ATROPINE SULPHATE (HP) Injection 1ml

INTRODUCTION ABOUT ATROPINE SULPHATE (HP) INJECTION

ATROPINE SULPHATE (HP) INJECTION contains Atropine which belongs to the group of
medicines called Anti-cholinergic drugs. It is used to restore normal heartbeat
during an event of cardiac arrest (heart stops working suddenly). It is often
used as a preanesthetic medication to manage the risk of sudden decrease in
heartbeat and to reduce saliva secretions during surgical procedures. It can
also be used in the poisoning caused due to certain substances like insecticides
or mushrooms. It is used in combination with other medicines to reverse the
effects of certain muscle relaxants (like vecuronium, rocuronium) given during
surgery. It can also reduce the overactivity of certain medicines (muscle
relaxants) used in the management of severe muscle disorders like myasthenia
gravis.

Atropine is an antimuscarinic agent. It works by blocking the effects of a
neurotransmitter called acetylcholine, which is responsible for causing
contraction of muscles, increase in body secretions, and decrease in heart rate.
As a result, it leads to stimulation of muscles, increase in heart rate, and
decrease in body secretions.

ATROPINE SULPHATE (HP) INJECTION is not recommended for use in patients
suffering from closed-angle glaucoma (increased eye pressure), an enlarged
prostate, myasthenia gravis, or any obstruction of gut. If you are pregnant or
breastfeeding, consult your doctor for advice before receiving ATROPINE SULPHATE
(HP) INJECTION. The most common side effects of ATROPINE SULPHATE (HP) INJECTION
are dry mouth, reduced sweating, blurred vision, constipation, increased heart
rate and confusion. Consult your doctor if any of the symptom worsens.

USES OF ATROPINE SULPHATE (HP) INJECTION

It is used:

• To restore normal heartbeat during emergency conditions like cardiac arrest
• As a preanesthetic medication to reduce salivary secretions
• To reverse the effect of muscle relaxants given during surgery
• To reduce the overactivity of certain medicines used to manage severe muscle disorders like myasthenia gravis
• As an antidote for insecticides and mushroom poisoning

HOW ATROPINE SULPHATE (HP) INJECTION WORKS

ATROPINE SULPHATE (HP) INJECTION is an antimuscarinic agent. It effectively
restores cardiac activity and body function by blocking the effects of a
neurotransmitter called acetylcholine in the body which is responsible for
various physiological functions (such as contraction of skeletal or smooth
muscles, increase in body secretions or bowel movements, and decrease in heart
rate). As a result, ATROPINE SULPHATE (HP) INJECTION stimulates skeletal
muscles, increases heart rate and reduces body secretions (such saliva, sweat,
bronchial and intestinal secretion) and bowel movements. This helps in restoring
cardiac activity during fatal conditions like cardiac arrest or poisoning,
reduces salivary secretion during surgical procedures and stimulates muscle
movements by counteracting the effects of muscle relaxants.

DIRECTIONS FOR USE

ATROPINE SULPHATE (HP) INJECTION will be given to you only by a doctor or a
nurse either into the vein (intravenously), muscle (intramuscularly), under the
skin (subcutaneously) or into the trachea (via endotracheal tube). Your doctor
will decide the correct dose and duration for you depending upon your age, body
weight, and disease condition.

SIDE EFFECTS OF ATROPINE SULPHATE (HP) INJECTION

COMMON

• Dryness of mouth
• Blurred vision
• Inability to tolerate light (photophobia)
• Rapid heartbeat
• Flushing
• Constipation
• Difficulty with urination
• Decreased sweating

RARE

• Delirium (confused thinking and reduced awareness of surroundings)

Consult your doctor if you experience any of the following side effects:

• Signs of allergic reaction (such as skin rash, itching, blistering, and peeling of skin, swelling of the eyelids, face or lips, sudden wheeziness, or difficulty in breathing)

HOW TO MANAGE SIDE EFFECTS

!### Constipation

Eat plenty of fiber rich foods such as fresh fruits, vegetables, and cereals and
drink plenty of water. Try to exercise more regularly. If you still feel
constipated, consult your doctor for advice.

!### Dry Mouth

Drink plenty of water and fruit juices. Consume soft foods with higher water and
fiber content. Artificial saliva can also be used in case of extreme dryness of
mouth. Consult your doctor if you experience dryness of mouth for prolonged
period.

WARNING & PRECAUTIONS

!### PREGNANCY

Monitoring requiredATROPINE SULPHATE (HP) INJECTION should not be used in pregnant women only if it
is clearly necessary by your doctor. Your doctor will prescribe ATROPINE
SULPHATE (HP) INJECTION only if the benefits are greater than any possible risk
to the unborn baby. Therefore, consult your doctor before receiving.

!### BREASTFEEDING

Monitoring requiredATROPINE SULPHATE (HP) INJECTION should be used in breastfeeding mothers only if
it is clearly necessary by your doctor. Your doctor will prescribe ATROPINE
SULPHATE (HP) INJECTION only if the benefits are greater than any possible risk
to the breastfeeding infant. Therefore, consult your doctor before receiving.

!### DRIVING AND USING MACHINES

Use with CautionDo not drive or operate any machines if your ability is affected by ATROPINE
SULPHATE (HP) INJECTION.

!### ALCOHOL

Consult your doctorAvoid consum
because it might increase dizziness and drowsiness.

!### KIDNEY

Use with CautionATROPINE SULPHATE (HP) INJECTION should be used with caution in patients with
kidney diseases. Consult your doctor before receiving.

!### LIVER

Use with CautionATROPINE SULPHATE (HP) INJECTION should be used with caution in patients with
liver diseases. Consult your doctor before receiving.

!### ALLERGY

ContraindicatedDo not receive ATROPINE SULPHATE (HP) INJECTION if you are allergic to Atropine.

!### LUNGS

Use with CautionATROPINE SULPHATE (HP) INJECTION should be taken with caution in patients having
chronic pulmonary disease (airflow to the lungs becomes restricted leading to
cough and breathlessness). Therefore, consult your doctor before receiving it.

!### HEART DISEASE

Use with CautionATROPINE SULPHATE (HP) INJECTION should be used with caution in patients with
heart diseases (such as high blood pressure, fast or irregular heartbeat,
angina, or heart failure) and in patients who had a heart transplantation.
Consult your doctor before receiving.

!### USE IN PEDIATRICS

Use with CautionATROPINE SULPHATE (HP) INJECTION should be used with caution in children and
adolescent (below 18 years), especially if they suffer from fever or when
surrounded by hot climate. Proper dose adjustments and careful monitoring are
required in such patients, as high doses of ATROPINE SULPHATE (HP) INJECTION can
cause CNS side effects.

!### USE IN GERIATRICS

Use with CautionATROPINE SULPHATE (HP) INJECTION should be used with caution in elderly patients
(65 years and above). Consult your doctor before receiving.

OTHERS

ATROPINE SULPHATE (HP) INJECTION is not recommended for use if you:

• Have myasthenia gravis (severe muscle weakness)
• Have toxic megacolon (swollen and inflamed colon causing stomach pain, bloating and fever)
• Have reflux esophagitis (inflammation of food pipe due to reflux of stomach acid)
• Have blockade or narrowing in the gut (ex. pyloric stenosis)
• Have paralytic ileus (paralysis of intestines that causes severe constipation and bloating)
• Have glaucoma (increased pressure in the eye)
• Have enlargement of the prostate gland

Before receiving ATROPINE SULPHATE (HP) INJECTION, inform your doctor if you:

• Have problems in mental and physical growth (ex. down's syndrome)
• Have an overactive thyroid gland
• Have diarrhea, heart burn or indigestion
• Have nerve damage
• Have ulcers or infections in the stomach or intestines
• Have hiatus hernia (protrusion of upper part of stomach into the chest)
• Have fever

INTERACTIONS

A. Drug-Drug interactions:

Before receiving ATROPINE SULPHATE (HP) INJECTION, inform your doctor if you are
taking any of the following medicines such as:

• Medicines used to manage abnormal heartbeat (ex. mexiletine, digoxin, disopyramide)
• Antihistamines (used to reduce allergic reactions) ex. diphenhydramine, chlorpheniramine
• Medicines used to manage depression such as tricyclic antidepressants (ex. amitriptyline, nortriptyline, doxepin)
• Anticholinesterase (used to reduce the activity of acetylcholine) ex. neostigmine or pyridostigmine)
• Medicines used to manage mental illness (ex. chlorpromazine, promethazine, haloperidol and droperidol)
• Amantadine (used to manage parkinsonism or viral infections)
• General anesthetics (used to induce loss of consciousness or sensation before surgery) ex. propofol
• Medicines used to manage nausea and vomiting (ex. domperidone)
• Ketoconazole (used to manage fungal infections)
• Medicines that dissolve slowly in your mouth (ex. sublingual tablets, chewable tablets or throat lozenges)

Overdosage:

ATROPINE SULPHATE (HP) INJECTION will be administered to you only by a doctor or
a nurse in a hospital, and so it is unlikely to receive an overdose. However,
consult your doctor or nurse if you experience any unpleasant symptoms such as
dry mouth or burning sensation in mouth, difficulty in swallowing, nausea,
vomiting, skin rash, dry or red skin, feeling sleepy, intolerance of light, high
body temperature, high blood pressure, irregular heart rate, breathing
difficulties, restlessness, hallucinations, severe confusion, excitement
(delirium), or convulsions.

SYNOPSIS

Drug	:	Atropine
Pharmacological Category	:	Muscarinic Receptor Antagonists
Therapeutic Indication	:	Restores heartbeat, reduces body secretions Manages Bradycardia, Stimulates muscle function Used in poisoning conditions
Dosage Forms	:	Eye Drops, Eye Ointment, Injection

MORE INFORMATION

STORAGE

• Keep ATROPINE SULPHATE (HP) INJECTION out of the sight and reach of children
• Store at room temperature

FAQs ABOUT ATROPINE SULPHATE (HP) INJECTION

Q: Can ATROPINE SULPHATE (HP) INJECTION be used for emergency conditions?

A: Yes. [GBNKEYWORD can be used during emergency conditions like cardiac arrest
to restore normal heartbeat. It can also use to manage poisoning caused due to
insecticides or mushrooms.

Q: What precautions do I need to follow while taking ATROPINE SULPHATE (HP) INJECTION?

A: Patients receiving ATROPINE SULPHATE (HP) INJECTION must inform their doctor
about their pre-existing disease conditions such as high blood pressure,
coronary artery disease, angina, chronic heart failure glaucoma, inflammation of
the stomach and intestines or blockade in the gut. Drink plenty of water or
fluid after receiving ATROPINE SULPHATE (HP) INJECTION, as it may lead to
increased dryness of mouth. Avoid concomitant use of other heart medicines with
ATROPINE SULPHATE (HP) INJECTION without consulting your as it may increase the
risk of side effects.

Q: Can ATROPINE SULPHATE (HP) INJECTION be given via tracheal route?

A: Yes. ATROPINE SULPHATE (HP) INJECTION can be given into the trachea (via an
endotracheal tube) if necessary. It must be administrated only the doctor or
nurse and cannot be self-administered. Your doctor will decide the correct dose
and suitable route of administration for you depending upon the severity of your
condition.

Q: Can ATROPINE SULPHATE (HP) INJECTION cause an increase in heart rate?

A: Yes. ATROPINE SULPHATE (HP) INJECTION is known to increase heart rate and is
used to restore your heart rate during emergency conditions like cardiac
failure. ATROPINE SULPHATE (HP) INJECTION should be used with caution in
patients with high blood pressure, coronary artery disease, and angina. Consult
your doctor before receiving.

Q: Can ATROPINE SULPHATE (HP) INJECTION cause high blood pressure?

A: Yes. ATROPINE SULPHATE (HP) INJECTION restores normal heartbeat by increasing
the blood pressure and so, it must be used with caution among patients having
heart diseases like high blood pressure, chest pain or heart attack. Consult
your doctor before receiving.

Q: Can ATROPINE SULPHATE (HP) INJECTION be used on infants?

A: ATROPINE SULPHATE (HP) INJECTION is generally not recommended for use in very
young children. Your doctor might suggest a low dose depending upon the child’s
age and body weight. Therefore, consult your doctor for advice.

Q: Can ATROPINE SULPHATE (HP) INJECTION cause dry skin?

A: Yes. ATROPINE SULPHATE (HP) INJECTION can cause dry skin in some individuals.
It is caused due to decreased secretion of sweat (anhidrosis). Patients who
received ATROPINE SULPHATE (HP) INJECTION are advised to keep their skin
hydrated always. Apply moisturizer generously to affected dry areas of the skin.
Drink plenty of water to keep yourself hydrated. Consult your doctor for advice
if you experience excessive skin dryness.

Q: Does ATROPINE SULPHATE (HP) INJECTION make your mouth dry?

A: Yes. ATROPINE SULPHATE (HP) INJECTION can cause dry mouth in some
individuals. Drink plenty of water and fruit juices. Consume soft foods with
higher water and fiber content. Artificial saliva can also be used in case of
extreme dryness of mouth. Consult your doctor if you experience dryness of mouth
for prolonged period.

REFERENCES

1. KD. Tripathi. Anticholinergic Drugs and Drugs Acting on Autonomic Ganglia.
   Essentials of medical pharmacology. Seventh edition. 2013. Page – 113-121.

2. Mohammed Joynal Abedin, Abdullah Abu Sayeed, Ariful Basher, Richard J
   Maude, Gofranul Hoque and M. A. Faiz. Open-Label Randomized Clinical Trial of
   Atropine Bolus Injection Versus Incremental Boluses Plus Infusion for
   Organophosphate Poisoning in Bangladesh. SpringerLink. February 2012. [Accessed
   on 22nd April
   2022]

3. Panagiotis V S Vasileiou, Evangelia Kouskouni and Theodoros Xanthos. Atropine
   in cardiac arrest. ResearchGate. October 2012. [Accessed on 22nd April
   2022]

4. Mercury Pharmaceuticals. Health Products Regulatory Authority. [Revised in
   March 2021] [Accessed on 22nd April
   2022]

5. Macarthys Laboratories Ltd, T/A Martindale Pharma. Electronic Medicines
   Compendium (EMC). [Revised in September 2018] [Accessed on 22nd April
   2022]

6. Macarthys Laboratories Ltd, T/A Martindale Pharma. Electronic Medicines
   Compendium (EMC). [Revised in September 2018] [Accessed on 22nd April
   2022]

7. Hospira, Inc. U.S. Food & Drug Administration. [Revised in October 2015]
   Accessed on 22nd April
   2022]

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