Muscarinic Antagonist (Atropine)
Atropine indication for use: atropine is used for treating low heart rates, hypersalivation, bronchial secretions, used to dilate the pupil, as well as a pain reliever caused by eye inflammation.
Mechanism of Action: Atropine competitively hinders the effect of acetylcholine, that is, by blocking the surplus acetylcholine due to the poisoning of organophosphorus at muscarinic cholinergic receptors in the central nervous system, smooth muscle, and secretory gland cells, among others.
Monitoring: the common side effect of atropine is tachycardia therefore, titrate atropine dose to effect when treating Brady dysrhythmia among individuals with coronary artery disease. Also, Atropine is associated with acute glaucoma hence is supposed to be prescribed with care to people with a history of acute glaucoma. Monitoring of atropine includes monitoring the symptoms associated with intraocular pressure. Muscarinic Antagonist (Atropine).
Side effects: dry mouth, urinary problems, fast heart rates, nausea, sweating, blurred vision, hypersensitivity reactions, tremors, and loss of balance (Avetisov et al., 2018). Atropine does not interact well with CAM such as bitter orange, Danshen, Ephedra, and Ginseng. Muscarinic Antagonist (Atropine).
Drug interactions: Acetylsalicylic acid (Aspirin), adrenalin, Ativan, Atrovent (ipratropium), Dextrose (glucose), Lasix (furosemide), Activated charcoal, Benadryl (diphenhydramine), and Haldol (haloperidol). Muscarinic Antagonist (Atropine).
Ethnic, cultural, and genetic Differences: atropine is the commonly used therapy for myopia (Chuang, et al., 2019). Research indicates that myopia progression is dependent on race, ethnicity, culture as well as genetics. Ethnic distinctions in the occurrence of myopia result from differences in ethnicities in axial length.
The ethnic group with high atropine usage in East Asia attributed to the coercion of the education sector in Asia leading to extended reading hours and less sunlight exposure, a risk factor for myopia (Luong et al., 2020). Myopia is a genetic condition as it involves hundreds of genes. There is a greater risk of having myopia if the immediate relatives had or have myopia as compared to non-infected individuals. Therefore the high rate of atropine usage among such individuals.
Other Considerations: there are several considerations physicians should observe when prescribing atropine including patient’s apical pulse before dosage administration, age as old adults are prone to CNS disturbances, an infant’s temperature when prescribing to an infant, monitor GI motility of the patient, the drug interaction in case a patient is on another medication and drug contradictions.
Muscarinic Antagonist (Atropine)
References
Avetisov, S. E., Fisenko, V. P., Zhuravlev, A. S., & Avetisov, K. S. (2018). Atropine is used for the prevention of myopia progression. Vestnik Oftalmologii, 134(4), 84-90.
Luong, T. Q., Shu, Y. H., Modjtahedi, B. S., Fong, D. S., Choudry,
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