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Acta Orthopaedica Et Traumatologica... 2005Postoperative nausea and vomiting prolong the time spent in postanesthesia recovery units. In this study, we investigated the effect of neostigmine and atropine... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Postoperative nausea and vomiting prolong the time spent in postanesthesia recovery units. In this study, we investigated the effect of neostigmine and atropine combination, used to avoid residual curarization, on nausea and vomiting.
METHODS
The study included 40 ASA I-II patients who were planned to have a short-term arthroscopic operation. The patients were administered a single dose of 0.4 mg/kg atracurium besylate for muscle relaxation, and then, were randomly divided into two groups. In group I, neuromuscular blockade was eliminated with 1.5 mg neostigmine and 0.5 mg atropine, whereas group II patients underwent spontaneous resolution. The patients were evaluated for nausea and vomiting and the need for antiemetic drugs in the recovery unit, patient room, and on the postoperative second day.
RESULTS
There were no significant differences between the two groups with respect to hemodynamic parameters and peripheral oxygen saturation. The mean operation time did not differ significantly (p>0.05), but the mean extubation time was significantly shorter in group I (p<0.05). No significant differences were observed for the occurrence of nausea and vomiting and the need for antiemetic drugs in the recovery unit, patient room, and on the postoperative second day (p>0.05).
CONCLUSION
In patients undergoing arthroscopic surgery, it is safe to use neostigmine and atropine combination before extubation to avoid residual neuromuscular blockade associated with the use of non-depolarizing myorelaxants.
Topics: Adult; Anesthesia Recovery Period; Anesthesia, General; Antiemetics; Arthroscopy; Atropine; Drug Therapy, Combination; Female; Humans; Male; Neostigmine; Parasympatholytics; Postoperative Nausea and Vomiting; Treatment Outcome
PubMed: 16269882
DOI: No ID Found -
Heart (British Cardiac Society) Dec 2005To determine the safety and cardiac chronotropic responsiveness to early atropine dobutamine stress echocardiography (DSE) in the elderly.
OBJECTIVE
To determine the safety and cardiac chronotropic responsiveness to early atropine dobutamine stress echocardiography (DSE) in the elderly.
DESIGN
Retrospective study of 258 patients >or= 70 years who underwent early atropine DSE and 290 patients >or= 70 years who underwent conventional DSE. In the early atropine protocol, atropine was started at 20 microg/kg/min of dobutamine if heart rate was < 100 beats/min, up to 2 mg. The cardiac chronotropic responsiveness in the elderly was compared with a control group of patients < 70 years matched for sex, myocardial infarction, diabetes, and treatment with beta blockers and calcium channel blockers.
RESULTS
The dose of dobutamine given to elderly patients was lower during early atropine than during conventional DSE (mean (SD) 29 (7) v 38 (4) microg/kg/min, p = 0.001). Early atropine DSE resulted in diminished incidence of ventricular extrasystoles, non-sustained ventricular tachycardia, bradycardia, and hypotension compared with conventional DSE. In comparison with patients < 70 years, elderly patients required lower doses of dobutamine and atropine and achieved a higher percentage of predicted maximum heart rate (92 (9)% v 88 (10)%, p = 0.0001). Except for more common hypotension (16% v 10%, p = 0.004), no other difference in adverse effects was observed between patients >or= 70 and < 70 years.
CONCLUSIONS
Early atropine DSE is a safe strategy in the elderly resulting in lower incidence of minor adverse effects than with the conventional protocol. Elderly patients presented adequate cardiac chronotropic responsiveness to early injections of atropine, requiring lower doses of drugs to reach test end points.
Topics: Aged; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Atropine; Cardiotonic Agents; Coronary Artery Disease; Dobutamine; Echocardiography, Stress; Female; Heart Rate; Humans; Hypertension; Hypotension; Male; Middle Aged; Retrospective Studies
PubMed: 15797935
DOI: 10.1136/hrt.2004.054445 -
Indian Journal of Ophthalmology Oct 2018To report clinical manifestations of ocular allergy to atropine eye drops used for retardation of progressive myopia in children.
PURPOSE
To report clinical manifestations of ocular allergy to atropine eye drops used for retardation of progressive myopia in children.
METHODS
Myopic children, who developed bothersome itching that subsided promptly after cessation of atropine eye drops, were included. History of systemic or ocular allergy, preexisting ocular conditions, and clinical features of allergy were noted.
RESULTS
Six children, age 5-15 years, were included. Four developed allergy to 1% atropine sulfate eye drops and two to 0.01% concentration of atropine sulfate. The onset of allergy was within a month to as late as 4 years after using atropine eye drops. The severity of allergy was higher with 1% concentration. The most common symptoms of atropine allergy were itching and burning. The most common signs were lid swelling and hyperemia. The allergic manifestations promptly reversed with the stoppage of eye drops. Reintroduction was possible in three patients, either by reducing the concentration of atropine or using benzalkonium free formulation.
CONCLUSION
Allergy to atropine eye drops in children may develop within a few weeks or after many years of usage. Prompt cessation followed by a reintroduction and continuation of therapy may be possible in few patients.
Topics: Adolescent; Atropine; Child; Child, Preschool; Dermatitis, Allergic Contact; Drug Hypersensitivity; Female; Humans; Male; Mydriatics; Myopia, Degenerative; Ophthalmic Solutions
PubMed: 30249831
DOI: 10.4103/ijo.IJO_165_18 -
Tijdschrift Voor Psychiatrie 2019In patients taking clozapine, about 30% experience sialorrhoea, with its related potentially important medical and psychosocial implications. Until now, systemic... (Review)
Review
In patients taking clozapine, about 30% experience sialorrhoea, with its related potentially important medical and psychosocial implications. Until now, systemic treatments have been unsuccessful and also have unfavourable side-effects.
AIM: To examine the current evidence regarding the use of local atropine in clozapine-induced sialorrhoea (cis), as well as for sialorrhoea of other etiology.
METHOD: PubMed and Google Scholar were searched using the keywords 'sialorrhea', 'clozapine' and 'atropine' to investigate the use of sublingual atropine for cis, as well as for sialorrhoea of other etiology. Two patients are described and discussed.
RESULTS: Of 24 identified patients, 21 experienced a beneficial effect on cis with sublingually administered atropine eye drops or 1% ipratropium bromide nasal spray (0.03%). Side-effects, such as a dry mouth, unpleasant taste and short duration of action of the eye drops, were reported. Of the 67 patients treated with local atropine for sialorrhoea of other etiology, generally a beneficial effect and few side-effects were reported.
CONCLUSION: The sublingual administration of atropine appears to be effective in the treatment of cis, as well as in sialorrhoea of other etiology. The dose is usually 1-2 eye drops, two to three times per day.Topics: Administration, Sublingual; Atropine; Clozapine; Humans; Sialorrhea
PubMed: 31243750
DOI: No ID Found -
The Journal of Veterinary Medical... Dec 2021We aimed to determine whether dexmedetomidine administration with or without atropine increases cardiac troponin I (cTnI) level in healthy dogs. We hypothesized that 10...
We aimed to determine whether dexmedetomidine administration with or without atropine increases cardiac troponin I (cTnI) level in healthy dogs. We hypothesized that 10 µg/kg dexmedetomidine + atropine increases the cTnI level, whereas 5 µg/kg dexmedetomidine + atropine does not. Eighteen healthy, pet dogs that underwent an orthopedic surgery or ovariohysterectomy were included in this study. The dogs were randomly assigned to atropine (0.02 mg/kg)-dexmedetomidine (10 µg/kg), saline-dexmedetomidine (10 µg/kg), and atropine (0.02 mg/kg)-dexmedetomidine (5 µg/kg) groups. Each dog was premedicated with atropine or saline intramuscularly (IM). After 10 min, they were IM injected with dexmedetomidine (10 or 5 µg/kg)-morphine (0.5 mg/kg)-midazolam (0.2 mg/kg). Following this, anesthesia was induced after 10 min with propofol and maintained with isoflurane in 100% oxygen. The median plasma cTnI level at 6, 12 and 24 hr after premedication was significantly higher than that at baseline. The cTnI level in the atropine-dexmedetomidine (10 µg/kg) group was significantly higher than that in the saline-dexmedetomidine (10 µg/kg) and atropine-dexmedetomidine (5 µg/kg) groups at 6 and 12 hr after premedication. The cTnI level returned to normal within 72 hr after premedication in all groups. The administration of atropine in combination with 10 µg/kg dexmedetomidine increased the cTnI level, indicating subclinical myocardial damage.
Topics: Animals; Atropine; Dexmedetomidine; Dogs; Isoflurane; Propofol; Troponin I
PubMed: 34629333
DOI: 10.1292/jvms.20-0657 -
British Journal of Anaesthesia Jun 1978The effects of equivalent doses of atropine and hyoscine following oral and i.m. administration were assessed on salivary secretion, heart rate, arterial pressure, body... (Comparative Study)
Comparative Study
The effects of equivalent doses of atropine and hyoscine following oral and i.m. administration were assessed on salivary secretion, heart rate, arterial pressure, body temperature, pupillary size, near-point of vision and sweat-gland activity. The ratio of oral to i.m. doses of atropine on heart rate and salivary secretion appears to be 2:1 and that of hyoscine on salivary secretion about 5-6:1. Following oral administration the effects on the eye are minimal even after the highest doses of the two drugs, while the decrease in salivation is adequate.
Topics: Administration, Oral; Adult; Atropine; Dose-Response Relationship, Drug; Eye; Female; Heart Rate; Humans; Injections, Intramuscular; Male; Salivation; Scopolamine; Sweat Glands; Time Factors
PubMed: 666935
DOI: 10.1093/bja/50.6.591 -
Medicina (Kaunas, Lithuania) Sep 2019Atropine is a nonselective muscarinic antagonist which has been used to prevent worsening of myopia in children. Different concentrations of atropine were used for...
Deduction of Novel Genes Potentially Involved in the Effects of Very Low Dose Atropine (0.003%) Treatment on Corneal Epithelial Cells Using Next-Generation Sequencing and Bioinformatics Approaches.
Atropine is a nonselective muscarinic antagonist which has been used to prevent worsening of myopia in children. Different concentrations of atropine were used for myopia, ranging from 0.01% to 1.0%. However, there are still potential toxicity of different doses of atropine to the cornea. Here, we present a study of investigating novel genes potentially involved in the effects of very low dose atropine treatment (0.003%) on corneal epithelial cells using next-generation sequencing (NGS) and bioinformatics approaches. Human corneal epithelial cells were treated with 0.003% atropine, cultured until confluence, and RNA extracted for differential expression profiling of mRNA and microRNA (miRNA) between control and atropine-treated corneal epithelial cells. The functional enrichment analysis for differentially expressed genes was performed using two bioinformatics databases, including Database for Annotation, Visualization and Integrated Discovery (DAVID) and Ingenuity Pathway Analysis (IPA). In addition, potential miRNA-mRNA interactions involved in atropine-treated corneal epithelial cells were predicted and validated using different miRNA target prediction databases. Our results showed 0.003% atropine might suppress the apoptosis of corneal epithelial cells, potentially through Ras and protein kinase A signaling pathways. We also validated the possible miRNA regulations by using TargetScan and miRDB databases. Hsa-miR-651-3p-, hsa-miR-3148- and hsa-miR-874-5p- were validated as possible miRNA regulations involved in corneal epithelial cells treated with 0.003% atropine. These findings may contribute novel insights into therapeutic strategies for treating cornea with 0.003% atropine.
Topics: Atropine; Computational Biology; Cornea; Epithelial Cells; Gene Expression Profiling; High-Throughput Nucleotide Sequencing; Humans; MicroRNAs; Muscarinic Antagonists; Myopia
PubMed: 31540331
DOI: 10.3390/medicina55090589 -
Journal of the American College of... Apr 1996This study sought to compare, head to head, the two most popular pharmacologic stress echocardiographic tests--dipyridamole and dobutamine--with state of the art... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
OBJECTIVES
This study sought to compare, head to head, the two most popular pharmacologic stress echocardiographic tests--dipyridamole and dobutamine--with state of the art protocols in a large multicenter prospective study.
BACKGROUND
In the continuing quest for ideal diagnostic accuracy, pharmacologic stress echocardiography has quickly moved over the years from low to high dose regimens and is currently performed with atropine coadministration.
METHODS
Dobutamine (up to 40 microgram/kg body weight per min) plus atropine (up to 1 mg over 4 h) and dipyridamole (up to 0.84 mg/kg per min over 10 h) plus atropine (up to 1 mg over 4 h) stress echocardiography was performed on different days, in random order and within 1 week in 360 patients with chest pain syndrome. Thirteen different echocardiographic laboratories, all fulfilling quality control criteria for stress echocardiographic reading, contributed to the study.
RESULTS
No major complications occurred during either test. The test was interrupted before achievement of predetermined end points for limiting side effects in 37 dobutamine-atropine and 7 dipyridamole-atropine stress echocardiographic studies (feasibility 90% vs. 98%, p < 0.01). Diagnostic accuracy was assessed in a subset of 110 patients with no obvious rest dyssynergy (akinesia or dyskinesia) who underwent coronary angiography independently of test results and within 1 week of testing. Significant coronary artery disease (> or = 50% diameter reduction in at least one major coronary vessel by quantitative coronary angiography) was found in 92 patients. Sensitivity for detection of coronary artery disease was 84% (77 of 92) for dobutamine-atropine and 82% (75 of 92) for dipyridamole-atropine stress echocardiography (p = NS), with a specificity of 89% (16 of 18) for dobutamine-atropine and 94% (17 of 18) for dipyridamole-atropine stress echocardiography (p = NS). A significant correlation was present between peak wall motion score index during dipyridamole-atropine and dobutamine-atropine stress echocardiography (r = 0.83, p < 0.0001).
CONCLUSIONS
Dobutamine-atropine and dipyridamole-atropine stress echocardiography are safe and feasible, although submaximal studies are more frequent with dobutamine. The two stresses have comparable accuracy in the detection of angiographically assessed coronary artery disease, although dobutamine is marginally more sensitive and dipyridamole marginally more specific. Stratification of the ischemic response in the space domain is also comparable with the two stresses.
Topics: Angina Pectoris; Atropine; Cardiotonic Agents; Dipyridamole; Dobutamine; Echocardiography; Humans; Prospective Studies
PubMed: 8609337
DOI: 10.1016/0735-1097(95)00586-2 -
JAMA Ophthalmology Sep 2021Patching is often less effective for severe amblyopia because of poor adherence. For the treatment of severe amblyopia, although combined atropine and patching therapy... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Patching is often less effective for severe amblyopia because of poor adherence. For the treatment of severe amblyopia, although combined atropine and patching therapy (CAPT) has been found to be efficacious, it is currently unknown whether CAPT is more efficacious than patching alone.
OBJECTIVE
To compare the efficacy of CAPT vs patching alone in children aged 3 to 12 years with severe amblyopia.
DESIGN, SETTING, AND PARTICIPANTS
This single-center randomized clinical trial was conducted from November 2018 to May 2020. The visual acuity (VA) examiner was masked to the treatment groups. The follow-up visits were at 3 months and 6 months. Participants aged 3 to 12 years with severe amblyopia (20/100 to 20/500) resulting from strabismus, anisometropia, or both were randomly assigned to CAPT or patching therapy.
INTERVENTIONS
CAPT or patching alone for 6 months.
MAIN OUTCOMES AND MEASURES
Change of the amblyopic eye VA from baseline to 6 months.
RESULTS
Among 108 participants, the mean (SD) age was 5.2 (1.8) years, and 54 (50%) were female. Overall, 53 participants (49%) were randomized to CAPT and 55 (51%) were randomized to patching therapy. At baseline, the mean (SD) amblyopic eye VA was 0.95 (0.22) logMAR (approximately 20/200 [2.2 lines]). At 6 months, the CAPT group's mean improvement in amblyopic eye VA was 0.72 logMAR (7.2 lines) compared with 0.58 logMAR (5.8 lines) in the patching alone group (difference, 0.14 logMAR [1.4 lines] greater in the CAPT group; 95% CI, 0.05-0.22 logMAR [0.5-2.2 lines]; P = .002). The amblyopic eye VA improvement in the CAPT group also was greater than that in the patching alone group at 3 months (difference in the means, 0.13 logMAR [1.3 lines]; 95% CI, 0.04-0.22 logMAR [0.4-2.2 lines]; P = .004). No participants were withdrawn because of adverse effects.
CONCLUSIONS AND RELEVANCE
CAPT resulted in more mean improvement of amblyopic eye VA than patching alone among participants enrolled in this trial, although the clinical relevance of this relatively small VA difference cannot be determined from this trial.
TRIAL REGISTRATION
Chinese Clinical Trial Registry Identifier: ChiCTR1800018663.
Topics: Amblyopia; Atropine; Child; Female; Follow-Up Studies; Humans; Male; Sensory Deprivation; Treatment Outcome
PubMed: 34264296
DOI: 10.1001/jamaophthalmol.2021.2413 -
Randomized double-blind trial of sublingual atropine vs. placebo for the management of death rattle.Journal of Pain and Symptom Management Jan 2013Noisy breathing because of respiratory tract secretions (RTS), often referred to as "death rattle," occurs in up to half of all dying patients. Despite a lack of... (Randomized Controlled Trial)
Randomized Controlled Trial
CONTEXT
Noisy breathing because of respiratory tract secretions (RTS), often referred to as "death rattle," occurs in up to half of all dying patients. Despite a lack of evidence showing benefit compared with placebo, antimuscarinic medications have been used in an attempt to decrease noise associated with RTS and to decrease family distress.
OBJECTIVES
The goal of this study was to compare the efficacy of the antimuscarinic medication atropine with that of placebo in reducing noise associated with death rattle.
METHODS
Terminally ill adult hospice inpatients who developed noisy breathing as a result of RTS were randomized to double-blind treatment with atropine or placebo. Study drug was given as a single sublingual dose. Noise from breathing was monitored at baseline and at two and four hours.
RESULTS
One hundred thirty-seven participants were randomized to atropine or placebo. Reduction in noise score from baseline to two hours after dose occurred in 37.8% and 41.3% of subjects treated with atropine and placebo, respectively (P=0.73). Noise score reduction at four hours occurred in 39.7% and 51.7% of subjects treated with atropine and placebo, respectively (P=0.21). Differences between groups were not significant at either time point. Atropine was well tolerated. Heart rate increased slightly in both groups (+1.1/minute for atropine and +3.1/minute for placebo) but not significantly.
CONCLUSION
Sublingual atropine given as a single dose was not more effective than placebo in reducing the noise associated with death rattle.
Topics: Administration, Sublingual; Adult; Aged; Aged, 80 and over; Atropine; Dose-Response Relationship, Drug; Double-Blind Method; Female; Humans; Male; Middle Aged; Muscarinic Antagonists; Respiratory Sounds; Terminally Ill
PubMed: 22795904
DOI: 10.1016/j.jpainsymman.2012.01.006