Products
Atropine is commercially available in the form of eye drops, drops, and as a solution for injection. It has been approved in many countries since 1987. Medicinal plants containing atropine have been used medicinally for much longer.
Structure and properties
Atropine (C17H23NO3, Mr = 289.4 g/mol) is a tertiary amine and belongs to the tropane alkaloid group. It is a racemate consisting of D- and L-hyoscyamine. Atropine is a white to almost white crystalline powder or forms colorless crystals which are odorless. It is very slightly soluble in water. In contrast, atropine sulfate, which is found in most medicines, dissolves very easily in water.
Stem plant
Atropine is found in various plants of the nightshade family (Solanaceae), such as belladonna, datura, and henbane.
Effects
Atropine (ATC A03BA01, ATC S01FA01) is parasympatholytic (anticholinergic). It causes pupillary dilation, elimination of accommodative capacity, and weak vasoconstriction by competitive inhibition of acetylcholine receptor binding sites at muscarinic receptors. Parasympathetic inhibition decreases tear, salivary, sweat, bronchial, and gastric acid secretion. At higher doses, the nicotinergic effects of acetylcholine at the ganglia as well as at the motor end plate are also inhibited. Atropine may enter the brain and produce central nervous effects.
Indications
- For prevention and disruption of adhesions/growths in acute and chronic inflammation of the iris.
- For corneal inflammation of the eye with iritic irritation.
- For the elimination of accommodation in the objective determination of visual acuity.
- For the treatment of strabismus children
- For premedication before anesthesia
- For cardiac arrhythmias with slow heartbeat.
- In intoxications with organophosphates and carbamates.
- Anticholinergic therapy, for example, increased salivation, excessive sweating, spasms of the colon.
Contraindications
Atropine is contraindicated in hypersensitivity, glaucoma, palpitations, cardiac arrhythmias, coronary artery calcification, prostatic enlargement with residual urine formation, megacolon, in constipation due to slackening of the bowel, and sole treatment of myasthenia gravis. Do not drive on the day of application or for a few days thereafter due to the lack of accommodative ability of the eye with ocular application. For complete precautions, see the drug label.
Interactions
The effects of atropine may be diminished by the concomitant administration of other atropine-like agents, tricyclic antidepressants, numerous H1 antihistamines, anticholinergic antiparkinsonian agents, phenothiazines, and neuroleptics. The effect may be diminished by concomitant administration of parasympathomimetics.
Adverse effects
Irritability, mental confusion, palpitations, possibly cardiac arrhythmias, dry mouth, difficulty swallowing, rapid breathing, inhibition of sweating, constipation, facial flushing, dermatitis, edema, anaphylactic reactions, loss of neuromuscular coordination, bladder emptying disorders, temperature increase, increase in intraocular pressure, prolonged dilation of pupils, photophobia, and delirium may occur with the use of atropine.
