Atropine Sulfate Injection, USP is a sterile, isotonic solution of Atropine Sulfate in Water for Injection q. s. Sodium Chloride added for isotonicity. pH adjusted with Sulfuric Acid. Preservative free. Atropine is a white crystalline alkaloid which may be extracted from belladonna root and hyoscyamine or may be produced synthetically. It is used in the form of atropine sulfate because this compound has much greater solubility in water.
1. In the treatment of parkinsonism. Rigidity and tremor relieved by the apparently selective depressant action.
2. In the gastrointestinal tract to relieve pylorospasm, hypertonicity of the small intestine and the hypermotility of the colon.
3. To relieve hypertonicity of the uterine muscle.
4. To relax the spasm of biliary and uretered colic and bronchial spasm.
5. To diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders.
6. To control the crying and laughing episodes in patients with brain lesions.
7. In cases of closed head injuries which cause acetylcholine to be released or to be present in cerebrospinal fluid which in turn causes abnormal EEG patterns, stupor and neurological signs.
8. In the management of peptic ulcer.
9. In anesthesia to control excessive salivation and bronchial secretions.
10. To control rhinorrhea of acute rhinitis or hay fever.
11. As an antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata and in cases of anticholinesterase insecticide poisoning.
12. In poisoning by the organic phosphate cholinesterase inhibitors found in certain insecticides and by chemical warfare nerve gases, large doses of atropine relieve the muscarine-like symptoms and some of the central-nervous-system manifestations. Adults suspected of contact with organic phosphorus insecticides of the parathion type should be given atropine sulfate, 0.8 mg, intramuscularly. If an atropine effect is not apparent within thirty minutes or if definite symptoms of the poisoning occur (nausea, vomiting, diarrhea, pupillary constriction, pulmonary edema, fasciculations of eyelids and tongue, jerky ocular movements, and excessive sweating, salivation, and bronchial secretion), atropine sulfate, 2 mg, should be given intramuscularly at hourly intervals until signs of atropinization are observed. Up to two or three times this dose (4 to 6 mg) may be required in severe cases. Removing contaminated clothing, washing the skin, and commencing artificial respiration and supportive therapy are also indicated.
Published Studies Related to Atropine
Risk factors for progressive myopia in the atropine therapy for myopia study. 
DESIGN: Retrospective cohort study... CONCLUSIONS: Doctors and parents need to be aware that there is a small group of
Atropine for the treatment of childhood myopia: changes after stopping atropine
0.01%, 0.1% and 0.5%. 
DESIGN: Prospective randomized double-masked clinical trial... CONCLUSION: There was a myopic rebound after atropine was stopped, and it was
Intrathecal atropine to prevent postoperative nausea and vomiting after Cesarean section: a randomized, controlled trial. [2011.08]
BACKGROUND: Postoperative nausea and vomiting (PONV) is a common adverse effect of intrathecal morphine, especially after Cesarean section. This randomized controlled trial investigated the effects of intrathecal administration of a small-dose of atropine on postoperative nausea and vomiting after Cesarean section... CONCLUSION: Intrathecal atropine had a significant antiemetic effect, making it a useful adjunct for intrathecal opioid-related PONV.
Comparative study between atropine and hyoscine-N-butylbromide for reversal of detomidine induced bradycardia in horses. [2011.05]
REASONS FOR PERFORMING STUDY: Bradycardia may be implicated as a cause of cardiovascular instability during anaesthesia. HYPOTHESIS: Hyoscine would induce positive chronotropism of shorter duration than atropine, without adversely impairing intestinal motility in detomidine sedated horses... CONCLUSION: Hyoscine is a shorter acting positive chronotropic agent than atropine, but does not potentiate the impairment in intestinal motility induced by detomidine. Because of severe hypertension, routine use of anticholinergics combined with detomidine is not recommended. POTENTIAL RELEVANCE: Hyoscine may represent an alternative to atropine for treating bradycardia. (c) 2010 EVJ Ltd.
Addition of atropine to submaximal exercise stress testing in patients evaluated for suspected ischaemia with SPECT imaging: a randomized, placebo-controlled trial. [2011.02]
PURPOSE: To evaluate the effects of the addition of atropine to exercise testing in patients who failed to achieve their target heart rate (HR) during stress myocardial perfusion imaging with single-photon emission computed tomography (SPECT)... CONCLUSION: The addition of atropine at the end of exercise testing is more effective than placebo in raising HR to adequate levels, without additional risks of complications. The use of atropine in patients who initially failed to achieve their maximal predicted HR is associated with a higher probability of achieving a diagnostic myocardial perfusion study.
Clinical Trials Related to Atropine
Trial Comparing Atropine to Atropine Plus a Plano Lens for the Sound Eye for Amblyopia in Children 3 to <7 Years Old [Active, not recruiting]
The purpose of the study is:
- To compare the effectiveness and safety of weekend atropine augmented with a plano lens
for the sound eye versus weekend atropine alone for moderate amblyopia (20/40 to 20/100)
in children 3 to less than 7 years old.
- To provide data on the response of severe amblyopia (20/125 to 20/400) to atropine
treatment with and without a plano lens.
Trial Comparing Patching Versus Atropine for Amblyopia in 7 to < 13 Year Olds [Active, not recruiting]
The purpose of this study is:
- To compare the effectiveness of weekend atropine plus near activities and daily patching
plus near activities for moderate amblyopia (20/40 to 20/100) and severe amblyopia
(20/125 to 20/400) in improving vision in the amblyopic eye of 7 to <13 year olds.
- To determine the maximum improvement in vision of the amblyopic eye with each
- To determine whether amblyopia is associated with structural abnormalities of optic
nerve fiber layer.
Trial Comparing Daily Atropine Versus Weekend Atropine [Completed]
The goals of this study are:
- To compare the visual acuity outcome in the amblyopic eye after 17 weeks of daily use of
atropine versus weekend-only use of atropine.
- To compare the proportion of patients achieving a complete treatment response (defined
as amblyopic eye acuity >20/25 or equal to that of the sound eye in the absence of a
reduction in the sound eye acuity from baseline) with daily atropine versus weekend-only
Atropine for Prevention of Dysrhythmias Caused by Percutaneous Ethanol Instillation for Hepatoma Therapy [Completed]
Ultrasound guided percutaneous ethanol injection (PEI) is an established method in the
treatment of hepatocellular carcinoma (HCC) and considered a safe procedure with severe
complications occurring rarely. Previous studies revealed, that the occurrence of bradycardia
and sinuatrial blockage is quite frequent during ethanol instillation sometimes accompanied
by clinical complications such as unconsciousness, respiratory arrest or seizure like
symptoms. Study purpose is to evaluate whether the use of i. v. Atropine before starting
ethanol instillation can prevent dysrhythmias during instillation. Study design: randomized,
placebo controlled, double blinded study. Atropine or saline solution will be administered
intravenously to 40 patients immediately before starting percutaneous ethanol instillation. A
6 line ECG with limb leads will be recorded at rest and during ethanol instillation to reveal
possibly occurring dysrhythmias.
Adjunctive Atropine During Ketamine Sedation [Recruiting]
- Ketamine seems an obvious choice in the setting of an emergency department
- Ketamine leads to increased production of salivary and tracheal secretions
- Antisialagogues(atropine)therefore have been recommended as a routine adjunct
- We compare atropine with placebo as an adjunct to ketamine sedation in children
undergoing primary closure of lacerated wound
Reports of Suspected Atropine Side Effects
Blood Pressure Decreased (8),
Respiratory Depression (7),
Respiratory Arrest (7),
Acute Respiratory Distress Syndrome (5),
Acute Respiratory Failure (5),
Sinus Tachycardia (5),
Ventricular Arrhythmia (4), more >>