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Atropine, a tropane alkaloid, is an enantiomeric mixture of d-hyoscyamine and l-hyoscyamine [35], with most of its physiological effects due to l-hyoscyamine, the 3(S)-endo isomer of atropine. Its pharmacological effects are due to binding to muscarinic acetylcholine receptors. It is an antimuscarinic agent.
[2] [3] It is a fixed-dose combination of the medications diphenoxylate, as the hydrochloride, an antidiarrheal; and atropine, as the sulfate, an anticholinergic. [1] It is taken by mouth. [2] Onset is typically within an hour. [4] Side effects may include abdominal pain, angioedema, glaucoma, heart problems, feeling tired, dry mouth, and ...
Organophosphate based nerve agent poisoning, such as VX, sarin, tabun, and soman (atropine is favoured in conjunction with an oxime, usually pralidoxime) [6] [7] Anticholinergics generally have antisialagogue effects (decreasing saliva production), and most produce some level of sedation, both being advantageous in surgical procedures. [8] [9]
When death occurs, it is most commonly due to respiratory failure due to paralysis of respiratory muscles and depression of central nervous system, which is responsible for respiration. For people affected by cholinergic syndrome, atropine sulfate combined with an oxime is used to combat the effects of the acute OP poisoning.
However, scopolamine has greater effects on the central nervous system (CNS) than atropine due to its ability to cross the blood–brain barrier. [4] At higher-than-therapeutic doses, atropine and scopolamine cause CNS depression characterized by amnesia, fatigue, and reduction in rapid eye movement sleep.
Side effects attributed to the atropine content (especially when taken in excess doses, or in children), include: flushing, dryness in many areas, urinary retention, insomnia, headache, anxiety, hyperthermia, and tachycardia. It is these side effects that make it undesirable for most patients to take higher amounts of the medicine.
Cyclopentolate [citation needed] or atropine can also be administered to reverse muscarinic and central nervous system effects of indirect cholinomimetic (anti-AChase) administration. It is on the World Health Organization's List of Essential Medicines. [3]
Atropine sulfate tablets are used in some circumstances to reduce salivation. The same for anticholinergic drugs which can be also a benefit because they decrease the activity of the acetylcholine muscarinic receptors and can result in decreased salivation. They may be prescribed by doctors in conjunction with behavior modification strategies.