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Klinische Monatsblatter Fur... Apr 2018The prevalence of myopia has increased worldwide in recent decades. In East Asia's metropolises ≥ 80% of young adults are affected. This dramatic increase is mainly... (Review)
Review
The prevalence of myopia has increased worldwide in recent decades. In East Asia's metropolises ≥ 80% of young adults are affected. This dramatic increase is mainly caused by changes in lifestyle and behaviour. Atropine has been used for more than 100 years to arrest myopia progression. It has become an evidence-based treatment regimen in the last decade, although the exact mechanism of the effect of treatment is still unknown. Atropine eye drops can slow myopia progression by an average of - 0.54 dioptres (D)/year in Asian children and - 0.35 D/year in Caucasian children. However, a non-response rate of about 10% has been found. Treatment should be established in schoolchildren only (age ≥ 6 years) with myopia ≤ - 2 D (spherical equivalent, cycoplegic refraction) and with documented myopic progression of - 0.5 D in the preceding year. 0.01% eyedrops should be instilled into the lower fornix at bedtime. Atropine 0.01% therapy is well tolerated. Atropine is usually administered for 2 years since efficacy is somewhat better in the second year. During treatment, a 6-month follow-up with cycoplegic refraction and axial length measurement is recommended. After the 2-year period, atropine withdrawal is justified if progression is less than - 0.25 D/year in the second year. Even after atropine has been stopped, follow-up examinations are needed to detect any rebound. Atropine-therapy is resumed if progression is again higher than - 0.5 D/year. Topical atropine is used off-label.
Topics: Age Factors; Atropine; Axial Length, Eye; Child; Disease Progression; Follow-Up Studies; Guideline Adherence; Humans; Myopia; Ophthalmic Solutions; Prospective Studies; Randomized Controlled Trials as Topic; Refraction, Ocular
PubMed: 29270929
DOI: 10.1055/s-0043-121982 -
La Revue Du Praticien Jan 1998
Topics: Atropine; Drug Interactions; Humans; Patient Selection
PubMed: 9781216
DOI: No ID Found -
Krankenpflege Journal 1987
Topics: Atropine; Humans
PubMed: 3645165
DOI: No ID Found -
ACS Chemical Neuroscience May 2019Anticholinergic drugs based on tropane alkaloids, including atropine, scopolamine, and hyoscyamine, have been used for various medicinal and toxic purposes for... (Review)
Review
Anticholinergic drugs based on tropane alkaloids, including atropine, scopolamine, and hyoscyamine, have been used for various medicinal and toxic purposes for millennia. These drugs are competitive antagonists of acetylcholine muscarinic (M-) receptors that potently modulate the central nervous system (CNS). Currently used clinically to treat vomiting, nausea, and bradycardia, as well as alongside other anesthetics to avoid vagal inhibition, these drugs also evoke potent psychotropic effects, including characteristic delirium-like states with hallucinations, altered mood, and cognitive deficits. Given the growing clinical importance of anti-M deliriant hallucinogens, here we discuss their use and abuse, clinical importance, and the growing value in preclinical (experimental) animal models relevant to modeling CNS functions and dysfunctions.
Topics: Animals; Atropine; Cholinergic Antagonists; Hallucinations; Humans; Nausea; Scopolamine; Vomiting
PubMed: 30566832
DOI: 10.1021/acschemneuro.8b00615 -
Der Anaesthesist May 1965
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Ugeskrift For Laeger May 1994
Topics: Atropine; Child; Humans; Preanesthetic Medication
PubMed: 8023418
DOI: No ID Found -
Annals of Emergency Medicine Sep 1984Bradyarrhythmias, with or without hypotension, may be associated with acute myocardial infarction, especially inferior. The early use of atropine in the management of...
Bradyarrhythmias, with or without hypotension, may be associated with acute myocardial infarction, especially inferior. The early use of atropine in the management of sinus bradycardia, with associated hypotension, spurred a continuing controversy that has found only partial solution in animal models. Experimentally there is increased sensory and autonomic motor activity with acute coronary occlusion. For example, in the cat, increased cholinergic activity was evidenced by the absence of bradycardia with atropinization and vagotomy, although these pretreatments accelerated the onset of significant ventricular arrhythmias. Atropine in experimentally infarcted dogs increased ischemia, while elevated heart rates reduced the threshold for ventricular fibrillation (VF) and vagal stimulation increased the threshold for VF, largely independent of heart rate. Specific clinical studies failed to support much of the animal data, although reports of tachyarrhythmias and VF resulting from the administration of atropine extended the controversy. The animal models, in the main, failed to mimic the clinical situation, for: 1) pentobarbital, with its propensity to alter some autonomic reflexes, dominated earlier work; 2) relatively large doses of atropine were employed; 3) the animals were presumed to be free of coronary and cardiac disease, factors known to influence autonomic reflexes; and 4) vagotomy and atropinization commonly preceded the acute occlusion.
Topics: Animals; Atropine; Bradycardia; Cats; Disease Models, Animal; Dogs; Hemodynamics
PubMed: 6476548
DOI: 10.1016/s0196-0644(84)80446-1 -
Nursing Nov 1988
Topics: Atropine; Humans
PubMed: 3211411
DOI: 10.1097/00152193-198811000-00017 -
The Journal of Pharmacy and Pharmacology Oct 1986A metabolic pattern of atropine in man, based on the detection of radiolabelled products in urine by high performance liquid chromatography after administration of...
A metabolic pattern of atropine in man, based on the detection of radiolabelled products in urine by high performance liquid chromatography after administration of [3H]atropine sulphate to a normal volunteer is proposed. Noratropine (24%), atropine-N-oxide (equatorial isomer) (15%), tropine (2%) and tropic acid (3%) appear to be the major metabolites, while 50% of the administered dose is excreted as apparently unchanged atropine. No conjugates were detectable. Evidence that atropine is present as (+)-hyoscyamine was found, suggesting that stereoselective metabolism of atropine probably occurs.
Topics: Atropine; Atropine Derivatives; Biotransformation; Chromatography, High Pressure Liquid; Chromatography, Thin Layer; Humans; Phenylpropionates; Stereoisomerism; Tropanes
PubMed: 2879005
DOI: 10.1111/j.2042-7158.1986.tb04494.x -
Klinische Monatsblatter Fur... Oct 2022The aim of this study was to evaluate traffic safety of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses in combination therapy with atropine.
BACKGROUND
The aim of this study was to evaluate traffic safety of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses in combination therapy with atropine.
PATIENTS AND METHODS
12 young adults (age: 24 - 45; 30,1 ± 5,7 years) were recruited to evaluate corrected distance visual acuity (CDVA), contrast sensitivity (CS; FrACT), glare sensitivity (Mesotest) under the influence of DIMS spectacle correction alone and combination therapy with 0,01% atropine.
RESULTS
When looking through the central area of the DIMS lens, far vision does not decrease due to the influence of atropine; influence of glare and atropine leads to a reduction of CDVA by 0.10 logMAR. When forced to look through the DIMS area, far vision is reduced by 0.09 logMAR due to the influence of atropine in the absence of glare; in the presence of glare, no further loss of visual acuity can be observed under the influence of atropine. Contrast vision with DIMS glasses is not altered by the effects of atropine. Concerning glare sensitivity, DIMS lenses did not show any visual impairment that would be relevant to vision and road safety. Additional atropinization does not affect glare sensitivity.
CONCLUSION
DIMS spectacle lenses are safe for participation in road traffic and do not relevantly impair traffic safety, neither alone nor under the acute influence of 0,01% atropine.
Topics: Young Adult; Humans; Adult; Middle Aged; Eyeglasses; Atropine; Myopia; Visual Acuity; Contrast Sensitivity; Vision Disorders; Lenses, Intraocular; Glare
PubMed: 36008055
DOI: 10.1055/a-1930-7116