Name of Drug

Atropine Sulfate

Classification
Mechanism of Action
Anticholinergic;
Parasympatholytic Acts by selectively
drug
blocking all
muscarinic responses
to acetylcholine,
whether excitatory or
inhibitory.
Antisecretory action
(vagolytic effect)
suppresses sweating,
lacrimation,
salivation, and
secretions from nose,
mouth, pharynx, and
bronchi. Blocks vagal
impulses to heart with
resulting decrease in
AV conduction time,
increase in heart rate
and cardiac output,
and shortened PR
interval. Atropine is a
potent bronchodilator
when
bronchoconstriction
has been induced by
parasympathomimetic
s. Produces mydriasis
(dilation of pupils)
and cycloplegia
(paralysis of
accommodation) by
blocking responses of
iris sphincter muscle
and ciliary muscle of
lens to cholinergic
stimulation.

Adverse Effects
Xerostomia; altered taste
perception; nausea;
vomiting; dysphagia;
heartburn, constipation;
bloated feeling; paralytic
ileus; gastroesophageal
reflux; urinary hesitancy
and retention; impotence;
blurred vision; mydriasis;
photophobia; cycloplegia;
increased intraocular
pressure; palpitations;
bradycardia (following low
doses of Atropine);
tachycardia (after higher
doses); headache; flushing;
nervousness; drowsiness;
weakness; dizziness;
insomnia; fever; severe
allergic reactions including
anaphylaxis, urticaria and
other dermal
manifestations; suppression
of lactation; nasal
congestion; decreased
sweating. Complete
anhidrosis cannot occur
because large doses would
be required, producing
severe side effects from
parasympathetic paralysis.

Indication
Atropine Sulfate
Injections, USP, is
indicated when
excessive (or
sometime normal)
muscarinic effects
are judged to be life
threatening or are
producing symptoms
sever enough to call
of temporary,
reversible
muscarinic
blockade.

Contraindication
Hypersensitivity
to belladonna
alkaloids;
synechiae; angleclosure glaucoma;
parotitis;
obstructive
uropathy, e.g.,
bladder neck
obstruction
caused by
prostatic
hypertrophy;
intestinal atony,
paralytic ileus,
obstructive
diseases of GI
tract, severe
ulcerative colitis,
toxic megacolon;
tachycardia
secondary to
cardiac
insufficiency or
thyrotoxicosis;
acute
hemorrhage;
myasthenia
gravis. Safety
during pregnancy
(category C) or
lactation is not
established.

Nursing Responsibilities
Monitor patients with Down Syndrome
for anticholinergic crisis. (These patients
may be more sensitive to Atropine.
Monitor for signs of anticholinergic
crisis, which result from overdosage:
fever, tachycardia, difficulty
swallowing, ataxia, reduced urine
output, psychomotor agitation,
confusion, hallucinations.
Observe for side effects.These
symptoms occur due to drugs action on
the ANS.
Caution patients that atropine impairs
heat regulation due to direct blockade of
the muscarinic receptors on the sweat
glands.
Inform male patients with benign
prostatic hypertrophy that atropine may
cause urinary hesitancy and retention
Monitor patients routinely for abdominal
distention and auscultate for bowel
sounds due to muscarinic blockade on
the tone and motility of intestinal
smooth muscle.
Use cautiously with the elderly or very
young.