Atropine

General characteristics. Structure:

Active ingredient: 1 mg of atropine (in the form of sulfate) in 1 ml of solution.

Pharmacological properties:

Pharmacodynamics. The m-holinoretseptorov blocker, is natural tertiary amine. Believe that atropine to the same extent communicates with m1-, sq.m - and m3 subtypes of muskarinovy receptors. Influences both on central, and peripheral m-holinoretseptory.

Reduces secretion salivary, gastric, bronchial, sweat glands. Reduces a tone of unstriated muscles of internals (including bronchial tubes, bodies of the alimentary system, an urethra, bladder), reduces motility of a GIT. Practically also the pancreas does not influence biliary secretion. Causes a mydriasis, accommodation paralysis, reduces secretion of the lacrimal liquid.

In average therapeutic doses atropine exerts the moderate stimulating impact on TsNS and delayed, but long sedation. Ability of atropine to eliminate a tremor at Parkinson's disease is explained by the central anticholinergic action. In toxic doses atropine causes excitement, agitation, hallucinations, coma.

Atropine reduces a tone of a vagus nerve that leads to increase in ChSS (at minor change of the ABP), to increase in conductivity in a ventriculonector.

In therapeutic doses atropine has no significant effect on peripheral vessels, but at overdose the vazodilatation is observed.

Pharmacokinetics. It is well absorbed from a GIT or through a conjunctival membrane. After system introduction it is widely distributed in an organism. Gets through GEB. Considerable concentration in TsNS is reached during 0.5-1 h. Linkng with proteins of plasma moderate.

T1/2 makes 2 h. It is removed with urine; about 60% - in not changed look, the rest - in the form of hydrolysates and conjugation.

Indications to use:

Spasm of smooth muscle bodies of a GIT, bilious channels, bronchial tubes; a peptic ulcer of a stomach and duodenum, acute pancreatitis, hypersalivation (parkinsonism, poisoning with salts of heavy metals, at dental interventions), an irritable colon, intestinal colic, renal colic, bronchitis with hypersecretion, a bronchospasm, a laryngospasm (prevention); premedication before surgeries; AV blockade, bradycardia; poisonings of m cholinomimetics and antikholinesterazny substances (reversible and irreversible action); X-ray inspection of a GIT (in need of reduction of a tone of a stomach and intestines).

Route of administration and doses:

Inside - on 300 mkg each 4-6 h.

For elimination of bradycardia in/in adult - 0.5-1 mg, if necessary in 5 min. it is possible to repeat introduction; to children - 10 mkg/kg.

For the purpose of premedication in oil adult - 400-600 mkg in 45-60 min. prior to anesthesia; to children - 10 mkg/kg in 45-60 min. prior to anesthesia.

Features of use:

At AV to blockade of distal type (with the wide QRS complexes) atropine is ineffective and is not recommended.

At instillation in a conjunctival sac it is necessary to press the lower lacrimal opening in order to avoid hit of solution in a nasopharynx. At subconjunctival or parabulbar introduction for reduction of tachycardia it is reasonable to appoint validol.

Intensively pigmented iris is steadier against dilatation and for achievement of effect happens it is necessary to increase concentration or frequency of introductions therefore it is necessary to be afraid of overdose of midriatik.

The mydriasis can provoke a bad attack of glaucoma at persons 60 years and the people with a hypermetropia predisposed to glaucoma because they have a superficial anterior chamber are more senior.

It is necessary to warn patients that driving of the car during at least 2 h after the ophthalmologic research is forbidden.

Side effects:

Dryness in a mouth, tachycardia, a lock, difficulty of an urination, a mydriasis, photophobia, accommodation paralysis, dizziness, disturbance of tactile perception.

Contraindications:

Hypersensitivity to atropine.

Storage conditions:

In the place protected from light at a temperature not above 25 °C. To store in the place, unavailable to children. A period of validity - 5 years.

Issue conditions:

According to the recipe

Packaging:

Solution for injections of 1 mg/ml in ampoules on 1 ml. On 5 ampoules in a blister strip packaging. On 1 or 2 blister strip packagings with the application instruction of drug in a pack from a cardboard.