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ATROJECT

ATROPINE INJ · by SURGE

ANTISPASMODIC & ANTICHOLINERGIC Anticholinergic, Antimuscarinics SURGE

Composition

Inj 50 mcg/500 mcg/0.6 mg/1 mg: Per ml: Atropine (assulphate) 50 mcg/500 mcg/0.6 mg/1 mg; solution; amp.

Indications & Dosage

Symptomatic relief of gastro-intestinal disorders characterized by smooth muscle spasm: Adult: 0.6-1.2 mg daily, dose to be taken at night. PREMEDICATION: BY IV INJ: Adults & Children above 12yrs: 300-600 mcg, to be administered immediately before induction of anaesthesia BY SC INJ, OR BY IM INJ: Adults & Children above 12yrs: 300-600 mcg, to be administered 30-60 minutes before induction of anaesthesia Intra-operative bradycardia: BY IVINJ: Adults & Children above 12yrs: 300-600 mcg, larger doses may be used in emergencies. Bradycardia due to acute massive over-dosage of beta-blockers: BY IV INJ: Adult: 3 mg Children: 40 mcg/kg (max. per dose 3 mg) Treatment of poisoning by organophosphorus Insecticide or nerve agent (in combination with Pralidoxime chloride): BY IV INJ: Adult: 2 mg every 5-10 minutes until the skin becomes flushed and dry, the pupils dilate, and bradycardia is abolished, frequency of administration dependent on the severity of poisoning. Children: 20 mcg/kg every 5-10 minutes (max. per dose 2 mg) until the skin becomes flushed and dry, the pupils dilate, and bradycardia is abolished, frequency of administration dependent on the severity ofpoisoning Control of muscarinic side-effects of neostigmine in reversal of competitive neuromuscular block: BY IV INJ: Adults & Children above 12 yrs: 0.6-1.2 mg Excessive bradycardia associated with beta-blocker use: BY IV INJ: Adult: 0.6-2.4 mg in divided doses (max. per dose 600 mcg) Bradycardia following myocardial infarction (complicated by hypotension): BY IV INJ: Adult: 500 mcg every 3-5 minutes; max. 3 mg per course

Compatibility

Incompatible with thiopental (Y-site administration), cimetidine/pentobarbital (in syringe), Compatibility when admixed: Incompatible with floxacillin, metaraminol, methohexital, norepinephrine.

Stability

Store injection at controlled room temperature of 15C-30C. Protect from light.

Contraindications

Hypersensitivity to atropine, tachycardia, thyrotoxicosis narrow angle glaucoma, obstructive disease of the GI tract, obstructive uropathy, prostatic hypertrophy, unstable cardiac rhythm.

Precautions

Antimuscarinics drugs used for premedication to general anaesthesia should only be administered by, or under professional supervision.Use with caution in children with spastic paralysis or brain damage.

Interactions

Anticholinergic agents may alter response to beta-adrenergic blockers.

Pregnancy

Caution advised.

Lactation

Caution advised. May suppress lactation; small amount present in milk.

Side Effects

Cardiac arrhythmia, atrioventricular dissociation, multiple ventricular ectopics, tachycardia, palpitations, hallucinations, confusion, drowsiness, fatigue,restlessness, ataxia delirium, headache, dry hot skin, thirst, dry mouth, impaired GI motility, tremor, blurred vision.