AL AYEN UNIVERSIRTY

FACULTY OF DENTISTRY

ATROPINE DROP
INTRODUCTION
• Atropine causes the muscles in your eye to become relaxed. This
widens (dilates) your pupil so that it will not respond to light.
• Atropine ophthalmic (for the eye) is used to dilate your pupils when
you have an inflammatory condition or in postsurgery situations in
which this effect may be helpful.
• Atropine ophthalmic is also used in people with a condition called
amblyopia (sometimes called "lazy eye"). Atropine ophthalmic can be
placed into the stronger eye to temporarily blur the vision in that eye.
This helps strengthen the weaker eye because the brain will force that
eye to work harder to focus.
Atropine Eye Drops

Generic Name: Atropine Eye Drops (A tro peen)

Brand Name: Atropin-Care
DOSAGE

• For inducing mydriasis (pupil dilation) or cycloplegia in adults: Instill

1-2 drops of 1% ophthalmic solution in eye 1 hour before procedure.
• For the treatment of inflammatory conditions of the eye
(iritis or uveitis) in adults: Instill 1-2 drops of 1% solution in eye up to
4 times per day
MORE INFORMATION
• Interaction with other medicinal products and other forms of interaction
• The effects of atropine may be enhanced by the concomitant use of other drugs
with antimuscarinic properties. Studies have indicated that the absorption of
atropine sulphate appears to be delayed by solutions of higher osmolarity.
• Fertility, pregnancy and lactation
• The safety for use in pregnancy and lactation has not been established, therefore,
use only when directed by a physician.
• effects on ability to drive and use machines
• May cause transient blurring of vision on instillation. Warn patients not to drive
or operate hazardous machinery until vision is clear.
ATROPINE HAS DIFFERENT DOSAGE FORM SUCH AS INJECTION , TAP , DROP ,etc
WORK MECHANISM OF ATROPINE
• In general, atropine counters the "rest and digest" activity of glands
regulated by the parasympathetic nervous system. This occurs because
atropine is a competitive, reversible antagonist of the muscarinic
acetylcholine receptors (acetylcholine being the main neurotransmitter
used by the parasympathetic nervous system). • Atropine is a competitive
antagonist of the muscarinic acetylcholine receptor types M1, M2, M3, M4
and M5.[29] It is classified as an anticholinergic drug (parasympatholytic). •
In cardiac uses, it works as a nonselective muscarinic acetylcholinergic
antagonist, increasing firing of the sinoatrial node (SA) and conduction
through the atrioventricular node (AV) of the heart, opposes the actions of
the vagus nerve, blocks acetylcholine receptor sites, and decreases
bronchial secretions.
• In the eye, atropine induces mydriasis by blocking contraction of the
circular pupillary sphincter muscle, which is normally stimulated by
acetylcholine release, thereby allowing the radial iris dilator muscle to
contract and dilate the pupil. Atropine induces cycloplegia by paralyzing
the ciliary muscles, whose action inhibits accommodation to allow accurate
refraction in children, helps to relieve pain associated with iridocyclitis, and
treats ciliary block (malignant) glaucoma. • The vagus (parasympathetic)
nerves that innervate the heart release acetylcholine (ACh) as their primary
neurotransmitter. ACh binds to muscarinic receptors (M2) that are found
principally on cells comprising the sinoatrial (SA) and atrioventricular (AV)
nodes. Muscarinic receptors are coupled to the Gi-protein; therefore, vagal
activation decreases cAMP. Gi-protein activation also leads to the
activation of KACh channels that increase potassium efflux and
hyperpolarizes the cells.
• Increases in vagal activities to the SA node decreases the firing rate of the pacemaker
cells by decreasing the slope of the pacemaker potential (phase 4 of the action
potential); this decreases heart rate (negative chronotropy). The change in phase 4 slope
results from alterations in potassium and calcium currents, as well as the slow-inward
sodium current that is thought to be responsible for the pacemaker current (If). By
hyperpolarizing the cells, vagal activation increases the cell's threshold for firing, which
contributes to the reduction in the firing rate. Similar electrophysiological effects also
occur at the AV node; however, in this tissue, these changes are manifested as a
reduction in impulse conduction velocity through the AV node (negative dromotropy). In
the resting state, there is a large degree of vagal tone on the heart, which is responsible
for low resting heart rates. • There is also some vagal innervation of the atrial muscle,
and to a much lesser extent, the ventricular muscle. Vagus activation, therefore, results
in modest reductions in atrial contractility (inotropy) and even smaller decreases in
ventricular contractility. • Muscarinic receptor antagonists bind to muscarinic receptors
thereby preventing ACh from binding to and activating the receptor. By blocking the
actions of ACh, muscarinic receptor antagonists very effectively block the effects of vagal
nerve activity on the heart. By doing so, they increase heart rate and conduction velocity
SIDE EFFECTS
• Patients may experience photophobia and eyes should be protected from bright light while the
pupils are dilated.
• Prolonged use of atropine eye drops may lead to local irritation, transient stinging, hyperaemia,
oedema and conjunctivitis. An increase in intra-ocular pressure may occur, especially in patients
with closed angle glaucoma.
• Hypersensitivity to atropine is not uncommon and may appear as a skin rash or conjunctivitis.
• Systemic toxicity may be produced by the instillation of the eye drops especially in infants and the
elderly. Reported symptoms include severe ataxia, restlessness, excitement and hallucinations.
• Other adverse effects may include a dry mouth with difficulty in swallowing and talking, flushing
and a dry skin, transient bradycardia followed by tachycardia, palpitations and arrhythmias,
reduced bronchial secretions, urinary urgency and retention and constipation.
• Side effects that occur occasionally include confusion (particularly in the elderly), nausea,
vomiting and giddiness.
‫أمنية رياض‬
‫سرى أحمد‬
‫تبارك عقيل‬