Overview
Atropine is an alkaloid originally synthesized from Atropa belladonna. It is a racemic mixture of d-and l-hyoscyamine, of which only l-hyoscyamine is pharmacologically active. Atropine is generally available as a sulfate salt and can be administered by intravenous, subcutaneous, intramuscular, intraosseous, endotracheal and ophthalmic methods. Oral atropine is only available in combination products. Atropine is a competitive, reversible antagonist of muscarinic receptors that blocks the effects of acetylcholine and other choline esters. It has a variety of therapeutic applications, including pupil dilation and the treatment of anticholinergic poisoning and symptomatic bradycardia in the absence of reversible causes. Atropine is a relatively inexpensive drug and is included in the World Health Organization List of Essential Medicines.
Indication
The intravenous, intramuscular, subcutaneous, intraosseous and endotracheal use of atropine is indicated for the temporary blockade of severe or life-threatening muscarinic effects. The intramuscular use of atropine in the form of a pen injector is indicated for the treatment of poisoning by susceptible organophosphorus nerve agents having cholinesterase activity as well as organophosphorus or carbamate insecticides in adult and pediatric patients. The ophthalmic use of atropine is indicated for mydriasis, cycloplegia, and penalization of the healthy eye in the treatment of amblyopia. In combination with difenoxin or diphenoxylate (tablets for oral use), atropine is indicated as adjunctive therapy in the management of acute nonspecific diarrhea.
Associated Conditions
- Amblyopia
- Atrioventricular Heart-block
- Bradycardia
- Bronchospasm
- Crying
- Detrusor Hyperreflexia
- Excessive bronchial secretion
- Hypertonic uterine contraction
- Hypertonicity of the small intestine
- Ocular Inflammation
- Parkinsonism
- Peptic Ulcer
- Poisoning by parasympathomimetics (cholinergics)
- Poisoning caused by mushrooms
- Poisoning caused by organophosphate anticholinesterase nerve agents
- Poisoning caused by organophosphorus pesticides
- Pylorospasm
- Rhinorrhoea
- Sinus Bradycardia
- Spasms
- Toxic effect of organophosphate and carbamate
- Hypermobility of the colon
- Laughing
- Life-threatening muscarinic side effects
- Muscarinic side effects
- Severe muscarinic side effects
Research Report
Atropine (DB00572): A Comprehensive Pharmacological and Clinical Monograph
Section 1: Introduction and Chemical Profile
1.1 Overview and Historical Context
Atropine is a tropane alkaloid and a potent, non-selective anticholinergic agent that functions as a competitive antagonist at muscarinic acetylcholine receptors. It is classified as a small molecule drug with the DrugBank ID DB00572.[1] As a cornerstone of modern pharmacology, its applications span numerous medical specialties, including emergency medicine, cardiology, anesthesiology, and ophthalmology.[2] Its profound importance in global health is underscored by its inclusion in the World Health Organization (WHO) List of Essential Medicines, a compilation of the most efficacious, safe, and cost-effective medications required for a basic health system.[1]
The history of Atropine is a compelling narrative that traces the journey of a natural product from ancient folk remedy to a scientifically validated and indispensable therapeutic agent. The physiological effects of plants containing Atropine have been recognized for millennia. As far back as the last century B.C., Cleopatra reportedly used extracts from the Egyptian henbane plant, which contains tropane alkaloids, to dilate her pupils for cosmetic allure.[4] This practice continued into the Renaissance, when women used the juice from the berries of the
Atropa belladonna plant for the same purpose. This cosmetic application gave the plant its name, which translates to "beautiful lady" in Italian.[4]
Clinical Trials
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Title | Posted | Study ID | Phase | Status | Sponsor |
---|---|---|---|---|---|
2021/10/25 | N/A | UNKNOWN | Buddhist Tzu Chi General Hospital | ||
2021/09/30 | Not Applicable | Active, not recruiting | |||
2021/08/16 | Phase 4 | UNKNOWN | Aya Sabry Mohamed Mohamed | ||
2021/05/26 | Not Applicable | Suspended | |||
2021/03/02 | Not Applicable | UNKNOWN | University Hospital, Linkoeping | ||
2021/01/07 | Not Applicable | Recruiting | |||
2020/11/24 | Phase 4 | Recruiting | |||
2020/11/12 | Not Applicable | Completed | |||
2020/08/10 | Not Applicable | Completed | Jun Xiao | ||
2020/05/19 | Phase 2 | Not yet recruiting | Amani Hassan Abdel-Wahab |
FDA Drug Approvals
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Approved Product | Manufacturer | NDC Code | Route | Strength | Effective Date |
---|---|---|---|---|---|
Akorn | 76478-015 | OPHTHALMIC | 10 mg in 1 mL | 5/2/2022 | |
NuCare Pharmaceuticals,Inc. | 68071-4063 | ORAL | 0.025 mg in 1 1 | 5/2/2023 | |
ProPharma Distribution | 84549-580 | INTRAMUSCULAR, SUBCUTANEOUS, INTRAVENOUS, ENDOTRACHEAL, INTRAMEDULLARY | 0.4 mg in 1 mL | 6/23/2025 | |
MWI | 13985-606 | OPHTHALMIC | 10 mg in 1 mL | 3/23/2015 | |
RedPharm Drug, Inc. | 67296-1675 | ORAL | 0.025 mg in 1 1 | 1/1/2019 | |
HF Acquisition Co LLC, DBA HealthFirst | 51662-1527 | INTRAVENOUS | 0.1 mg in 1 mL | 1/22/2024 | |
Henry Schein, Inc. | 0404-9989 | INTRAVENOUS | 1 mg in 1 mL | 9/5/2023 | |
Winder Laboratories LLC | 75826-127 | ORAL | 0.0194 mg in 5 mL | 10/10/2019 | |
Carilion Materials Management | 68151-0607 | ORAL | 0.0194 mg in 1 1 | 12/3/2013 | |
A-S Medication Solutions | 50090-6295 | OPHTHALMIC | 10 mg in 1 mL | 5/2/2022 |
EMA Drug Approvals
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Health Canada Drug Approvals
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Approved Product | Company | DIN | Dosage Form | Strength | Market Date |
---|---|---|---|---|---|
R.O.-ATROPINE | richmond pharmaceuticals inc. | 01901311 | Liquid - Ophthalmic | 1 % | 12/31/1992 |
MINIMS ATROPINE SULPHATE | bausch & lomb inc | 02148358 | Drops - Ophthalmic | 1 % / W/V | 12/31/1995 |
DONNATAL EXTENTABS | ayerst laboratories | 01909274 | Tablet (Extended-Release) - Oral | 0.0582 MG | 12/31/1991 |
CIMA AEMPS Drug Approvals
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