Atropine

Indication
Keratitis, iritis, cyclitis, & refractive procedure in children. Mydriatic & cyclopplegic.

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Adult Dose
Ophthalmic Inflammatory eye disorders Adult: Instill 1-2 drops of a 1% solution up to 4 times daily. Ointment: as required. Eye refraction Adult: Instill 1 drop of a 1% solution bid for 1-2 days before the procedure, or on a single occasion 1 hr before the procedure.

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Child Dose
Ophthalmic Inflammatory eye disorders Child: As sulfate: Instill 1 drop of a 1% solution up to tid. Ointment: as required. Eye refraction Child: As sulfate: Instill 1 or 2 drops of a 0.5% soln (or 1 drop of a 1% solution) bid for 1-3 days before the procedure, with a further dose given 1 hr before the procedure.

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Contraindication
Narrow angle glaucoma.
Mode of Action
Atropine is an anticholinergic agent which competitively blocks the muscarinic receptors in peripheral tissues. It also has mydriatic and cycloplegic effect.
Precaution
Toxic systemic reaction may occur in the very young & very old. Lactation: Trace amounts enter breast milk; use with caution (AAP Committee states “compatible with nursing”)

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Side Effect
Eye drops: Systemic toxicity esp in children, on prolonged use may lead to irritation, hyperaemia, oedema, dry eyes, vascular congestion, dermatitis, blurred vision and conjunctivitis. Increased intraocular pressure.
Pregnancy Category Note
Pregnancy Category: C Lactation: Trace amounts enter breast milk; use with caution (AAP Committee states “compatible with nursing”)

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Interaction
Additive anticholinergic effects with quinidine, antidepressants and some antihistamines.