Generic: - Discard product if it contains particulate matter, is cloudy, or discolored - Discard unused product within 24 hours of opening bottle - Store between 68 to 77 degrees F Atreza: - Store at room temperature between 59 to 86 degrees F Atropine Care : - Store between 36 to 77 degrees F Atropisol : - Store between 36 to 77 degrees F Isopto Atropine: - Store between 36 to 77 degrees F Ocu-Tropine: - Store at room temperature between 59 to 86 degrees F.
Atropine should not be used in patients with known atropine or other belladonna alkaloids hypersensitivity because they may develop an allergic or other adverse reaction, including anaphylaxis. NOTE: Intense flushing of the face blush area and trunk may occur after parenteral injection of atropine. This is called the 'atropine flush' and is not harmful when it occurs.
Use these formulations with caution in patients with known sulfite hypersensitivity in which sulfites may precipitate an allergic reaction. Atropine autoinjectors are indicated only for treatment of organophosphate or carbamate poisoning and are intended as an initial treatment of muscarinic symptoms.
Do not rely upon atropine to provide complete protection. Seek definitive medical care immediately. Preferably, persons with adequate training in the recognition and treatment of nerve agent or insecticide intoxication should administer the autoinjector; however, caregiver or self-administration is acceptable in an emergency situation when a trained provider is not available.
Use protective masks and clothing when available, evacuate from the contaminated environment immediately, and undertake decontamination as soon as possible.
Provide symptomatic support as needed e. Because of the potential for toxicity, systemic atropine should not be taken in amounts above prescription limits. Because atropine may cause blurred vision, drowsiness, or dizziness, patients should use caution when driving or operating machinery until they are aware of the effects of the drug. Use atropine with caution in patients with known cardiac disease including cardiac arrhythmias, congestive heart failure, coronary artery disease, angina, acute myocardial infarction, or other cardiac instabilities where an increase in heart rate could be detrimental.
Atropine-induced tachycardia may cause ischemia, extend or initiate myocardial infarcts, and stimulate ventricular ectopy and fibrillation. To minimize tachycardia, restrict the total dose of atropine to 2 to 3 mg maximum 0. Do not use atropine to treat sinus bradycardia in patients who have undergone heart transplant without evidence for autonomic reinnervation.
Atropine is ineffective for treatment of post heart transplant sinus node dysfunction because of denervation. Atropine should be used cautiously in patients with chronic lung disease CLD. The use of atropine can dry and thicken bronchial secretions in the respiratory tract, thereby aggravating respiratory infection, or asthma or chronic obstructive pulmonary disease COPD in some patients.
However, depending on the dosage and route of administration, antimuscarinics may have beneficial effect in some patients with pulmonary disease. Atropine is considered a potent bronchodilator. Atropine is extensively metabolized in the liver. Those with hepatic disease may be at increased risk for developing increased drug concentrations, with resultant side effects.
Use systemic formulations with caution. Antimuscarinics, including atropine, should be used with caution in patients with renal impairment or renal failure. Metabolites and unchanged drug are excreted in the kidneys. Additionally, the antimuscarinic actions of atropine may cause urinary retention and should be avoided in patients with prostatic hypertrophy, bladder obstruction, or urinary tract obstruction.
Atropine should be avoided in patients with myasthenia gravis, because the anticholinergic competes with the small amount of acetylcholine that has potential to act in the bodies of these patients. However, atropine may be administered if it is used to reduce the adverse muscarinic effects of a cholinesterase inhibitor.
Atropine should similarly be used with extreme caution in patients with autonomic neuropathy. Atropine should be administered with caution to patients with GI disease, including those with partial organic pyloric stenosis or GI obstruction e. Likewise, antimuscarinic use should be avoided in patients with ulcerative colitis, ileus, and intestinal atony because they decrease GI motility and can exacerbate these conditions.
Toxic megacolon may also be precipitated or aggravated. Use extreme caution in persons with suspected or known GI infection such as infectious diarrhea e. Also, atropine should be used with caution in patients with diarrhea that may be an early sign of incomplete GI obstruction, especially in patients with ileostomy or colostomy.
This drug should be used cautiously in patients with gastroesophageal reflux disease GERD or hiatal hernia associated with reflux esophagitis. Atropine may decrease gastric motility and relax the lower esophageal sphincter, promoting gastric retention and reflux. Although antimuscarinics have been used as adjunct treatment of peptic ulcer disease, there are no conclusive data that the drug aids in healing, decreases rate of recurrence, or prevents the complications of peptic ulcer.
In patients with gastric ulcer, antimuscarinics may delay gastric emptying and promote antral stasis. Avoid use of atropine in patients with closed-angle glaucoma as the drug, administered either systemically or ophthalmically, can increase intraocular pressure by inducing cycloplegia and mydriasis.
Atropine should be avoided in patients with synechia iris adhesion to the cornea or the capsule of the crystalline lens or increased intraocular pressure. The anticholinergic effect of atropine may also make the eyes dry; this can cause an increased lens awareness, or blurred vision for wearers of contact lenses. The use of lubricating drops may be necessary, or in severe cases discontinued use of contact lenses while taking this drug.
Atropine may suppress sweat gland activity which, in a warm environment or with strenuous exercise, can lead to hyperthermia and heat injury. Avoid conditions that elevate core body temperature e. Special care and close monitoring may be necessary when administering atropine and related antimuscarinic drugs to children and adolescents.
Neonates, infants, and young children are especially sensitive to the anticholinergic effects. Intoxication has been observed even upon conjunctival instillation in some circumstances. In a survey of children accidentally exposed to higher doses of atropine up to 0. Limited data with atropine injection use during pregnancy are insufficient to inform a drug associated risk of adverse developmental outcomes. Adequate animal development and reproduction studies have not been conducted with atropine.
There are risks to the fetus and mother associated with untreated severe or life-threatening muscarinic effects; life-sustaining therapy for the pregnant woman should not be withheld due to potential concerns regarding the effects of atropine on the fetus. In a cohort study of pregnancies in the first trimester and pregnancies in the second or third trimester, atropine injection use was not associated with an increased risk of congenital malformation.
In a surveillance study of newborns exposed to atropine injection in the first trimester, 18 major birth defects were observed when 16 were expected. No specific pattern of major birth defects was identified. In another surveillance study of 50 pregnancies in the first trimester, atropine injection use was not associated with an increased risk of malformations.
Atropine is systemically bioavailable after topical ocular administration. Use topical atropine ophthalmically during pregnancy only if the potential benefit justifies the potential risk to the fetus. Trace amounts of atropine have been reported in human breast milk after oral intake. There are no data on atropine concentrations in human milk after intravenous or ocular administration, the effects on the breast-fed infant, or the effects on milk production.
The elimination half-life of atropine is more than doubled in children less than 2 years of age. To minimize potential infant exposure to atropine after injection, a breast-feeding woman may pump and discard her milk for 24 hours after use before resuming to breast-feed her infant. Consider the developmental and health benefits of breast-feeding along with the mother's clinical need for ocular atropine and any potential adverse effects on the breast-fed child from topical ophthalmic administration of atropine.
Atropine may aggravate dental disease with chronic use because the anticholinergic effects may decrease salivary flow. Systemic forms of atropine should be used with caution in geriatric patients. The elderly are more likely to have medical conditions aggravated by the use of this drug, or to experience paradoxical CNS stimulation or anticholinergic adverse effects.
The anticholinergic effects of atropine may be significant and are additive with other anticholinergic medications. According to the Beers Criteria, the use of atropine as an antispasmodic agent is considered a potentially inappropriate medication PIM in geriatric patients and should be avoided due to strong anticholinergic activity and uncertain effectiveness.
Medications with anticholinergic properties, such as atropine, may cause many adverse effects that are common and problematic, especially in older individuals. The use of multiple medications with anticholinergic properties may be particularly problematic because of cumulative effects. Abatacept: Minor Because abatacept has been shown to potentiate the onset of respiratory infections, concomitant use of drugs that decrease mucociliary clearance should be used cautiously.
Anticholinergics, such as atropine, have been shown to be capable of depressing the mucociliary transport system. Acetaminophen; Caffeine; Dihydrocodeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when dihydrocodeine is used concomitantly with an anticholinergic drug. Opiates increase the tone and decrease the propulsive contractions of the smooth muscle of the gastrointestinal tract.
Prolongation of the gastrointestinal transit time may be the mechanism of the constipating effect. Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Clinicians should note that anticholinergic effects might be seen not only on GI smooth muscle, but also on bladder function, the eye, and temperature regulation.
Additive drowsiness may also occur when antimuscarinics are combined with sedating antihistamines. Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.
Acetaminophen; Chlorpheniramine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Chlorpheniramine; Dextromethorphan: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.
Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect.
Patients need to be asked whether they have taken pseudoephedrine before receiving atropine. Acetaminophen; Chlorpheniramine; Phenylephrine : Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect.
Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Acetaminophen; Codeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with an anticholinergic drug.
Acetaminophen; Dextromethorphan; Doxylamine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Acetaminophen; Dextromethorphan; Guaifenesin; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect.
Acetaminophen; Dextromethorphan; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Acetaminophen; Dextromethorphan; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect.
Acetaminophen; Diphenhydramine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Guaifenesin; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect.
Acetaminophen; Hydrocodone: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when hydrocodone is used concomitantly with an anticholinergic drug. Acetaminophen; Oxycodone: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when oxycodone is used concomitantly with an anticholinergic drug.
Acetaminophen; Pamabrom; Pyrilamine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Pentazocine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when pentazocine is used concomitantly with an anticholinergic drug. Acetaminophen; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect.
Aclidinium: Moderate Although aclidinium is minimally absorbed into the systemic circulation after inhalation, there is the potential for aclidinium to have additive anticholinergic effects when administered with other anticholinergics or antimuscarinics. Per the manufaturer, avoid concomitant administration of aclidinium with other anticholinergic medications, when possible. Aclidinium; Formoterol: Moderate Although aclidinium is minimally absorbed into the systemic circulation after inhalation, there is the potential for aclidinium to have additive anticholinergic effects when administered with other anticholinergics or antimuscarinics.
Acrivastine; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect. Alfentanil: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when alfentanil is used concomitantly with an anticholinergic drug. Alosetron: Major Concomitant use of alosetron and anticholinergics, which can decrease GI motility, may seriously worsen constipation, leading to events such as GI obstuction, impaction, or paralytic ileus.
Although specific recommendations are not available from the manufacturer, it would be prudent to avoid anticholinergics in patients taking alosetron. Aluminum Hydroxide: Moderate Antacids may inhibit the oral absorption of anticholinergics.
Simultaneous oral administration should be avoided when feasible; separate dosing by at least 2 hours to limit an interaction. Aluminum Hydroxide; Magnesium Carbonate: Moderate Antacids may inhibit the oral absorption of anticholinergics.
Aluminum Hydroxide; Magnesium Hydroxide: Moderate Antacids may inhibit the oral absorption of anticholinergics. Aluminum Hydroxide; Magnesium Hydroxide; Simethicone: Moderate Antacids may inhibit the oral absorption of anticholinergics.
Aluminum Hydroxide; Magnesium Trisilicate: Moderate Antacids may inhibit the oral absorption of anticholinergics. Amantadine: Major Amantadine may exhibit anticholinergic activity. Antimuscarinics, such as atropine, may potentiate the anticholinergic effects of amantadine, and may increase the risk of antimuscarinic-related side effects.
Ambenonium Chloride: Contraindicated Routine administration of atropine with ambenonium chloride is contraindicated. Belladonna derivatives, such as atropine, may suppress the parasympathomimetic symptoms of excessive gastrointestinal stimulation. This leaves only the more serious symptoms fasciculation and paralysis of voluntary muscles as signs of overdosage. Amoxapine: Moderate Depending on the specific agent, additive anticholinergic effects may be seen when amoxapine is used concomitantly with other anticholinergic agents.
Additive CNS effects are also possible when these drugs are combined with amoxapine. Antacids: Moderate Antacids may inhibit the oral absorption of anticholinergics. Aspirin, ASA; Butalbital; Caffeine; Codeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with an anticholinergic drug.
Aspirin, ASA; Caffeine; Dihydrocodeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when dihydrocodeine is used concomitantly with an anticholinergic drug.
Aspirin, ASA; Caffeine; Orphenadrine: Moderate The anticholinergic effects of atropine may be enhanced when combined with other commonly used drugs with moderate to significant anticholinergic effects including orphenadrine.
Clinicians should note that anticholinergic effects may be seen not only on GI smooth muscle, but also on bladder function, the eye, and temperature regulation. Aspirin, ASA; Carisoprodol; Codeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with an anticholinergic drug. Aspirin, ASA; Oxycodone: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when oxycodone is used concomitantly with an anticholinergic drug.
Atomoxetine: Major Atropine and atomoxetine should be combined cautiously in patients with known cardiac disease. Atropine or scopolamine may alter the heart rate; the predominant clinical effect is sinus tachycardia.
An additive effect on heart rate may occur as atomoxetine may elevate heart rate as well as blood pressure. Atropine; Difenoxin: Moderate Diphenoxylate is a synthetic opiate derivative that appears to exert its effect locally and centrally on the smooth mucle cells of the GI tract to inhibit GI motility and slow excess GI propulsion.
Atropine is commonly added in small amounts to these formulas for diarrhea as a deterrant to diphenoxylate abuse. However, therapeutic doses of systemic atropine may cause additive side effects. In some cases, constipation might occur, and effects on the CNS or bladder function may also be additive.
Atropine; Edrophonium: Major Coadministration of Atropine and Edrophonium Chloride can produce mutually antagonistic effects. Belladonna; Opium: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when opium is used concomitantly with an anticholinergic drug.
Benzhydrocodone; Acetaminophen: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when benzhydrocodone is used concomitantly with an anticholinergic drug.
Brompheniramine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Brompheniramine; Carbetapentane; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Moderate Drowsiness has been reported during administration of carbetapentane. An enhanced CNS depressant effect may occur when carbetapentane is combined with other CNS depressants including anticholinergics.
Brompheniramine; Dextromethorphan; Guaifenesin: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.
Brompheniramine; Dextromethorphan; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Brompheniramine; Guaifenesin; Hydrocodone: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when hydrocodone is used concomitantly with an anticholinergic drug.
Brompheniramine; Hydrocodone; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect.
Moderate Monitor patients for signs of urinary retention or reduced gastric motility when hydrocodone is used concomitantly with an anticholinergic drug.
Brompheniramine; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Brompheniramine; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect.
Brompheniramine; Pseudoephedrine; Dextromethorphan: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect. Buprenorphine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when buprenorphine is used concomitantly with an anticholinergic drug.
Buprenorphine; Naloxone: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when buprenorphine is used concomitantly with an anticholinergic drug. Bupropion: Moderate The anticholinergic effects of atropine may be enhanced when combined with other drugs with moderate to significant anticholinergic effects including bupropion.
Clinicians should note that antimuscarinic effects might be seen not only on GI smooth muscle, but also on bladder function, the eye, and temperature regulation. Additive drowsiness may also occur. Bupropion; Naltrexone: Moderate The anticholinergic effects of atropine may be enhanced when combined with other drugs with moderate to significant anticholinergic effects including bupropion.
Butalbital; Acetaminophen; Caffeine; Codeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with an anticholinergic drug. Butorphanol: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when butorphanol is used concomitantly with an anticholinergic drug.
Calcium Carbonate: Moderate Antacids may inhibit the oral absorption of antimuscarinics. Calcium Carbonate; Famotidine; Magnesium Hydroxide: Moderate Antacids may inhibit the oral absorption of antimuscarinics. Calcium Carbonate; Magnesium Hydroxide: Moderate Antacids may inhibit the oral absorption of antimuscarinics. Calcium Carbonate; Risedronate: Moderate Antacids may inhibit the oral absorption of antimuscarinics. Calcium Carbonate; Simethicone: Moderate Antacids may inhibit the oral absorption of antimuscarinics.
Cannabidiol: Moderate Monitor for excessive sedation and somnolence during coadministration of cannabidiol and atropine. CNS depressants can potentiate the effects of cannabidiol. Carbetapentane; Chlorpheniramine: Moderate Drowsiness has been reported during administration of carbetapentane.
Carbetapentane; Chlorpheniramine; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Carbetapentane; Diphenhydramine; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Carbetapentane; Guaifenesin: Moderate Drowsiness has been reported during administration of carbetapentane.
Carbetapentane; Guaifenesin; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Carbetapentane; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Carbetapentane; Phenylephrine; Pyrilamine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect.
Carbetapentane; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect. Carbetapentane; Pyrilamine: Moderate Drowsiness has been reported during administration of carbetapentane. Carbidopa; Levodopa: Minor The doses of antimuscarinics and levodopa may need to be adjusted when the drugs are given simultaneously. Through central antimuscarinic actions, anticholinergics can potentiate the dopaminergic effects of levodopa.
While some patients may benefit from this interaction, clinicians should be ready to decrease doses of levodopa if an antimuscarinic is added. Carbidopa; Levodopa; Entacapone: Minor The doses of antimuscarinics and levodopa may need to be adjusted when the drugs are given simultaneously.
Carbinoxamine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Carbinoxamine; Dextromethorphan; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect. Carbinoxamine; Hydrocodone; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect.
Carbinoxamine; Hydrocodone; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect. Carbinoxamine; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Carbinoxamine; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect.
Cenobamate: Moderate Monitor for excessive sedation and somnolence during coadministration of cenobamate and atropine. Concurrent use may result in additive CNS depression. Coadministration may increase the risk of anticholinergic and CNS depressant-related side effects. If concurrent use is necessary, monitor for excessive anticholinergic effects, sedation, and somnolence.
Cetirizine; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect.
Chlophedianol; Dexbrompheniramine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.
Chlophedianol; Dexchlorpheniramine; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect. Chlophedianol; Guaifenesin; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect.
Chlorcyclizine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Chlorpheniramine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Chlorpheniramine; Codeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with an anticholinergic drug.
Chlorpheniramine; Dextromethorphan: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Chlorpheniramine; Dextromethorphan; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Chlorpheniramine; Dextromethorphan; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect.
Chlorpheniramine; Dihydrocodeine; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Moderate Monitor patients for signs of urinary retention or reduced gastric motility when dihydrocodeine is used concomitantly with an anticholinergic drug.
Chlorpheniramine; Dihydrocodeine; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect. Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect. Chlorpheniramine; Hydrocodone: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when hydrocodone is used concomitantly with an anticholinergic drug.
Chlorpheniramine; Hydrocodone; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Chlorpheniramine; Hydrocodone; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect. Chlorpheniramine; Ibuprofen; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect.
Chlorpheniramine; Phenylephrine: Major Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. Chlorpheniramine; Pseudoephedrine: Major Atropine blocks the vagal reflex bradycardia caused by pseudoephedrine, and increases its pressor effect.
Chlorpromazine: Moderate Additive anticholinergic effects may be seen when anticholinergics are used concomitantly with phenothiazines, including chlorpromazine. Clinicians should note that antimuscarinic effects may be seen not only on GI smooth muscle, but also on bladder function, the eye, and temperature regulation. Additive drowsiness or other additive CNS effects may also occur. Design: Prospective, between subjects, experimental study. Setting: Vivarium.
Blood samples were drawn at regular intervals after atropine administration and analyzed for plasma atropine concentration. Pharmacokinetic parameters were obtained from modeling the plasma concentrations. Main outcome measurements: Pharmacokinetic parameters, maximum concentration Cmax and time to maximum concentration Tmax. Stop infusion if HR is greater than bpm. Do not give intra-arterially. Titrate to attain normoglycemia. Dextrose and insulin dosages are adjusted based on serum glucose and potassium concentrations.
Abrupt discontinuation of dextrose infusion is not recommended due to the risk of rebound hypoglycemia. Glucose concentrations less than D15 should be administered via a central vein to minimize risk of phlebitis and thrombosis.
May increase in increments of 2. Consider if poor peripheral perfusion, evidence of shock, or thready pulses after epinephrine and volume expansion and bicarbonate Administer into a central vein when possible.
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