硫酸阿托品

用途

• Treating organophosphate toxicity
• Treating organophosphate toxicity
• As a preanesthetic adjuvant (geriatric patients)
• As a preanesthetic adjuvant
• As a preanesthetic adjuvant
• During cardiopulmonary cerebral resuscitation (CPCR) efforts
• Treatment of bradycardias
• Treatment of cholinergic toxicity
• As a premed
• As a preanesthetic
• Adjunctive treatment of bovine hypersensitivity disease
• Treatment of cholinergic toxicity (organophosphates)
• Treatment of bradyarrhythmias due to increased parasympathetic tone

給藥方式

可能的副作用

• Dry mouth (xerostomia)
• Dysphagia
• Constipation
• Vomiting
• Thirst
• Urinary retention or hesitancy
• CNS stimulation, drowsiness, ataxia, seizures, respiratory depression
• Blurred vision, pupil dilation (mydriasis), cycloplegia, photophobia
• Sinus tachycardia (at higher doses)
• Paradoxical bradycardia (initially or at very low doses)
• Hypertension or hypotension
• Arrhythmias (ectopic complexes)
• Decreased gut motility (can induce colic in horses or rumen stasis in cattle)

注意事項與禁忌

• Narrow-angle glaucoma
• Synechiae (adhesions) between the iris and lens
• Hypersensitivity to anticholinergic drugs
• Tachycardias secondary to thyrotoxicosis or cardiac insufficiency
• Myocardial ischemia
• Unstable cardiac status during acute hemorrhage
• GI obstructive disease or paralytic ileus
• Severe ulcerative colitis
• Obstructive uropathy
• Myasthenia gravis (unless used to reverse adverse muscarinic effects secondary to therapy)
• **General Precautions:** - Use with extreme caution in patients with known or suspected **GI infections**; decreased motility can prolong retention of causative agents or toxins. - Use with extreme caution in patients with **autonomic neuropathy**. - Use cautiously in patients with hepatic or renal disease, geriatric or pediatric patients, hyperthyroidism, hypertension, CHF, tachyarrhythmias, prostatic hypertrophy, or esophageal reflux. **Species-Specific Warnings:** - **Neonates**: Reportedly not effective in treating bradycardias in puppies <14 days old or kittens <11 days old. May damage hypoxic myocardia in neonates. - **Rabbits**: Glycopyrrolate is preferred, as ~40% of rabbits possess endogenous atropinesterase, rendering atropine ineffective. - **Horses**: Systemic use may decrease gut motility and induce colic. May reduce arrhythmogenic doses of epinephrine. - **Cattle**: May result in inappetence and rumen stasis persisting for several days. - **Food Animals**: FARAD recommends a 28-day meat and 6-day milk withdrawal time when used at doses up to 0.2 mg/kg.

藥物相互作用

• Amantadine: May enhance the activity or toxicity of atropine
• Anticholinergic agents (other): May enhance the activity or toxicity of atropine
• Antihistamines (e.g., diphenhydramine): May enhance the activity or toxicity of atropine
• Disopyramide: May enhance the activity or toxicity of atropine
• Meperidine: May enhance the activity or toxicity of atropine
• Phenothiazines: May enhance the activity or toxicity of atropine; do not use in atropine overdose
• Procainamide: May enhance the activity or toxicity of atropine
• Primidone: May enhance the activity or toxicity of atropine
• Tricyclic antidepressants (e.g., amitriptyline, clomipramine): May enhance the activity or toxicity of atropine
• Alpha-2 agonists (e.g., dexmedetomidine, medetomidine): Use with alpha-2 blockers may significantly increase arterial blood pressure, heart rates, and the incidence of arrhythmias. Concurrent use is controversial.
• Amitraz: Atropine may aggravate signs of amitraz toxicity, leading to hypertension and further inhibition of peristalsis

常見問題