentiating their action. i) With opioid analgesics Simultaneous administration with antimuscarinics may increase the risk of severe constipation, which may give rise to paralytic ileus and/or urinary retention. j) With potassium chloride, especially wax-matrix preparations Simultaneous administration with antimuscarinics may increase the severity of gastrointestinal lesions induced by potassium chloride. Atropine sulfate is compatible with butorphanol tartrate and buprenorphine hydrochloride. It is incompatible with bromides, iodides, bases (e.g., sodium bicarbonate, alkaline barbiturates), norepinephrine bitartrate, and metaraminol bitartrate. Atropine sulfate may be administered concomitantly with thiamylal sodium provided the mixture is prepared immediately before administration. Ophthalmic route: Talk to your doctor or pharmacist before using Atropine. Caution is recommended in: - Patients with benign prostatic hyperplasia (BPH) - Heart failure or coronary insufficiency - Ataxia - Cases of sensitivity to belladonna alkaloids - Paralytic ileus Atropine, as with all parasympatholytic drugs, increases intraocular pressure. It is advisable to determine intraocular pressure before use. Caution is recommended in children and elderly patients given the risk of systemic effects. Inform your doctor or pharmacist if you are using, have recently used, or might use other medicines. Atropine may be systemically absorbed, so it is important to inform your doctor of all medicines you are taking or intend to take during treatment. This medicine should not be used in combination with other medicines containing mydriatic agents in their composition. The effects of atropine and other antimuscarinics may be potentiated by the concomitant use of other medicines with antimuscarinic properties such as amantadine, certain antihistamines, phenothiazine antipsychotics, and tricyclic antidepressants. Monoamine oxidase inhibitors (MAOIs) may enhance the antimuscarinic effects of atropine when it is systemically absorbed.