G Atropine 1 gm/100 ml Eye Drops

Anticholinergic used as:

• Injection: slow heart rate (symptomatic bradycardia), before anaesthesia to reduce secretions, organophosphate/carbamate (insecticide) poisoning antidote, reversal of neuromuscular block (with neostigmine)
• Eye drops 0.5–1%: dilating the pupil and relaxing focusing for eye examination, uveitis/iritis treatment, amblyopia (penalisation)
• Low-dose eye drops 0.01–0.05%: slowing myopia progression in children (specialist)

Injection (health professionals only):

• Bradycardia: 0.5 mg IV every 3–5 minutes, maximum 3 mg.
• Premedication: 0.3–0.6 mg IV/IM/SC before anaesthesia; children 20 mcg/kg.
• Organophosphate poisoning: 1–2 mg IV (children 20–50 mcg/kg), doubling every 5 minutes until the chest is clear and heart rate > 80 (large total doses may be needed).

Eye drops 1%: uveitis: 1 drop 2–3 times daily; refraction in children: as directed by the eye doctor.

Myopia control 0.01%: 1 drop at bedtime in each eye (specialist).

• Narrow-angle glaucoma (eye drops, unless for specific treatment)
• Myasthenia gravis (except with anticholinesterase)
• Bowel obstruction, paralytic ileus, severe ulcerative colitis
• Urinary retention / prostate obstruction
• (Contraindications are relative in life-threatening emergencies)

Systemic: dry mouth, blurred vision, sensitivity to light, fast heartbeat, flushing, dry hot skin, reduced sweating (fever), urinary retention, constipation, confusion (elderly, children).

Eye drops: stinging, light sensitivity and blurred near vision for days (1% lasts up to 1–2 weeks), allergic reactions; absorbed drops can cause systemic effects in children.

• After 1% eye drops, avoid driving until vision is normal; wear sunglasses.
• Press on the inner corner of the eye for 1–2 minutes after drops (reduces absorption, especially in children).
• Heart disease, high blood pressure, fever, hyperthyroidism, Down syndrome (sensitivity): caution.

Use in emergencies when needed. Eye drops: use only if needed. Small amounts may pass into milk; may reduce milk supply.

• Other anticholinergics: tricyclics, antihistamines, antipsychotics, antispasmodics (increased side effects)
• Reduces effect of metoclopramide and domperidone
• May delay absorption of other oral drugs

"Hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter": fever, dry flushed skin, dilated pupils, fast heartbeat, agitation, hallucinations, seizures. Emergency care.

Store below 25–30°C, protected from light. Eye drops: discard 4 weeks after opening.