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Ways to use atropine. Atropine: instructions for use, analogues and reviews, prices in Russian pharmacies Atropine what does

First of all, atropine is a substance of natural origin, an alkaloid contained in such serious plants as dope, henbane, belladonna. Its ability to block M-cholinergic receptors has made this, figuratively speaking, gift of nature in demand in medicine. By blocking the M-cholinergic receptors of smooth muscle cells of internal organs and tissues, atropine relaxes the muscles and reduces their contractility. The tone falls and the peristalsis of the digestive tract is inhibited, the tone of the biliary tract and the genitourinary tract, the uterus, the bladder, and the bronchial tree decreases. The activity of the external secretion glands decreases, which is manifested by inhibition of the secretion of saliva, mucus, and sweat. As for gastric and pancreatic secretion, the effect of atropine on these processes is not so pronounced, because. these functions are regulated not only nervously, but also humorally, through the enzymes gastrin, secretin, histamine. Atropine has a stimulating effect on the heart, transferring all its functions to the forcing mode: myocardial contractility, its excitability increases, the automaticity of the conduction of nerve impulses increases. As a rule, in response to the introduction of atropine, the heart rate increases, the pulse quickens, myocardial oxygen demand increases, and cardiac blood flow intensifies. Atropine does not directly affect the tone of blood vessels, preventing only the vasodilating and hypotensive effect of M-cholinomimetics.

Once in the central nervous system, atropine inactivates M-cholinergic receptors and inhibits the transmission of nerve impulses in cholinergic synapses, which increases the excitability of respiratory neurons and the vagus nerve (vagus). In moderate doses, atropine stimulates the central nervous system to a certain extent, and after a while its sedative effect begins to be realized. When instilled into the eye, the maximum expansion of the pupil is observed at 30-40 minutes.

Atropine is available in two dosage forms: injection and eye drops. This drug is sold strictly according to doctor's prescriptions. Atropine is on the "A" list (poisonous drugs), which immediately makes it clear the seriousness of his intentions. The injection solution can be administered intravenously, intramuscularly or subcutaneously. Eye drops are instilled 1-2 drops 2-3 times a day. Children under 7 years old can only be instilled with a 0.5% solution, but at present, atropine eye drops are available only at a concentration of 1%. The use of atropine is possible only under the strictest medical supervision. In fact, it cannot be otherwise, given such strict rules for the sale of this drug from pharmacies. And certainly atropine cannot be called a drug for self-medication.

Pharmacology

Blocker of m-cholinergic receptors, is a natural tertiary amine. It is believed that atropine equally binds to the m 1 -, m 2 - and m 3 subtypes of muscarinic receptors. It affects both central and peripheral m-cholinergic receptors.

Reduces the secretion of salivary, gastric, bronchial, sweat glands. Reduces the tone of smooth muscles of internal organs (including bronchi, organs of the digestive system, urethra, bladder), reduces gastrointestinal motility. Virtually no effect on the secretion of bile and pancreas. Causes mydriasis, accommodation paralysis, reduces the secretion of lacrimal fluid.

In average therapeutic doses, atropine has a moderate stimulating effect on the central nervous system and a delayed but prolonged sedative effect. The central anticholinergic effect explains the ability of atropine to eliminate tremor in Parkinson's disease. In toxic doses, atropine causes agitation, agitation, hallucinations, coma.

Atropine reduces the tone of the vagus nerve, which leads to an increase in heart rate (with a slight change in blood pressure), an increase in conductivity in the bundle of His.

In therapeutic doses, atropine does not have a significant effect on peripheral vessels, but vasodilation is observed with an overdose.

When applied topically in ophthalmology, the maximum expansion of the pupil occurs after 30-40 minutes and disappears after 7-10 days. Mydriasis caused by atropine is not eliminated by the instillation of cholinomimetic drugs.

Pharmacokinetics

It is well absorbed from the gastrointestinal tract or through the conjunctival membrane. After systemic administration, it is widely distributed in the body. Penetrates through the BBB. A significant concentration in the central nervous system is achieved within 0.5-1 h. Plasma protein binding is moderate.

T 1/2 is 2 hours. Excreted in the urine; about 60% - unchanged, the rest - in the form of hydrolysis and conjugation products.

Release form

5 ml - vials.
5 ml - polyethylene dropper bottle.
5 ml - polyethylene dropper bottles (1) - cardboard packs.
5 ml - bottles (1) - packs of cardboard.
10 ml - bottles (1) - packs of cardboard.
10 ml - polyethylene dropper bottles (1) - cardboard packs.

Dosage

Inside - 300 mcg every 4-6 hours.

To eliminate bradycardia in / in adults - 0.5-1 mg, if necessary, after 5 minutes, the introduction can be repeated; children - 10 mcg / kg.

For the purpose of premedication in / m adults - 400-600 mcg 45-60 minutes before anesthesia; children - 10 mcg / kg 45-60 minutes before anesthesia.

When applied topically in ophthalmology, 1-2 drops of a 1% solution are instilled (in children, a solution of a lower concentration is used) into the sore eye, the frequency of application is up to 3 times with an interval of 5-6 hours, depending on the indications. In some cases, a 0.1% solution is administered subconjunctivally 0.2-0.5 ml or parabulbarno - 0.3-0.5 ml. By electrophoresis, a 0.5% solution from the anode is injected through the eyelids or eye bath.

Interaction

With simultaneous ingestion with antacids containing aluminum or calcium carbonate, the absorption of atropine from the gastrointestinal tract decreases.

With simultaneous use with anticholinergic agents and agents with anticholinergic activity, the anticholinergic effect is enhanced.

With simultaneous use with atropine, it is possible to slow down the absorption of zopiclone, mexiletine, reduce the absorption of nitrofurantoin and its excretion by the kidneys. Probably increased therapeutic and side effects of nitrofurantoin.

With simultaneous use with phenylephrine, an increase in blood pressure is possible.

Under the influence of guanethidine, a decrease in the hyposecretory effect of atropine is possible.

Nitrates increase the likelihood of increased intraocular pressure.

Procainamide enhances the anticholinergic effect of atropine.

Atropine reduces the concentration of levodopa in plasma.

Side effects

With systemic use: dry mouth, tachycardia, constipation, difficulty urinating, mydriasis, photophobia, accommodation paralysis, dizziness, impaired tactile perception.

When applied topically in ophthalmology: hyperemia of the skin of the eyelids, hyperemia and swelling of the conjunctiva of the eyelids and the eyeball, photophobia, dry mouth, tachycardia.

Indications

Systemic use: spasm of smooth muscle organs of the gastrointestinal tract, bile ducts, bronchi; peptic ulcer of the stomach and duodenum, acute pancreatitis, hypersalivation (parkinsonism, poisoning with salts of heavy metals, during dental interventions), irritable bowel syndrome, intestinal colic, renal colic, bronchitis with hypersecretion, bronchospasm, laryngospasm (prevention); premedication before surgical operations; AV blockade, bradycardia; poisoning with m-cholinomimetics and anticholinesterase substances (reversible and irreversible action); x-ray examination of the gastrointestinal tract (if necessary, reduce the tone of the stomach and intestines).

Topical application in ophthalmology: to study the fundus, to dilate the pupil and achieve accommodation paralysis in order to determine the true refraction of the eye; for the treatment of iritis, iridocyclitis, choroiditis, keratitis, embolism and spasm of the central retinal artery and some eye injuries.

Contraindications

Hypersensitivity to atropine.

Application features

Use during pregnancy and lactation

Atropine crosses the placental barrier. Adequate and strictly controlled clinical studies of the safety of the use of atropine during pregnancy have not been conducted.

With intravenous administration during pregnancy or shortly before childbirth, tachycardia in the fetus may develop.

Atropine is found in breast milk in trace concentrations.

Application for violations of liver function

Use with caution in liver failure (decreased metabolism).

Application for violations of kidney function

Use with caution in renal insufficiency (risk of side effects due to reduced excretion).

Use in children

Use with caution in chronic lung diseases, especially in young children and debilitated patients (a decrease in bronchial secretion can lead to thickening of the secretion and the formation of plugs in the bronchi); with brain damage in children, cerebral palsy, Down's disease (the reaction to anticholinergics increases).

special instructions

Use with caution in patients with diseases of the cardiovascular system, in which an increase in heart rate may be undesirable: atrial fibrillation, tachycardia, chronic heart failure, ischemic heart disease, mitral stenosis, arterial hypertension, acute bleeding; with thyrotoxicosis (possibly increased tachycardia); at elevated temperature (may still increase due to suppression of the activity of the sweat glands); with reflux esophagitis, hiatal hernia, combined with reflux esophagitis (decrease in motility of the esophagus and stomach and relaxation of the lower esophageal sphincter can slow gastric emptying and increase gastroesophageal reflux through the sphincter with impaired function); in diseases of the gastrointestinal tract accompanied by obstruction - esophageal achalasia, pyloric stenosis (possible decrease in motility and tone, leading to obstruction and retention of stomach contents), intestinal atony in elderly patients or debilitated patients (possible development of obstruction), paralytic ileus; with an increase in intraocular pressure - closed-angle (mydriatic effect, leading to an increase in intraocular pressure, can cause an acute attack) and open-angle glaucoma (mydriatic effect can cause some increase in intraocular pressure; therapy may need to be adjusted); with nonspecific ulcerative colitis (high doses can inhibit intestinal motility, increasing the likelihood of paralytic ileus, in addition, the manifestation or exacerbation of such a severe complication as toxic megacolon is possible); with dry mouth (long-term use may cause a further increase in the severity of xerostomia); with liver failure (decreased metabolism) and renal failure (risk of side effects due to reduced excretion); in chronic lung diseases, especially in young children and debilitated patients (a decrease in bronchial secretion can lead to thickening of secretions and the formation of plugs in the bronchi); with myasthenia gravis (the condition may worsen due to inhibition of the action of acetylcholine); prostatic hypertrophy without urinary tract obstruction, urinary retention or a predisposition to it, or diseases accompanied by urinary tract obstruction (including the bladder neck due to prostatic hypertrophy); with gestosis (possibly increased arterial hypertension); brain damage in children, cerebral palsy, Down's disease (the reaction to anticholinergics increases).

Between taking atropine and antacids containing aluminum or calcium carbonate, the interval should be at least 1 hour.

With subconjunctival or parabulbar administration of atropine, the patient must be given a validol tablet under the tongue in order to reduce tachycardia.

Influence on the ability to drive vehicles and control mechanisms

During the period of treatment, the patient must be careful when driving vehicles and engaging in other potentially hazardous activities that require increased concentration, psychomotor speed and good vision.

The drug Atropine lowers the tone of the internal muscles of the bronchi, stomach and bladder. It is prescribed to reduce the secretion of the salivary, sweat and bronchial glands. You need to know in what dosage the medicine is taken, and what side effects it has on the body.

The main task of Atropine is the blocking of M-cholinergic receptors. The drug will reduce the secretion of saliva in bronchial diseases. Atropine will also increase heart rate for a therapeutic effect. The medicine can reduce the tone in the bronchi and in the abdominal cavity. If the patient has an elevated vagal tone, then Atropine will act even more strongly. The medicine affects the dilation of the pupil in the eye. This happens at the moment of relaxation of the muscles in the shell of the eye.

Doctors prescribe Atropine as a symptomatic therapy for such diseases:

• stomach ulcer;
• Problems with the duodenum;
• Acute pancreatitis;
• At the time of pylorospasms;
• For the treatment of gallstone disease;
• Treatment of cholecystitis;
• Severe spasms in the intestines;
• problems with the urinary tract;
• Severe attacks of bronchial asthma;
• To increase nerve tone in bradycardia;
• To reduce the tone of the activity of organs during x-rays.

Also, the doctor may prescribe injections of the drug for such purposes:

1. Before the introduction of anesthesia at the time of surgery;
2. To relieve bronchial spasms during surgery;
3. To reduce the secretion of the gland;
4. Removal of a reflex reaction;
5. It is prescribed as an antidote for overdose of cholinomimetic drugs.

In some cases, the use of Atropine is dangerous to the health of the patient. Doctors prohibit the medicine in such situations:

• Severe allergy to any component in the composition;
• problems with the heart system;
• The occurrence of atrial fibrillation;
• Attacks of tachycardia;
• Insufficiency in the work of the heart;
• Ischemic attacks;
• Dangerous with mitral stenosis;
• It is not prescribed for the severe stage of arterial hypertension;
• If the patient has any bleeding;
• Dangerous drug for thyrotoxicosis;
• Not prescribed for hyperthermic syndrome;
• If the patient has stomach problems;
• Dangerous for glaucoma;
• It is not prescribed for problems with the kidneys and liver;
• If the patient has frequent urinary retention;
• Dangerous for severe brain damage.

If the drug is used in specific cases, it can cause complications and harm the body. Be sure to get tested to properly use Atropine.

You need to know with which drugs Atropine is incompatible or can cause side effects. Here is a complete list of drug combinations:

• Use together with MAO inhibitors leads to a change in the rhythm in the heart;
• The use of Atropine with Quinidine causes an increase in anticholinergic action;
• If you take the drug together with tannin, this will weaken the effect of both substances;
• Atropine will reduce the analgesic effect of all opiates;
• The drug reduces the time of action of narcotic drugs;
• Parallel intake of Diphenhydramine enhances the effect of Atropine;
• The use of haloperidol leads to an increase in pressure inside the eye;
• The use together with sertraline will cause a feeling of depression and oppression;
• Taking penicillin leads to an increase in the effect of both drugs;
• If you use Atropine together with ketoconazole, its absorption into the blood will decrease.

Also, experts have identified a number of other interactions that you need to pay attention to before taking:

1. The drug attapulgite will reduce the therapeutic effect of Atropine;
2. The drug will, when taken in parallel, reduce the therapeutic effect of Pilocarpine;
3. When using octadine, the effect of Atropine is reduced;
4. If you use the medicine together with sulfa drugs, a big problem with the kidneys and liver may begin;
5. Concurrent use with potassium preparations leads to ulcers in the stomach. It can also cause bleeding;
6. The effect of the drug Atropine is enhanced when taking antidepressants, Amantadine and Phenothiazine;
7. Any other drugs will be absorbed and act more slowly after taking Atropine.

If the patient is taking other drugs for therapy, he needs to adjust the dosage or temporarily suspend treatment. This should be decided only by the attending physician.

Doctors have identified a number of diseases in which Atropine is prescribed with great care. In this case, the doctor must monitor the patient's condition and adjust the dosage. Here is a list of the main diseases in which the drug can harm:

• Cerebral palsy in children;
• problems with urination;
• Down's disease;
• With hernias in the digestive zone;
• Any stage of ulcerative colitis;
• At the moment of megacolony;
• Caution for dosage in elderly patients;
• With an advanced stage of lung disease;
• For children with autonomic neuropathy.

Patients with such diseases should definitely monitor the state of health after the use of Atropine and inform the attending physician.

Doctors do not allow the use of Atropine by pregnant women at any time. Also, do not use the drug at the time of breastfeeding. Scientists have proven that toxic substances can get to the baby through milk. This will lead to severe allergies and health complications.

Driving during treatment

Be aware that atropine causes side effects of dizziness and mild hallucinations. That is why you should refrain from driving until the end of therapy. Doctors advise patients also not to work with mechanisms that require a lot of concentration.

Atropine can be administered intramuscularly, intravenously and subcutaneously. To reduce heart contraction and reduce bronchial glands, doctors prescribe 0.5 mg of the drug as a subcutaneous injection. It must be used one hour before anesthesia along with morphine.

In case of severe poisoning with cholinomimetic substances, use the drug at a dose of 2 mg by intramuscular injection. It is necessary to enter Atropine every half an hour. It is necessary to stop the administration of the drug after reddening of the skin or with an attack of tachycardia. In severe stage of poisoning, use the drug for 1-2 weeks.

The maximum dose for an adult is 3 mg per day. At one time, you can enter 1 mg of Atropine. For children, an individual dosage is selected by the attending physician. It depends on the age and weight of the baby, as well as on the stage of the disease. Dosage should be used with caution in elderly patients.

If a person begins to experience side effects, the doctor should reduce the dose of Atropine or reduce the frequency of injections.

If you give too much of the drug to the patient, he may begin complications and health problems. The first signs of an overdose are displayed in the following symptoms:

1. Strong feeling of nausea, vomiting;
2. The patient's blood pressure drops;
3. There is a tremor;
4. The person feels overexcited;
5. severe convulsions;
6. Difficulty falling asleep at night
7. Hallucinations may begin;
8. The patient becomes nervous and irritable;
9. Hyperthermia occurs;
10. The process of oppression in the nervous system;
11. Decreased activity in the respiratory zone.

As soon as the patient feels such symptoms, he should immediately stop using Atropine and go to the hospital. Doctors are required to quickly rinse the stomach and introduce cholinomimetic agents into the body. With a symptom of hyperthermia, you need to wipe the patient with wet towels and prescribe antipyretic drugs.

If a person feels overexcited and afraid, the doctor prescribes thiopental injections. You can also take Physostigmine. If glaucoma is detected, the patient should instill Pilocarpine into the eye sac. At this point, you can inject Prozerin 3 times a day. The patient can leave the hospital only after all unpleasant symptoms have passed.

Adverse drug reactions

In the instructions for use, you can see all the side effects of the drug. Usually, complications occur with individual intolerance to the drug or with an overestimated dosage for use.

Where do they occur?	Side effects
In the stomach, such side effects can begin	Feeling of dry mouth; Strong thirst; Changes in taste sensations when eating; Problems with motility in the intestines; Decreased tone in bile; The occurrence of dysphagia; Problems with urination.
In the heart zone, such complications can begin	Attacks of tachycardia; Severe arrhythmia; An attack of ischemic disorder; The patient's face turns red; There is a feeling of a rush of blood to the body.
In the nervous system, such side effects are observed	Attacks of severe headache; The patient is dizzy; There is a feeling of nervousness and fear; It is difficult for a person to fall asleep at night.
In vision, such complications can begin	The patient's pupils will dilate; Photophobia occurs; An attack of paralysis of accommodation; The pressure inside the eye rises; Visual clarity drops rapidly.
In the respiratory system, such side effects are manifested	The tone of the bronchi decreases; The sputum becomes more viscous; The patient has difficulty coughing.
The following side effects are observed on the skin:	Red rash on the body; The occurrence of urticaria; Manifestation of exfoliative dermatitis; Severe allergy to the composition of the drug.
Other side effects on the drug	The patient begins to sweat less; The skin at the injection site becomes dry; There is dysarthria; The skin may turn red due to sensitivity to the composition.

If any side effect is detected, it is necessary to stop the injection with the drug. The doctor must determine the cause of such a reaction. It may be necessary to reduce the dosage or replace Atropine with a similar agent.

Keep the drug only in the original packaging. It is important to keep the ampoules at a temperature of no more than +25 degrees and no less than +15 degrees. In no case do not put Atropine in the refrigerator. It is important that children cannot get medicines and take them inside. The shelf life of ampoules is no more than 3 years from the date of production. It is forbidden to inject if Atropine is expired.

The price of the drug

Now you can buy Atropine in the form of ampoules at any pharmacy. Some pharmacists will require a doctor's prescription with the exact dosage. The average price of the drug is from 70 to 90 rubles. For this cost, you can purchase 1 ampoule of a 0.1 percent solution.

"Atropine" - anticholinergic drug, is a blocker of cholinergic receptors. What side effects of atropine sulfate can the patient expect when using?

The main feature of the drug is its ability to block anticholinergic systems in the body, located in the heart muscle, as well as the central nervous system.

Release form "Atropine"

According to the instructions for use, it is known that the drug is of the following types:

1. Solution for injection, containing one milliliter of a solution of one milligram of atropine sulfate (in ampoules of one milliliter).
2. Eye drops (1%).

Indications

What is the description of the substance (atropinum) atropine? The drug is considered an anticholinergic and antispasmodic drug. Its active ingredient is a poisonous alkaloid found in plants of the nightshade family, for example:

• henbane;
• belladonna;
• dope.

Reception "Atropine" helps to reduce the secretory work of the glands, expand the hole in the iris, increase intraocular pressure and the ability of the eye to change the focal length.

According to the instructions for use and reviews of Atropine, it is known that the acceleration and stimulation of cardiac activity after using the drug is due to its ability to eliminate the inhibitory effect of the vagus nerve. The action of the drug on the central nervous system is carried out in the form of activation of the nerve formation in the medulla oblongata, and when using excessive dosages, convulsions and visual hallucinations may occur.

Usually "Atropine" is prescribed for:

1. Gastric ulcer (a chronic disease that occurs with the formation of lesions in the stomach, as well as a tendency to further development and complications).
2. Spasms of the muscles of the stomach and intestines.
3. Hypersalivation (increased secretion of saliva as a result of increased activity of the salivary glands).
4. Bradycardia (slow heart rate).
5. Acute pancreatitis (damage to a large endocrine and digestive gland located behind the stomach).
6. Intestinal and renal colic (an acute attack of pain in the lumbar region, caused by a sharp violation of the outflow of urine from the kidney and impaired blood circulation in it).
7. Spastic colitis (inflammatory process in the area of ​​the mucous membrane of the large intestine).
8. Bronchospasm (a pathological condition that occurs when the smooth muscles of the bronchi contract and reduce their lumen).
9. Bronchitis with hypersecretion (diffuse-inflammatory disease of the bronchi, affecting the mucous membrane or the entire thickness of the wall of the bronchi).
10. Laryngospasm (a pathological condition characterized by uncontrolled contraction of the larynx).

And also the drug is used when conducting an x-ray of the stomach and intestines, for conducting preliminary medical preparation of the patient for general anesthesia and surgical intervention in ophthalmology. Also, the drug is used for:

• dilatation of the pupil during the study of refraction of the eye;
• fundus examinations;
• elimination of spasm of the central artery of the inner shell of the eye;
• elimination of inflammation of the cornea of ​​​​the eye;
• healing of damage to the iris of the visual organ;
• elimination of the inflammatory process in the choroid of the eye;
• restoration of the mucosa in case of eye injuries.

Contraindications

The use of "Atropine" is prohibited in case of sensitivity to microelements included in the structure of the drug. This can be both individual intolerance to the components, and sensitivity associated with the use of agents incompatible with Atropine.

Instructions for use

Depending on the doctor's prescription, the drug is administered subcutaneously, intramuscularly or intravenously at 0.25-1 milligrams, the frequency of use is up to two times a day.

For adult patients, to eliminate bradycardia intravenously, 0.5-1 milligram is used, if necessary, the procedure must be repeated after five minutes. The dosage for children is determined according to the weight of the patient - 0.01 milligrams per kilogram.

For preliminary drug preparation of the patient for general anesthesia and surgical intervention, "Atropine" is administered intramuscularly forty-sixty minutes before the operation. The drug is administered until the sensitivity of the body or its part decreases, up to the complete cessation of perception:

1. Adult patients need to enter 0.4-0.6 milligrams.
2. Children need 0.01 milligrams per kilogram of weight.

It must be remembered that the drug can cause side effects in children.

"Atropine" is used in ophthalmology: one or two drops of a one percent solution are instilled into the affected visual organ, the frequency of use is up to three times a day, observing an interval of five to six hours. Under the conjunctiva, it is necessary to inject 0.2-0.5 milliliters of the drug.

"Atropine": side effects from taking

Even with the correct use of the drug, the following negative reactions may occur:

• tachycardia;
• dry mouth;
• difficulty urinating;
• dizziness;
• intestinal obstruction;
• photophobia.

If the drug is used in the form of drops, then the characteristic side effects of Atropine are:

• pupil dilation.
• vision loss at close range.

The negative consequences that occur with an overdose of the drug are observed an hour after using the drug. Typical side effects of "Atropine" are:

• dryness of all mucous membranes;
• decrease in sweating;
• increased heart rate;
• trembling of the limbs;
• hard breath;
• redness of the skin.

Peculiarities

"Atropine" must be used with extreme caution in diseases of the heart and blood vessels, in which it is not recommended to increase heart rate:

1. Tachycardia.
2. Atrial fibrillation.
3. Ischemia of the heart.
4. Heart disease.
5. Arterial hypertension.
6. Valve defect.

"Atropine" should also not be taken in the presence of the following pathologies:

1. Elevated hormone levels.
2. Acute bleeding.
3. Diseases of the esophagus, accompanied by the development of an inflammatory process on its mucosa.
4. Elevated body temperature.
5. Increase in intraocular pressure.
6. Diseases of the stomach and intestines.
7. Gestose.
8. Dryness in the mouth.
9. Chronic inflammatory disease of the colon mucosa.
10. Lung damage.
11. Liver and kidney failure.
12. Adenoma.
13. An autoimmune neuromuscular disease characterized by pathologically rapid fatigue of the striated muscles.
14. Down Syndrome.

It is necessary to observe a gap of at least one hour between taking antacids and Atropine. With subconjunctival use of drugs, in order to reduce tachycardia, the patient needs to take a validol capsule under the tongue. During therapy with Atropine, care must be taken when driving a car and when working in hazardous industries.

Generics

If this drug does not suit you, you can always use analogues of Atropine. Instructions for the use of generics will not differ much and have similar indications and side effects. Substitute medicine can:

1. "Midrimax".
2. "Cyclomed".
3. "Midriacil".
4. "Cycloptus".
5. "Bellacehol".
6. "Tropicamide".
7. "Becarbon".

"Cyclomed"

The drug is produced in the form of a one percent solution. Drops have no shade and aroma, are available in five milliliter bottles, which are equipped with a pipette at the end.

One milliliter of the drug contains ten milligrams of the active ingredient - cyclopentolate hydrochloride.

"Cyclomed" is prescribed to prepare the patient for operations on the visual organs, to dilate the pupil in case of extracapsular cataract. The drug is also used before the study of the eyeball. The cost of the drug is 400 rubles.

"Tropicamide"

The drug is produced in the form of a 0.5% and 1% solution for instillation into the eyes. The drug is available in vials equipped with a dropper pipette, with which it is convenient to determine the required dosage of Tropicamide.

For therapeutic purposes, "Tropicamide" is used as eye drops six times a day.

It is important for people using contact lenses to note that the structure of the drug contains benzalkonium chloride, a trace element that remains on the surface of the lenses and can cause damage to their structure. Before using the medication, the lenses must be removed and put on no earlier than fifteen minutes after the procedure. The cost of the medicine is 70 rubles.

"Cycloptik"

The medicine is produced in the form of eye drops, the drug is dispensed in dropper bottles of five milliliters. Contraindications for use are: constipation, prostatic hyperplasia, retirement age.

When using "Cycloptica" it is important to control intraocular pressure. To reduce the likelihood of side effects, after using eye drops, it is necessary to press your fingers on the inner corners of the eyes for two minutes.

People during the instillation of "Cycloptica" need to refrain from driving and work that involves hazardous activities that require increased reaction and attention. The price of "Cycloptica" is 200 rubles.

"Midrimax"

A complex drug for topical use in ophthalmology, which dilates the pupil. In addition, it is a cholinergic receptor blocker in conjunction with an adrenomimetic. "Midrimax" is released in pharmacies in the form of eye drops. It is produced in the form of a clear solution or a light brown liquid. You can buy a medicine only with a prescription.

"Becarbon"

The drug belongs to antispasmodic drugs. The drug is produced in the form of tablets for oral use (six pieces in a contour pack, the number of blisters in a pack: from two to five).

The medication is taken orally, before meals, one tablet two to three times a day. The maximum daily dosage for adults can be up to five tablets per day.

Long-term treatment with "Becarbon" is not recommended for patients who have kidney stones. Belladonna, which is part of the drug, enhances the negative effects of cardiac glycosides, as well as clonidine. In addition, Belladonna reduces the effectiveness of anticholinesterase drugs. When carrying out treatment with "Bekarbon", a sick person must be especially careful when driving. The price of the medicine is 40 rubles.

Atropine is a drug that contributes to the creation of drug-induced mydriasis, or in other words, the expansion of the pupil. Due to the vast number of contraindications and side effects, Atropine is rarely used in therapy today.

Atropine is an alkaloid of plant origin. The main active ingredient is extracted from plants that belong to the nightshade family.

Atropine promotes the expansion of the pupil and prevents the outflow of intraocular fluid, which in turn leads to an increase in intraocular pressure, the development of accommodation paralysis. The latter has not only a therapeutic effect, but is also accompanied by impaired visual acuity, which should be taken into account by vehicle drivers.

After Atropine enters the surface of the eye, its muscle responsible for fixing the lens is relaxed, and the outflow of intraocular fluid changes.

A pronounced therapeutic effect, as a rule, can be observed after half an hour after the application of the composition. A full restoration of eye function occurs after three days of treatment.

Release form

Atropine belongs to anticholinergic drugs, blockers of m-cholinergic receptors. It is produced in the form of eye drops and injection solutions with the main active ingredient - atropine sulfate.

Injection solutions are sold in 1 ml ampoules. The concentration of atropine in 1 ml is 1 mg. What is pumped with eye drops, then 1 ml of the composition contains about 10 mg of atropine. The drug is sold in polyethylene bottles with a volume of 5 ml.

Instructions for use

Atropine is prescribed to patients to reduce the secretory functions of the glands, relax the tone of organs with smooth muscles, dilate the pupil, increase intraocular pressure and accommodation paralysis, which is characterized by changes in the focal length of the eye. The medicinal composition is also recommended in the case when it is necessary to accelerate or excite cardiac activity.

Atropine is used in the treatment of patients with:

• peptic ulcer of the stomach and duodenum;
• spasms of the bile ducts, smooth muscle organs of the gastrointestinal tract, bronchi;
• hypersalivation;
• bradycardia;
• acute form of pancreatitis;
• intestinal and renal colic;
• irritable bowel syndrome;
• bronchial spasms;
• bronchitis with hypersecretion;
• AV blockade;
• laryngospasms;
• poisoning with anticholinesterase substances and m-cholinomimetics.

Atropine is also used if it is necessary to conduct x-ray studies of the gastrointestinal tract.

In ophthalmology, the medicinal composition is recommended for determining ocular refraction, when examining the bottom of the eye, as well as for therapeutic purposes with diagnoses represented by spasms of the central retinal arteries, keratitis, iritis, choroiditis, iridocyclitis, embolism and some eye injuries.

Price

Atropine is produced by a domestic pharmaceutical manufacturer, the Moscow Endocrine Plant, which has set the following prices for its own products:

Release form	Manufacturer	Cost, rub.	Pharmacy
1% solution, 5 ml, eye drops	MEZ, Russia	53,00	https://apteka.ru
Eye drops 1% vial, 5 ml	MEZ, Russia	52,50	Pharmacy "Roxana"
Eye drops 1%, 5ml	MEZ, Russia	51,00	Apteka LLC
Eye drops fl-cap. 1%, ml	MEZ, Russia	52,80	Pharmacy "Violet"
Eye drops 1%, bottle 5ml	MEZ, Russia	51,16	"Samson-Pharma"
Eye drops 1%, bottle 5ml	MEZ, Russia	53,30	Planet Health
Eye drops 1%, bottle 5ml	MEZ, Russia	53,00	Onfarm
Eye drops 1%, bottle 5ml	MEZ, Russia	49,76	Agave
Eye drops 1%, bottle 5ml	MEZ, Russia	53,00	Nova Vita
Eye drops 1%, bottle 5ml	MEZ, Russia	53,80	"City Pharmacy"

Analogues

As already noted, Atropine is rarely used today for therapeutic and prophylactic purposes. Experts prefer the following analogues, which are no less effective, but safer:

• Taufon- eye drops based on taurine. The drug is prescribed for corneal dystrophy, cataracts, corneal injuries and degenerative lesions of the retina. The solution is sold in 10 ml dropper bottles. The average cost of a medicine is 125 rubles.
• Systane ultra- composition for moisturizing the surface of the cornea and increasing eye comfort. It is distinguished by its complex composition, and the American pharmaceutical company Alcon is engaged in its production. Prices for the drug are in the range from 190 to 557 rubles.
• Midriacil- an ophthalmic solution based on tropicamide, which contributes to the expansion of the pupil, the development of accommodation paralysis. Produced in 15 ml bottles, the average cost of which is 350 rubles.
• Tropicamide- eye drops with a mydriatic, anticholinergic nature of the impact. The main active ingredient is tropicamide. It differs from Atropine in a shorter action of induced accommodation paralysis, as well as a slight effect on the state of intraocular pressure. Produced in bottles of 5 ml, the average cost of which is 90 rubles.
• Cycloptic- eye drops based on cyclopentolate hydrochloride. The medicinal solution is used for diagnosis when performing ophthalmoscopy, to detect keratitis, iridocyclitis, episcleritis, scleritis and inflammatory pathologies affecting the anterior sections of the eyes. Produced in bottles of 5 ml, the average price of which is 130 rubles.
• Irifrin- eye drops based on phenylephrine hydrochloride. It is prescribed to dilate the pupil for diagnostic purposes during ophthalmoscopy and during other studies that will help determine the condition of the back of the eyes. Produced in bottles with a volume of 5 ml and an average cost of 560 rubles.

Contraindications

The main contraindications, in which the appointment of Atropine should be excluded, are presented:

• hypersensitivity to the constituent components of the drug;
• angle-closure and narrow-angle forms of glaucoma or if its development is suspected;
• synechia affecting the iris of the eyes;
• up to 7 years of age.

With caution, the drug should be used during the period of bearing a child. The result of the research is confirmation of the penetration of atropine through the placental barrier. At the same time, the clinical safety of the composition for the fetus has not been proven.

It is noted that intravenous administration of Atropine during pregnancy or before childbirth can cause the development of tachycardia in a child. The use of the drug during lactation is also accompanied by the penetration of the medicinal composition into breast milk.

Manufacturers of patients with arrhythmia, high blood pressure, any other disorders of the functioning of the organs of the cardiovascular system, as well as those over the age of 40, recommend prescribing the drug only after a comprehensive examination.

No less dangerous conditions in which Atropine should be taken with caution are diseases of the gastrointestinal tract, urinary tract, endocrine system disorders and fever.

Dosage

Depending on the expected therapeutic effect, the drug can be prescribed in the following dosages:

• If premedication is necessary, adults are prescribed the administration of the composition at a dosage calculated from 300 to 600 mcg per kilogram of weight.
• In case of intoxication with cholinomimetics and agents with phosphorus, it is recommended to administer the drug intravenously in a dose of 1.4 ml.
• With bradycardia, intravenous administration of the composition in an amount of 0.5 to 1 mg is recommended. Another introduction is allowed if necessary and after 5 minutes.
• Eye drops are recommended to be used no more than 3 times a day, 1-2 drops and adhering to an interval of 5 hours.

When using the drug, it is important not to exceed the maximum allowable daily dosage of 3 mg and a single dosage of 600 mcg.

Side effects

Serious side effects may occur during treatment with Atropine. This is about:

• dizziness, dryness in the oral cavity, tachycardia, urinary retention, constipation, photophobia, accommodation paralysis, disturbances in tactile perception, which may develop against the background of systemic use of the drug;
• feeling of anxiety, headaches, acceleration of the heartbeat;
• hyperemia and edema of the conjunctiva, tachycardia, which is typical for the use of Atropine topically;
• allergic reactions.

Atropine can cause mydriasis, which can persist for 7 to 10 days. At the same time, the installation of cholinomimetics does not contribute to the normalization of the condition. In view of the above side effects, which are visual impairment, it is recommended to refuse to drive a car in the first 2-3 hours after the installation of the composition in the area of ​​the conjunctival sac.

Compatibility

The addition of Atropine with antacids containing aluminum or calcium carbonate helps to reduce the absorption of the drug in the digestive tract. In order to avoid such consequences, it is recommended to adhere to the interval between doses of 1 hour or more.

Simultaneous administration of Atropine with phenylephrine can cause arterial hypertension, but in combination with Procainamide, an increase in the effect of the first drug is noted.

When using eye drops, it is important to avoid getting the solution into the nasopharyngeal area. To do this, experts recommend pressing the lacrimal opening, located in the lower part. It is also important to consider that in patients with an intensely colored iris, blurred pupil dilation is possible. In this case, it is important to prevent overdose.

Overdose

If the recommended allowable dosages of the drug are exceeded, or in conditions of frequent use, unpleasant symptoms may develop that are characteristic of an overdose. Patients are at risk of visual impairment, unsteady gait, difficulty breathing, drowsiness, hallucinations, hyperthermia, muscle weakness.

In this case, treatment is carried out with physostigmine. The composition should be administered intravenously in an amount of not less than 0.5 and not more than 2 mg, adhering to a rate of not more than 1 mg per minute.

The daily dosage of the drug used should not exceed 5 mg. For first aid in case of an overdose of Atropine, it is also possible to use neostigmine methyl sulfate, which is administered intramuscularly every 3 hours, 1-2 mg, depending on the patient's condition.

Atropine Sulfate (or simply Atropine) is mydriatic and antispasmodic produced in various dosage forms. Such a variety can allow the drug to be used for its intended purpose in any convenient form - tablets or injection solutions. Substances of the chemical structure of the agent belong to the group of alkaloids and are found mainly in nightshade plant families. Belladonna (or belladonna) is one of their most famous representatives.

The composition of the drug developed from chemical and synthetic compounds in factories using special technologies. Atropine Sulfate belongs to the pharmacological group of anticholinergics, adjusted for the blockade of M-cholinergic receptors. The drug is used primarily to relieve tension in smooth muscle tissue and spastic conditions. The drug has found application in the prevention and treatment of ophthalmic diseases.

Atropine indications: for use

Atropine is used for a wide variety of purposes. The full range of directions for using the product is indicated in the instructions that can be found in each package.

Conditions in which the drug is prescribed:

• Spasm of the gastric pylorus
• Ulcer in the stomach or intestines
• Colic caused by gallstones
• Intestinal, renal or biliary colic
• Inflammatory processes in the pancreas and gallbladder
• All forms of bradycardia
• irritable bowel syndrome
• Bronchospasm caused by an allergic or asthmatic condition.

Atropine is often used before an operation using anesthesia. This is done to reduce salivation.

In the X-ray diagnosis of the digestive tract, the drug is also used. Since the drug reduces the efficiency of the skin glands, it is also used in the pathology of sweating. As an antidote, the drug is applicable for poisoning with certain poisons.

Ophthalmologists use the drug for mydriasis, that is, a special effect of pupil dilation. This is done in order to gain access to the patient's fundus and perform the necessary manipulations and diagnostics. It is also used to treat inflammation and diseases of the cornea and iris. After an injury or surgery on the eyeball, Atropine drops relax the eye muscles to the required state and help to achieve a speedy recovery, providing them with complete rest.

Since the drug is subject to quantitative accounting in pharmacies, it is impossible to buy it without a doctor's prescription. In the absence of contraindications to the components of Atropine, the doctor may prescribe this medicine, which is part of the group of poisonous and narcotic drugs (group A).

Atropine sulfate

The presented drug can be used for inhalation with problems of bronchospasm, administered intramuscularly and intravenously, taken orally and as a fine aerosol.

Injection 0.1% is administered twice a day. If you take the solution inside, then once a day is also 0.1%. If it is necessary to use Atropine aerosol, the dosage is negotiated in advance with the attending physician and, as a rule, is the same 0.1% solution. used required amount times, usually 3-5 minutes before getting rid of the attack.

Atropine eye drops

For ophthalmic use Atropine ophthalmic solution can be purchased at pharmacies with a dosage of 5 ml of a 1% solution. In case of inflammation and damage to the eye, for favorable conditions, ophthalmologists prescribe drops 5-6 times a day, 1-2 doses in each eye. In such cases, medriaz lasts about a week and occurs within half an hour after using the drops.

If the patient turned to an ophthalmologist for the purpose of diagnosing, the duration of medriaz is regulated by the dose of the drug and this effect lasts no more than two days. Some manufacturers produce eye films, gels and ointments containing the main substance.

The mechanism of action of atropine

M-cholinergic receptors are actively blocked with the help of a special ability of Atropine, which underlies the mechanism of its action. These receptors are located predominantly in smooth muscle tissues in the region of the endings of parasympathetic nerve fibers. The specific mechanism of action of the drug provokes the following pharmacological effects:

• Causes an increase in heart rate
• Causes pupil dilation
• Normalizes the permeability of nerve impulses of the heart muscle
• Inhibits the secretion of sweat, salivary, digestive and bronchial glands
• Relaxes the smooth muscles of the gastrointestinal tract, bronchi and urinary system

Such a wide range of rather serious effects in pharmacology increases the likelihood of side effects from the drug, and also explains the rather long list of contraindications to the use of the drug.

Atropine contraindications

Medication instructions says about all kinds of situations when the drug can cause irreparable damage to health, so it must be used with some caution or completely excluded from complex treatment.

Contraindications:

• Keratoconus
• Bowel obstruction
• Age up to 7 years
• Kidney pathology
• Heart rhythm disorder
• Fast or slow heartbeat
• Organic or pathological disorders of the heart muscle
• Allergy to the drug
• Individual intolerance to one or more components of the drug
• Reflux - esophagitis
• paralysis of the small intestine
• Prostate adenoma causing urination disorder
• Glaucoma (is a contraindication to drops, powders, solutions and tablets of Atropine)

In case of an overdose or non-compliance with the rules for using the drug, as well as in case of hypersensitivity of the body to the agent, the following can be expected side effects:

• allergic reaction
• tachycardia
• visual impairment
• headache
• dry mouth
• dizziness
• urinary problems

Only the attending physician, based on the diagnosis and tests performed, can prescribe use of atropine, in order to avoid negative consequences from the uncontrolled use of the drug.

Atropine tablets

A fairly widely used form of release of Atropine is tablets. They are prescribed to reduce the secretion of digestive enzymes in complex treatment of ulcers intestines and stomach.

Dosage of Atropine tablets– 0.5 mg. They are taken half an hour before meals or 1-2 hours after it. The dose is compiled by the attending physician individually for each patient. The main guideline of the gastroenterologist in the selection of the dosage is the symptom of dry mouth of the patient based on the intake of Atropine tablets. These symptoms indicate that a further increase in the dose of the drug is fraught with stronger negative effects.

Overdose of Atropine

If the drug is used uncontrollably, there is overdose poisoning which is indicated by the following symptoms:

• Constipation
• Vomiting and nausea
• Redness of the mucous membranes and their dryness
• Arrhythmia or tachycardia
• Increased breathing
• Trembling of limbs
• Swallowing reflex disorder, hoarseness
• Excitation of muscle tissue
• Loss of consciousness
• convulsions

In case of targeted poisoning with the drug, or in cases of severe overdose of the drug, the patient can expect a lethal, caused by paralysis of the respiratory muscles. To avoid such rare situations, you can buy a medicine only by presenting the appropriate document at the pharmacy, officially allowing the pharmacist to sell the drug.

Atropine reviews

The pharmacological effect of the drug exceeds the problems from its overdose or misuse, so positive reviews are still more numerous, although they are diluted with adverse effects and related reviews.

Since this medicine has been replaced by more modern and effective drugs with a much smaller range of side effects, the reviews of experts about it are also ambiguous.

Atropine analogues

Atromed is considered to be a complete analogue of Atropine in terms of a composite feature, but it has a relative drawback - the release form is exclusively in eye drops, therefore, the agent is not suitable for other therapeutic areas. To replace Atropine, you can use belladonna extracts or tinctures, but subject to prior approval of the treatment from the doctor.

The following drugs have a completely different composition, but a similar pharmacological effect:

• Darifenacin
• Platifillin
• Cyclodol
• Pirenzepine

atropine during pregnancy

In such a fragile situation as pregnancy, it is advisable to avoid taking Atropine or use it only when absolutely necessary and under the strict supervision of the attending physician. There are cases when the active substances of the drug penetrated the barrier of the placenta, causing serious ailments and pregnancy disorders.

With the introduction of a solution for injection of Atropine to a pregnant woman intravenously, it can provoke pathologies of fetal development even in the mother's womb. During lactation, the drug can be used, but also with caution, since trace concentrations of the substance can penetrate into breast milk.

Atropine drops for children

With extreme caution, Atropine is allowed to be used in the treatment of children from 7 years of age. With brain lesions, cerebral palsy and downism, the use of the drug is possible, but it is worth considering a more powerful reaction of the child's body to drugs of this pharmacological group.

If the drug must be used on a child with recurrent or chronic diseases of the upper and lower respiratory tract, it is advisable to do this in a hospital under the strict supervision of specialists. The same recommendations apply to children weakened by various diseases. Doctors should monitor the concentration of bronchial secretions to avoid increasing the density and viscosity, and then clogging the bronchial passages.

special instructions

When taking atropine in any of the prescribed ways, in order to avoid the possible development of tachycardia, you can put a pill under the tongue. For almost every indication, there is a number of contraindications– this should not be forgotten either.

If during the period of treatment the patient needs to drive vehicles or use increased concentration of attention, one should be extremely careful in dosage and intake.

Atropine price

Buy Atropine in a pharmacy with a doctor's prescription is not difficult. Also recently it has become incredibly convenient to buy drugs in online pharmacies. This method eliminates unnecessary queues and saves a lot of time. The price of Atropine is not a decisive factor in choosing a purchase method, since both in a regular pharmacy and on the Internet you can buy a package of medicine for 40-50 rubles.