MedPath

Atropine

Generic Name
Atropine
Brand Names
Atnaa, Atropen, Busulfex, Donnatal, Duodote, Enlon-plus, Isopto Atropine, Lomotil, Minims Atropine Sulphate, Motofen, Phenohytro
Drug Type
Small Molecule
Chemical Formula
C17H23NO3
CAS Number
51-55-8
Unique Ingredient Identifier
7C0697DR9I

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.

Background

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

FDA Approved Products

Atropine Sulfate
Manufacturer:Hospira, Inc.
Route:INTRAVENOUS
Strength:0.1 mg in 1 mL
Approved: 2020/06/30
NDC:0409-4910
Atropine Sulfate
Manufacturer:Medical Purchasing Solutions, LLC
Route:INTRAVENOUS, INTRAMUSCULAR, SUBCUTANEOUS
Strength:0.4 mg in 1 mL
Approved: 2023/05/31
NDC:71872-7037
ATROPINE SULFATE
Manufacturer:HF Acquisition Co LLC, DBA HealthFirst
Route:ENDOTRACHEAL, INTRAMEDULLARY, INTRAMUSCULAR, INTRAVENOUS, SUBCUTANEOUS
Strength:0.4 mg in 1 mL
Approved: 2024/01/28
NDC:51662-1619
DIPHENOXYLATE HYDROCHLORIDE AND ATROPINE SULFATE
Manufacturer:Direct Rx
Route:ORAL
Strength:0.025 mg in 1 1
Approved: 2016/06/22
NDC:61919-080
Diphenoxylate Hydrochloride and Atropine Sulfate
Manufacturer:A-S Medication Solutions
Route:ORAL
Strength:0.025 mg in 1 1
Approved: 2018/02/14
NDC:50090-0040

Singapore Approved Products

ATROPINE INJECTION BP 600 mcg/ml
Manufacturer:PFIZER (PERTH) PTY LTD
Form:INJECTION
Strength:600 mcg/ml
Online:Yes
Approved: 1993/03/15
Approval:SIN07360P
SUN-DIANOX TABLET
Manufacturer:SUNWARD PHARMACEUTICAL PRIVATE LIMITED, Sunward Pharmaceutical Sdn. Bhd.
Form:TABLET
Strength:0.025 mg
Online:Yes
Approved: 1996/12/20
Approval:SIN09095P
ALCON ATROPINE SULFATE EYE DROPS 1%
Manufacturer:ALCON-COUVREUR NV
Form:SOLUTION
Strength:1%
Online:Yes
Approved: 1990/04/17
Approval:SIN04140P
DHAMOTIL TABLET
Manufacturer:BEACONS PHARMACEUTICALS PTE. LTD.
Form:TABLET, FILM COATED
Strength:0.025 mg
Online:Yes
Approved: 1991/01/29
Approval:SIN05379P
MARTINDALE PHARMA ATROPINE SULFATE SOLUTION FOR INJECTION 600 MCG/ML
Manufacturer:Macarthys Laboratories Ltd T/A Martindale Pharma
Form:INJECTION, SOLUTION
Strength:600 mcg/ml
Online:Yes
Approved: 2019/01/11
Approval:SIN15611P

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