Atropine sulfate 0.1% ampoule 1ml №5

pharmachologic effect :
Cholinolytic.
Blocks m-cholinergic receptors. Causes mydriasis, accommodation paralysis, increased intraocular pressure, tachycardia, xerostomia. Inhibits the secretion of bronchial and gastric, sweat glands. Relaxes the smooth muscles of the bronchi, gastrointestinal tract, bile and urinary systems - antispasmodic effect. Excites (large doses) of the central nervous system. After i / v administration, the maximum effect appears after 2–4 minutes, after oral administration (in the form of drops) after 30 minutes. In the blood is 18% bound to plasma proteins. It passes through the BBB. Excreted by the kidneys (50% - unchanged).

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

Dosing regimen:
To eliminate the bradycardia in / in adults - 0.5-1 mg, if necessary, after 5 min, the introduction can be repeated; children - 10 mcg / kg.
For the purpose of premedication with i / m for adults - 400-600 mcg 45-60 minutes before anesthesia; children - 10 mcg / kg for 45-60 minutes before anesthesia.

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

Contraindications for use:
Hypersensitivity to atropine.

Use during pregnancy and lactation:
Atropine crosses the placental barrier. Adequate and strictly controlled clinical studies of the safety of atropine during pregnancy has not been conducted.
When a / in the introduction during pregnancy or shortly before birth may develop tachycardia in the fetus.
Atropine is found in breast milk in trace concentrations.

Application for violations of the liver:
Use caution when liver failure (decrease metabolism).

Application for violations of renal function:
Use caution in case of renal failure (risk of side effects due to decreased elimination).

Use in children:
Use with caution in chronic lung diseases, especially in young children and debilitated patients (reduction of bronchial secretion can lead to thickening of the secret and the formation of traffic jams in the bronchi); with brain damage in children, cerebral palsy, Down's disease (the reaction to anticholinergics is enhanced).

Use in elderly patients:
Use with caution in patients with diseases of the cardiovascular system, in which an increase in heart rate may be undesirable; with intestinal atony in elderly patients or weakened patients (possible obstruction), with prostatic hypertrophy without obstruction of the urinary tract, urinary retention or susceptibility to it or diseases involving obstruction of the urinary tract (including bladder neck due to prostatic hypertrophy) glands).

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, coronary artery disease, mitral stenosis, hypertension, acute bleeding; with thyrotoxicosis (possibly increased tachycardia); at elevated temperature (it may even increase due to the suppression of the activity of the sweat glands); with reflux esophagitis, hernia of the esophageal orifice of the diaphragm combined with reflux esophagitis (reduced motility of the esophagus and stomach and relaxation of the lower esophageal sphincter can help slow gastric emptying and enhance gastroesophageal reflux through the sphincter with impaired function); in diseases of the gastrointestinal tract, accompanied by obstruction - achalasia of the esophagus, pyloric stenosis (possibly reduced motility and tone, leading to obstruction and delay of the contents of the stomach),intestinal atony in elderly patients or debilitated patients (possible obstruction), paralytic intestinal obstruction; with an increase in intraocular pressure — a closed angle (mydriatic effect, leading to an increase in intraocular pressure, may cause an acute attack) and open-angle glaucoma (a mydriatic effect may cause some increase in intraocular pressure; correction of therapy may be required); in case of non-specific ulcerative colitis (high doses may inhibit intestinal peristalsis, increasing the likelihood of paralytic ileus of the intestine, in addition, the manifestation or aggravation of such a serious complication as toxic megacolon is possible); with dry mouth (prolonged use may cause further increase in the intensity of xerostomia); in liver failure (reduced metabolism) and renal failure (the risk of side effects due to reduced excretion); in chronic lung diseases, especially in young children and debilitated patients (reduction of bronchial secretion can lead to thickening of the secret and the formation of traffic jams in the bronchi); with myasthenia gravis (the condition may worsen due to the inhibition of the action of acetylcholine); prostatic hypertrophy without obstruction of the urinary tract, urinary retention or susceptibility to it or diseases accompanied by obstruction of the urinary tract (including bladder neck due to prostatic hypertrophy); with preeclampsia (possibly increased hypertension); brain damage in children, cerebral palsy, Down's disease (the reaction to anticholinergics is increasing).
Between doses of atropine and antacid preparations containing aluminum or Calcium carbonate, the interval should be at least 1 hour.
When subconjunctival or parabulbar administration of atropine, the patient should be given a Validol pill under the tongue in order to reduce tachycardia.

Influence on ability to drive motor transport and control mechanisms:
During the period of treatment, the patient must be careful when driving vehicles and doing other potentially dangerous activities that require increased concentration, psychomotor speed and good vision.

Drug Interactions:
With simultaneous ingestion with antacids containing aluminum or calcium carbonate, the absorption of atropine from the gastrointestinal tract decreases.
When used simultaneously with anticholinergic agents and agents possessing anticholinergic activity, the anticholinergic effect is enhanced.
With simultaneous use with atropine may slow absorption of zopiclone, meksiletina, reduced absorption of nitrofurantoin and its excretion by the kidneys. Increased therapeutic and side effects of nitrofurantoin are likely.
With simultaneous use with phenylephrine may increase blood pressure.
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 the blood plasma.

Atropine storage conditions
In the dark place at a temperature of no higher than 25 ° C.
Keep out of the reach of children.