Atropine respiratory effects

Since organophosphate toxicosis results in respiratory failure, the treatment approach for must include the maintenance of a patent airway. Artificial respiration may also need to be employed. The first pharmacological approach is the administration of atropine. Atropine competes with acetylcholine for its receptor site, thus reducing the effects of the neurotransmitter. N-methylpyridinium 2-aldoxime (2-PAM) is used in with atropine therapy as an effective means to restore the covalently bound enzyme to a normal state. It reacts with the phosphorylated cholinesterase enzyme removing the phosphate group. As previously mentioned, carbamates interact with cholinesterase by weak, ionic bonding thus 2-PAM is of no use to combat toxicosis caused by these compounds. However, atropine is effective to prevent the effects on respiration. 

The answer is local anesthetic properties it can block the initiation or conduction of a nerve impulse. It is biotransformed by plasma esterases to inactive products. In addition, cocaine blocks the reuptake of norepinephrine. This action produces CNS stimulant effects including euphoria, excitement, and restlessness Peripherally, cocaine produces sympathomimetic effects including tachycardia and vasoconstriction. Death from acute overdose can be from respiratory depression or cardiac failure Cocaine is an ester of benzoic acid and is closely related to the structure of atropine. 

Muscarine, an alkaloid from certain species of mushrooms, is a muscarinic receptor agonist. The compound has toxicologic importance muscarine poisoning will produce all of the effects that are associated with an overdose of ACh (e.g., bronchocon strict ion, bradycardia, hypotension, excessive salivary and respiratory secretion, and sweating). Poisoning by muscarine is treated with atropine. 

We used an additional analysis to support the estimated LD50/ID50 ratio for BZ. Upon reviewing the LD50 of several glycolates in the mouse, it appeared that the lethality of each closely paralleled its peripheral (as reflected in heart rate changes) rather than central effects (as reflected in performance decrements). This calls into doubt the opinion, voiced in previous textbooks of pharmacology, that death from belladonnoids such as atropine results from respiratory paralysis -primarily a central nervous system effect. 

All smooth muscle activity which is physiologically under a strong parasympathetic influence is effectively inhibited by atropine, for example in the gastrointestinal, genitourinary and respiratory tract. Parasympatholytics are very useful drugs in the treatment of spastic conditions (colic) in these regions. 

The first step in treatment of anticholinesterase poisoning should be injection of increasing doses of atropine sulfate to block all adverse effects resulting from stimulation of muscarinic receptors. Since atropine will not alleviate skeletal and respiratory muscle paralysis, mechanical respiratory support may be required. 

C. Atropine will not directly paralyze the respiratory muscles. However, it can prevent the detection of early signs of an overdose of neostigmine, which can quickly progress to a depolarizing block of skeletal muscle and paralysis of the respiratory muscles. Dry mouth, ocular disturbances, and tachycardia are common side effects of atropine given alone, but these effects are less likely to occur with competition between atropine and the increase in the synaptic ACh produced by inhibition of AChE by neostigmine. 

The overdose toxicity occurs when the high dose of drug is required for the specific treatment or the drug is taken accidentally or with the intention of suicide. The effects are predictable and dose related. For example delirium by the use of atropine and respiratory failure by morphine occur due to their overdoses. The well known antitubercular drug, streptomycin causes vestibular damage and deafness on prolonged use. 

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