Stanotropin

Indications

Atropine sulphate is used in two main ways:

• Eye drops and eye ointment: to widen (dilate) the pupil and relax the focusing muscle of the eye for eye examinations, especially in children, and to treat painful inflammation inside the eye (uveitis or iritis). Very low-strength drops are sometimes prescribed by eye specialists to slow short-sightedness (myopia) in children.
• Injection: used in hospitals before surgery to reduce saliva and airway secretions, to treat a dangerously slow heart rate, and as an antidote for poisoning by organophosphate insecticides and some nerve agents.

How It Works

Atropine is an anticholinergic (antimuscarinic) medicine. It blocks acetylcholine, a natural chemical messenger that narrows the pupil, slows the heart and increases secretions. Blocking it widens the pupil, speeds up the heart and dries up secretions.

Dosage and Administration

• Eye drops (usually 1%): as prescribed by the eye doctor. For inflammation in adults, commonly 1 drop into the affected eye up to 2 or 3 times a day. For examinations in children, use only as the eye doctor instructs. Low-strength myopia drops: as prescribed, usually once at bedtime.
• Eye ointment: as prescribed.
• Injection: given only by a doctor or nurse; the dose depends on the reason and the patient's weight and response.

After putting in drops, press gently on the inner corner of the eye for 1 to 2 minutes to reduce the amount that reaches the rest of the body. Wash your hands afterwards, especially when treating a child.

Interactions

Effects add up with other medicines that have anticholinergic effects, such as some antihistamines (Chlorpheniramine), tricyclic antidepressants (Amitriptyline), antipsychotics, Hyoscine and some medicines for Parkinson's disease, increasing dry mouth, constipation, urine retention and confusion. Atropine can reduce the effect of eye drops used to treat glaucoma (such as Pilocarpine) and can slow the absorption of other medicines taken by mouth.

Contraindications

Allergy to atropine; angle-closure glaucoma or a narrow drainage angle in the eye (risk of a sudden rise in eye pressure). For non-emergency use, also avoid in severe enlarged prostate with urine retention, bowel blockage and myasthenia gravis. In life-threatening poisoning or a very slow heart rate, the doctor may still use it.

Side Effects

Eye drops: stinging, blurred near vision and sensitivity to bright light, which can last 1 to 2 weeks with 1% drops; eyelid redness or swelling. If too much is absorbed: dry mouth, flushing, fever, fast heartbeat, constipation, difficulty passing urine, and restlessness or confusion, especially in young children and older people.

Get urgent medical help if you notice sudden eye pain with redness, headache, nausea and seeing haloes around lights (possible acute glaucoma), or if a child becomes hot, flushed, very restless, confused, or has a very fast heartbeat after using the drops.

Pregnancy and Lactation

Use in pregnancy only if a doctor decides it is needed. Small amounts may pass into breast milk and may reduce milk supply; use while breastfeeding only on medical advice.

Precautions and Warnings

Do not drive or use machines while your vision is blurred. Wear sunglasses in bright light. Remove soft contact lenses before using the drops. Use with extra care in babies, young children, people with Down syndrome, older people, and those with heart disease, high blood pressure, overactive thyroid or fever. Avoid getting overheated, as atropine reduces sweating. Do not touch the dropper tip to the eye.

Overdose

Swallowing eye drops, especially by a child, can be dangerous. Signs include dry hot flushed skin, fever, wide pupils, very fast heartbeat, confusion, agitation and hallucinations. Get emergency medical help straight away and take the bottle with you.

Therapeutic Class

Anticholinergic (antimuscarinic) agent; mydriatic and cycloplegic eye medicine; antidote.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Throw away eye drops 4 weeks after first opening.