Atropine contraindications

Premedication atropine (1 ml/0.5 mg s.c.) about 15 minutes prior to the biopsy (paying due attention to atropine contraindications). (15)... 

Atropine contraindicated, especially when accompanied by wide-complex ventricular escape beats... 

Preanesthetic drugs may be omitted in those 60 years or older because many of the medical disorders for which these drugsare contraindicated are seen in older individuals For example, atropine and glycopyrrolate, drugs that can be used to decrease secretions of the upper respiratory tract, are contraindicated in certain medical disorders such as prostatic hypertrophy, glaucoma, and myocardial ischemia. Other preanesthetic drugs that depress the central nervous astern (CN, such as narcotics barbiturates and antianxiety drugs with or without antiemetic properties may be contraindicated in the older individual. 

Buscopan is a branded preparation containing hyoscine butylbromide, an antimuscarinic agent that reduces gastrointestinal motility. Antimuscarinic agents are contraindicated in cases of angle-closure glaucoma as they may aggrevate the condition. Hyoscine butylbromide is a quaternary ammonium compound, unlike atropine, which is a tertiary ammonium compound. 

Diphenoxylate (marketed in combination with atropine as Lomotil in the United States) is chemically related to both analgesic and anticholinergic compounds. It is as effective in the treatment of diarrhea as the opium derivatives, and at the doses usually employed, it has a low incidence of central opioid actions. Diphenoxylate is rapidly metabolized by ester hydrolysis to the biologically active metabolite difenoxylic acid. Lomotil is recommended as adjunctive therapy in the management of diarrhea. It is contraindicated in children under 2 years old and in patients with obstructive jaundice. Adverse reactions often caused by the atropine in the preparation include anorexia, nausea, pruritus, dizziness, and numbness of the extremities. 

Contraindications Not recommended in patients receiving routine administration of atropine or other belladonna derivatives. Not recommended in patients receiving mecamylamine. 

Contraindications History of hypersensitivity to atropine, soya lecithin, or related food products such as soybean and peanut... 

The central anticholinergic drugs having a higher central versus peripheral cholinergic action ratio are useful. The drugs like atropine are much less effective than levodopa but they are used when levodopa is not tolerated or contraindicated or the patient is not benefitted by levodopa or drug induced parkinsonism. 

Contraindications to the use of antimuscarinic drugs are relative, not absolute. Obvious muscarinic excess, especially that caused by cholinesterase inhibitors, can always be treated with atropine. 

Conditions that are contraindications to the use of atropine and related drugs are glaucoma and prostatic hypertrophy, in which cases they cause urinary retention. 

As a gastric secretagogue, alcohol stimulates the secretion of gastric juice, which is rich in acid and pepsin. Therefore, the consumption of alcohol is contraindicated in subjects with untreated acid-pepsin disease (Figure 68.2). In addition, alcohol releases histamine, which in turn releases gastric juice. This effect is not blocked by atropine. 

Contraindications Extremely toxic. Even moderate doses could be fatal. Root contains apoatropine which can be lethal even in small amounts, especially when taken orally. Use not recommended. See ATROPINE and SCOPOLAMINE. 

Contraindications Excessive amounts toxic. May cause blacking out and severe headaches. Yaqui Indian brujos claims that smoking or ingestion of flowers will cause insanity. See SCOPOLAMINE and ATROPINE. 

Antihistaminics are popular as nonprescription (over-the-counter) sleep remedies (e.g., diphenhydramine, doxylamine, p. 118), in which case their sedative side effect is used as the principal effect. The hypnotic effect is weak adverse effects (e.g., atropine-like) and corresponding contraindications need to be taken into account. 

Patients taking certain systemic medications are also more sensitive to the pressor effects of phenylephrine. In individuals taking atropine, the pressor effect of phenylephrine is augmented, and tachycardia can occur. Tricyclic antidepressants and monoamine oxidase (MAO) inhibitors also potentiate the cardiovascular effects of topical phenylephrine. The concomitant use of phenylephrine is contraindicated with these agents, even up to 21 days after cessation of MAO inhibitor therapy. Similarly, patients taking reserpine, guanethidine, or methyldopa are at increased risk for adverse pressor effects from topical phenylephrine because of denervation hypersensitivity accompanying the chemical sympathectomy. 

Atropine is contraindicated for patients who are hypersensitive to the belladonna alkaloids, have open-angle or angle-closure glaucoma, or have a tendency toward lOP elevations. Manufecturers recommended dosages should not be exceeded, particularly in infants, small children, and the elderly. Children with Down s syndrome demonstrate a hyperreactive pupillary response to topical atropine. 

Contraindications for homatropine are essentially the same as for atropine. As with atropine, very small amounts of homatropine have been detected in breast milk. According to the American Academy of Pediatrics, however, homatropine use is compatible with breast-feeding, but caution should be exercised when administering homatropine to nursing women. As with topical administration of atropine, homatropine can also induce CNS toxicity in the elderly. 

Box 33-2 Advantages, Indications, and Contraindications for Atropine Penalization in the Management of Amblyopia... 

Disadvantage is that absorption can occur, especially when there is tissue destruction so that systemic effects result, e.g. adrenal steroids and neomycin to the skin, atropine to the eye. Ocular administration of a P-adrenoceptor blocker may cause systemic effects (any first-pass elimination is bypassed) and such eye drops are contraindicated for patients with asthma or chronic lung disease. There is extensive literature on this subject characterised by expressions of astonishment that serious effects, even death, can occur. 

Intracardiac conduction disturbances should not be considered as absolute contraindications to epidural anesthesia there were only nine cases of sinus bradycardia, easily reversed with atropine sulfate, in 66 patients (123). However, rare cases of complete heart block and complete left bundle branch block have occurred (SEDA-21, 132) (124). 

Basic life-support measures must be maintained. The patient should be moved to fresh air, and exposed eyes and skin should be irrigated with large amounts of water. Atropine is used to counteract muscarinic side effects. Pralidoxime is contraindicated. Charcoal may be used to absorb methomyl. 

Adults After cyanosis is overcome, atropine sulfate should be used, 2 mg i.v. Doses should be repeated at 5-10 min intervals until signs of atropin-ization appear. This should be maintained for 24 h or longer if necessary. 2-PAM (pralidoxime chloride) should be given. Adult dose 1 g, slowly, intravenously. Contraindicated are morphine, aminophylline, theophylline, phenothiazine tranquilizers, and barbiturates. 

Induction of emesis is contraindicated in the case of parathion poisoning due to the early onset of respiratory depression and seizures. Gastric lavage may be indicated if performed immediately after parathion ingestion. Activated charcoal/cathartic therapy may be adopted to retard the absorption from the gastrointestinal tract. Atropine should be administered intravenously until atropinization is achieved. In adults, 2-5 mg kg should be administered every 10-15 min and in children 0.05 mg kg must be... 

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