Atropine is used to treat slow heart rate (bradycardia) and insecticide poisoning. It can also be used before an eye exam or as a premedication before an anesthetic procedure.
In addition, this drug can also be used in the treatment of irritable bowel syndrome (IBS) or diverticulitis. Atropine is an anticholinergic drug. This drug will increase heart rate, relax the intestines, and reduce mucus production, by blocking the action of chemicals, such as acetylcholine and choline ester
Atropine is available in the form of tablets, injections, and eye drops. Atropine eye drops are usually used to relieve pain from inflammation of the center of the eye and to relax the eye muscles before an eye exam.
Atropine trademarks: Atropine, Atropine Sulfate, Cendro Tropine
What is Atropine
| group | Prescription drugs |
| Category | Anticholinergic |
| Benefit | Treat bradycardia or organophosphate insecticide poisoning, as a drug before eye examinations, and as a premedication before anesthetic procedures |
| Used by | Adults and children |
| Atropine for pregnant and lactating women | Category C: Animal studies have shown adverse effects on the fetus, but there are no controlled studies in pregnant women. Drugs should only be used if the expected benefit outweighs the risk to the fetus. Atropine can be absorbed into breast milk. For breastfeeding mothers, it is recommended to consult a doctor before using this drug. |
| Drug form | Tablets, injections, eye drops |
Precautions Before Using Atropine
Before using this medicine, you need to pay attention to the following things:
- Do not use atropine if you are allergic to this drug. Tell your doctor about any allergies you have.
- Tell your doctor if you have angle-closure glaucoma, paralytic ileus, enlarged prostate, pyloric stenosis, or myasthenia gravis. Atropine should not be given to patients with these conditions.
- Tell your doctor if you have or have had urinary problems, diarrhea, reflux esophagitis, constipation, heart disease, asthma, liver disease, chronic obstructive pulmonary disease, hypertension, thyroid disease, kidney disease, or Down's syndrome.
- Do not drive a vehicle or do activities that require alertness while you are taking atropine, as this medicine can cause blurred vision.
- Avoid being exposed to hot weather or exercising for too long, as atropine can reduce sweat production and make you more susceptible to heat stroke (heat stroke).
- Tell your doctor if you are taking certain medications, supplements, or herbal products.
- Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.
- See your doctor right away if you have an allergic drug reaction, serious side effect, or overdose after using atropine.
Dosage and Rules for Use of Atropine
The dose of atropine prescribed by a doctor can be different for each patient. The following are atropine doses based on the patient's condition, form of drug, and age:
Condition: Bradycardia
Shape: Inject
- Mature: 0.5 mg, every 3-5 minutes. The maximum dose is 3 mg.
- Children: 0.02 mg/kg, every 5 minutes. The maximum dose is 0.5 mg per dose.
Condition: Organophosphate insecticide poisoning
Shape: Inject
- Mature: 1–2 mg, every 5–60 minutes until the toxic effect wears off. For severe poisoning conditions, will be given 2-6 mg every 5-60 minutes until the symptoms of poisoning disappear. The maximum dose is 50 mg in the first 24 hours.
- Children: 0.05–0.1 mg/kgBW, given every 5-10 minutes until the toxic effect disappears.
Condition: Premedication before anesthetic procedure
Shape: Inject
- Mature: 0.3–0.6 mg, 30–60 minutes before anesthetic administration.
- Children<3kg: 0.1 mg, 30–60 minutes before anesthetic administration.
- Children7–9 kg: 0.2 mg, 30–60 minutes before anesthetic administration.
- Children12–16 kg: 0.3 mg, 30–60 minutes before anesthetic administration.
- Children>20kg: 0.4–0.6 mg, 30–60 minutes before anesthetic administration.
Condition: diverticulitis, irritable bowel syndrome (IBS), nonulcer dyspepsia
Shape: Tablet
- Mature: 0.6–1.2 mg, once daily, taken at night before bed.
Condition: Inflammation of the middle eye (uveitis)
Form: Eye drops
- Mature: 1-2 drops of 1% atropine solution, 4 times a day.
- Children: 1 drop of 1% atropine solution, 3 times a day.
Condition: Before eye exam
Form: Eye drops
- Mature: 1–2 drops of 1% atropine solution, 40–60 minutes before the procedure.
- Children: 1 drop of 1% atropine solution, for 1-3 days before the procedure.
How to Use Atropine Correctly
Follow the doctor's advice and read the information listed on the drug packaging label before using atropine. Do not reduce or increase the dose without consulting your doctor first.
Injectable atropine will be given by injection through a vein (intravenous/IV), into a muscle (intramuscularly/IM), or under the skin (subcutaneously/SC) by a doctor or medical officer under the supervision of a doctor.
Atropine tablets can be taken before or after meals. Try to take atropine regularly at the same time each day. It is recommended to take the drug before going to bed.
To use atropine eye drops, there are several steps that need to be considered, namely:
- Wash hands with soap and water until clean.
- Tilt your head so that your face is facing upwards and gently pull your lower eyelid down with your fingers.
- Bring the tip of the dropper bottle close to the eye, but do not touch the eyeball, then drop the liquid by pressing the medicine bottle.
- Close your eyes for 2-3 minutes to allow the atropine drops to spread throughout the eye. Do not blink or rub your eyes with your hands.
- Apply a little pressure and wipe off excess fluid around the eyes with a tissue.
- Do the same for the other eye.
- After the atropine is finished, wash your hands thoroughly.
If you are using more than one drop in the same eye, wait at least 10 minutes after using atropine.
Do not use atropine eye drops while wearing contact lenses. Wait at least 15 minutes after using the medication before putting on contact lenses.
If you forget to take a tablet or use atropine drops, it is advisable to do it immediately if the break with the next schedule of use is not too close. If it is close, ignore it and do not double the dose.
Store atropine at room temperature and in a closed container to avoid sun exposure. Keep this medicine out of reach of children.
Atropine Interactions with Other Drugs
The following are some of the drug interactions that can occur when atropine is used with certain drugs:
- Decreased absorption of ketoconazole or mexiletine in the body
- Increased antimuscarinic effect when used with amantadine, antiarrhythmics, antipsychotics, tricyclic antidepressants, antiparkinson's, MAOIs, antispasmodics, or some drugs in the antihistamine class, such as promethazine
- Increased risk of severe constipation or side effects when taking opioid medications, such as codeine or fentanyl
- Decreased therapeutic effect of carbachol, neostigmine, or pilocarpine
- Decreased action of slow-release antiglaucoma drugs, such as echothiopate, to shrink the pupil
- Increased toxic effects of myasthenia gravis drugs, potassium citrate, or potassium supplements
- Decreased effect of cisapride, domperidone, or metoclopramide on gastrointestinal movement
Side Effects and Dangers of Atropine
Some of the side effects that may occur after using atropine are:
- Dry mouth, nose or throat
- Constipation
- Fast heart rate
- Hyperthermia
- Blurred vision or eyes that are sensitive to light
- Dizziness, headache, or drowsiness
Check with your doctor if the side effects mentioned above don't go away or get worse. See your doctor right away if you have an allergic reaction to a drug or a more serious side effect, such as:
- Unusual tired
- Fast, irregular heartbeat, or palpitations
- Restless or confused
- Nausea, vomiting, stomach pain, or a full or bloated stomach
- Eye pain, blurred vision, or seeing a halo
- Difficult to urinate
- Skin feels hot and dry
- Tremors, balance problems, or movement disorders
- Dizziness so heavy that you want to pass out