Atropine injection

Name: Atropine injection

What should I avoid while taking atropine?

This medicine may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Atropine can decrease sweating and you may be more prone to heat stroke.

Atropine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have:

  • a light-headed feeling, like you might pass out;

  • pounding heartbeats or fluttering in your chest;

  • restlessness;

  • speech problems, trouble swallowing;

  • confusion, hallucinations;

  • weakness, loss of balance;

  • hot, dry skin; or

  • a severe skin rash.

Common side effects may include:

  • dry mouth, nose, or throat;

  • dry eyes, blurred vision;

  • dizziness; or

  • headache, drowsiness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What do I need to tell my doctor BEFORE I take Atropine Injection?

  • If you have an allergy to atropine or any other part of atropine injection.
  • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.

This medicine may interact with other drugs or health problems.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

How is this medicine (Atropine Injection) best taken?

Use atropine injection as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • It is given as a shot into a muscle, under the skin, or into a vein.

What do I do if I miss a dose?

  • Call your doctor to find out what to do.

If OVERDOSE is suspected

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

For Healthcare Professionals

Applies to atropine: compounding powder, injectable solution, intramuscular solution, intravenous solution, oral tablet

General

Although individual reactions vary greatly, systemic doses are likely to produce the following effects:
0.5 mg: Slight dryness of the nose and mouth, bradycardia
1 mg: Greater dryness of nose and mouth with thirst; slowing, then acceleration of the heart; slight mydriasis
2 mg: Very dry mouth, tachycardia with palpitations, mydriasis, slight blurring of near vision
5 mg: Increase in the above symptoms plus disturbance of speech, difficulty swallowing, headache, hot, dry skin, restlessness with asthenia
10 mg and over: Above symptoms to extreme degrees, plus ataxia, excitement, disorientation, hallucinations, delirium, and coma
65 mg: May be fatal[Ref]

Cardiovascular

Common (1% to 10%): Tachycardia (arrhythmias, transient exacerbation of bradycardia)
Very rare (less than 0.01%): Atrial arrhythmias, ventricular fibrillation, angina, hypertensive crisis
Frequency not reported: Bradycardia, slowing then acceleration of heart, palpitations, circulatory collapse, blood pressure declines, sinus tachycardia, supraventricular tachycardia, junctional tachycardia, ventricular tachycardia, ventricular flutter, ventricular fibrillation, atrial arrhythmia, atrial fibrillation, atrial ectopic beats, ventricular premature contractions, bigeminal beats, trigeminal beats, nodal extrasystole, supraventricular extrasystole, asystole, cardiac syncope, prolongation of sinus node recovery time, cardiac dilation, left ventricular failure, myocardial infarction, intermittent nodal rhythm (no P wave), prolonged P wave, shortened PR segment, R on T phenomenon, shortened RT duration, widening and flattening of QRS complex, prolonged QT interval, flattening of T wave, repolarization abnormalities, altered ST-T waves, retrograde conduction, transient AV dissociation, increased blood pressure, labile blood pressure, weak or impalpable peripheral pulses, paradoxical atrioventricular block[Ref]

Nervous system

Very common (10% or more): Loss of taste
Common (1% to 10%): Incoordination
Uncommon (0.1% to 1%): Seizure, drowsiness
Frequency not reported: Disturbance of speech, headache, asthenia, ataxia, coma, dizziness, tremor, locomotor difficulties, medullary paralysis, neurological abnormalities, lethargy, somnolence, syncope, runs of alpha waves on EEG, alpha waves (EEG) blocked upon opening eyes, seizures (generally tonic-clonic), abnormal movements, stupor, amnesia, diminished tendon reflexes, hyperreflexia, opisthotonos, Babinski's reflex/Chaddock's reflex, hypertonia, dysmetria, muscle clonus, sensation of intoxication, difficulty concentrating, vertigo, dysarthria, loss of taste, giddiness, staggering[Ref]

Ocular

Very common (10% or more): Visual disturbances (mydriasis, inhibition of accommodation, blurred vision, photophobia)
Frequency not reported: Blurring of near vision, pupils poorly reactive to light, decreased contrast sensitivity, decreased visual acuity, cycloplegia, strabismus, heterophoria, cyclophoria, acute angle closure glaucoma, conjunctivitis, keratoconjunctivitis sicca, blindness, tearing, dry eyes/dry conjunctiva, irritated eyes, crusting of eyelids, blepharitis, increase in photic stimulation on EEG, increase in intraocular pressure[Ref]

Gastrointestinal

Very common (10% or more): Dryness of mouth (difficulty swallowing and talking, thirst), parasympathetic inhibition of gastrointestinal tract (constipation and reflux), inhibition of gastric secretion, nausea, vomiting, bloated feeling
Frequency not reported: Abdominal distension, abdominal pain, paralytic ileus, decreased bowel sounds, delayed gastric emptying, decreased food absorption, dysphagia, retrosternal pain due to gastric reflux[Ref]

Dermatologic

Very common (10% or more): Anhidrosis, urticaria, rash
Common (1% to 10%): Flushing
Frequency not reported: Dry skin, hot skin, scarlatiniform rash, skin rashes, exfoliation, dry mucus membranes, warm skin, maculopapular rash, erythematous rash, sweating/moist skin, cold skin, cyanosed skin, salivation[Ref]

Psychiatric

Common (1% to 10%): Excitement, confusion, hallucinations
Uncommon (0.1% to 1%): Psychotic reactions
Frequency not reported: Restlessness, disorientation, delirium, loss of libido, delirium, depression, manic behavior, irritability, agitation, insomnia, agitation, paranoia, anxiety, mental disorders, mania, withdrawn behavior, behavior changes, nervousness[Ref]

Other

Common (1% to 10%): Hyperthermia
Frequency not reported: Death, fever, heat intolerance, impairment of temperature regulation (especially in a hot environment), fatigue, hyperpyrexia, chest pain, weakness, feeling hot, signs of drowsiness on EEG[Ref]

Genitourinary

Common (1% to 10%): Inhibition of parasympathetic control of the urinary bladder, urinary retention
Frequency not reported: Urinary hesitancy, impotency, difficulty in micturition, urine urgency, distended urinary bladder, bed wetting[Ref]

Hypersensitivity

Rare (less than 0.1%): Allergic reactions
Very rare (less than 0.01%): Anaphylaxis
Frequency not reported: Hypersensitivity[Ref]

Respiratory

Frequency not reported: Dryness of nose, respiratory failure, tachypnea, slow respirations, shallow respirations, inspiratory stridor, laryngitis, laryngospasm, pulmonary edema, subcostal recession, reduced bronchial secretions, formation of bronchial plugs[Ref]

Metabolic

Frequency not reported: Thirst, excessive thirst, dehydration, hyponatremia, hypokalemia, hypoglycemia, hyperglycemia[Ref]

Musculoskeletal

Frequency not reported: Muscle twitching[Ref]

Local

Frequency not reported: Pain at injection site, local swelling, injection site reaction, redness or other signs of irritation at the injection site[Ref]

Hematologic

Frequency not reported: Leukocytosis, elevated hemoglobin, elevated erythrocytes, low hemoglobin[Ref]

Renal

Frequency not reported: Elevated BUN[Ref]

Some side effects of atropine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Usual Adult Dose for Bradyarrhythmia

0.4 to 1 mg, IV, every 1 to 2 hours as needed
-Larger doses, up to a maximum of 2 mg, may be required

Use: To overcome severe bradycardia and syncope due to a hyperactive carotid sinus reflex

Usual Adult Dose for Anticholinesterase Poisoning

0.4 mg to 0.6 mg, IV, intramuscularly, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episode in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-To lessen the degree of atrioventricular heart block when increased vagal tone is a major factor in the conduction defect, as in some cases due to digitalis

Usual Adult Dose for Peptic Ulcer

0.4 mg to 0.6 mg, IV, intramuscularly, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episode in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-To lessen the degree of atrioventricular heart block when increased vagal tone is a major factor in the conduction defect, as in some cases due to digitalis

Usual Adult Dose for Radiographic Exam

1 mg, IM

Use: Relaxation of the upper gastrointestinal tract and colon during radiography

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