Drug encyclopedia

Atropine is connatural alkaloid “atropa belladonna”.

Atropine is absorbed in a gastrointestinal tract and bred with urine. Atropine is exposed to a metabolism in a liver and has time of half-decay 2-3 hours. Ampulas with atropine should be stored in the dark and not be refrigerated.

Application:
At utilisation for a premedication atropine reduces secretion bronchial and sialadens, quenches the bradycardia bound to some drugs, used in an anaesthesia, for example, Halothanum.

Apply atropine at a stomach and duodenum peptic ulcer, a pylorospasm, a cholecystitis, a cloelithiasis, at enterospasms and urinary pathes, a bronchial asthma, to reduction of secretion of salivary, stomachal and bronchial Ferri lactases, at the bradycardia which have educed as a result of rising of a tonus of a vagus nerve.

At the pains bound to spastic strictures of smooth muscles, atropine often introduce together with anaesthetics (analginum, Promedolum, Morphinum, etc.).

In anesthesiology practice atropine apply before a narcosis and operation and during operation to the prevention bronhiolo – and a laryngospasm, restriction of secretion of salivary and bronchial Ferri lactases and reduction of other reflex reactions and the by-effects bound to excitation of a vagus nerve. Apply also atropine to a X-ray inspection of an intestinal tract if necessary to reduce a tonus and a stomach and intestine motor performance.

In connection with ability to reduce secretion of sweat glands atropine use sometimes at the raised sweating. Atropine is an effective antidote at venenatings with cholinomimetic materials, including a FOS.

In ophthalmic practice atropine apply to a mydriasis with the diagnostic purpose (at eyeground research, definition of a true refraction, etc.), and also for the therapeutic purposes at acute inflammatory diseases (an iritis, an iridocyclitis, a keratitis, etc.) and eye traumas; the release phenomenon of muscles of an eye invoked by atropine promotes its functional dormancy and accelerates liquidation of pathological process.

It is expedient to apply atropine to the medical purposes as the reacting mydriatic agent is long; for the diagnostic purposes it is more expedient to use is less long reacting materials. Atropine invokes the maximum mydriasis through 30-40 mines, the effect is conserved till 7-10 days. The accomodation paralysis comes in 1-3 h and lasts till 8-12 days.

At the same time Homatropinum invokes the maximum mydriasis through 40-60 mines; the mydriatic effect and an accomodation paralysis are conserved 1-2 days. The mydriatic effect and an accomodation paresis at Platyphyllinum application are conserved 5-6 h.

In connection with influence by rendered atropine on cholinergic systems of a brain, it was offered to use it in psychiatric practice for treatment of psychoses (affective, paranoiac, catatonic and other states). So-called atropino-coma therapy provides application of the big doses of atropine.

The atropinic coma is accompanied by sharply expressed neurologic and somatic distresses that demands exclusively big guard at this method of treatment. In connection with presence of a question on degree of efficacyy of atropino-coma therapy and side effects the method has the extremely circumscribed application.

Dosings:
For a premedication at adults it is used about 500-600 mkg of atropine intramusculary 30-60 minutes prior to operation or it is introduced intravenously before the anaesthesia beginning. The dosing at children compounds 20 mkg/kg.

Main effects:
Routinely there is a rhythm increase, and sometimes a tachycardia, and also oppression of secretion of sialadens (result ins dryness in a mouth), a release phenomenon of a smooth musculation of an intestine, an urinary tract and gall ducts. As atropine passes through a blood-brain barrier the elderly can have an amnesia, block or excitation. There is a mydriasis and a paralysis of accomodation with ophthalmotonus rising that is dangerous to patients with a glaucoma. At small intravenous doses there are episodes of a bradycardia because of the central effect that is stopped by dose augmentation.

Side effects:
As atropine is a parasympathetic anticholinergic drug signs of parasympathetic blockage, such as dryness in a mouth, sight disturbance, rising of an ophthalmotonus and an ischuria can educe.