ATROPINE SULPHATE and HYOSCINE BUTYL BROMINE

ATROPINE SULPHATE 

It is an antimuscarnic drug that inhibits the actions of acetylcholine by blocking muscarnic receptors.

Mechanism of Action:

Acetylcholine (Ach) cannot bind to these sites due to the drug's high affinity for muscarinic receptors, which inhibits parasymptotic effects. It lessens muscular contraction in smooth muscles.

Indication

• Colic of the digestive system (as antispasmodic; relaxes smooth muscle of intestinal, urinary and biliary tract)
• Treatment for Parkinson's disease; reduces rigidity and tremor.
• Alleviates bradycardia
• Used as a remedy for poisoning by organophospores
• Used to relax the eye muscles and enlarge the pupil.

Dose

Adult: 0.6-1mg po or 0.3mg 0.6mg iv orim in 1 repeated dose

Child: 0.03 mg/kg

Contraindication

Intestinal atony, paralytic ileus, obstructive GI tract diseases, severe ulcerative colitis, toxic megacolon, tachycardia secondary to cardiac insufficiency, thyrotoxicosis, and myasthenia gravis are among the conditions that can cause hypersensitivity to belladonna alkaloids.

Side Effect 

Dry mouth, thirst, dysphagia, AV dissociation, atrial or ventricular fibrillation, headache, blurred vision, mydraisis, Palpitation, postural hypotension, dizziness, anxiety, tremor.

Nursing Consideration:

• Observe the vital signs. The patient's response to atropine is sensitively indicated by heart rate. Keep an eye out for variations in temperature and BP as well as in the quality, rate, and rhythm of your breathing and heartbeat.
• Watch I&0, especially in patients who have just had surgery and older persons (drug may contribute to urinary retention).
• Watch out for "atropine fever" in newborns, young children, and elderly people. Make sure you're getting enough water, and keep the temperature controlled to avoid hyperpyrexia.
• Take the following steps to relieve dry mouth: drink enough water, rinse your mouth out frequently with tepid water, practice strict oral and dental hygiene, and sucking sugarless sourballs.
• Avoid driving and other tasks that require visual acuity and mental alertness since atropine may cause sensitivity to light, blurring of near vision, and momentarily impaired ability to judge distance.
• Take extra care if you have intestinal obstruction or glaucoma. BPH Without first consulting a doctor, avoid breastfeeding while taking this medication.

HYOSCINE BUTYL BROMINE 

It functions as an antimuscarinic and antispasmodic.

Mechanism of Action

Act most likely by obstructing nerve impulses and conduction across a cholinergic link in the pathway connecting the vestibular apparatus to the vomiting center.

Indication

Abdominal pain brought on by a spasm in the muscles of the urinary or digestive systems.

Dose

• Adults: 10-20 mg tid/qid (Max 100mg / d * ay ) po/iv
• Child:
  • 6-12 years: 10 mg tid (po)
  • 12-18 years: 20 mg tid/qid (po)
  • 2-6 years: 5mg im/iv (Max 15 mg/day) 6-12 years: 5-10mg im/iv (Max 30 mg/day) 12-18 yrs old: 20mg im/iv (Max 80 mg/day)

Contraindication

Children younger than six years old, urinary retention, BPH, acute bleeding, narrow-angle glaucoma Myasthenia gravis, paralytic ileus, and tachycardia from cardiac insufficiency.

Side effect

Sedation, dryness of mouth, Tachycardia, Reduced ability to sweat, Dizziness, Drowsiness, Fatigue Headache, Memory loss Allergic reactions, urinary retention, Flushing, Postural hypotension, Dry skin.

Nursing Consideration

• IV route: After dilution with sterile water, administer directly IV; administer gently.
• After parenteral administration, avoid operating machinery and driving.
• Avoid extreme heat
• Instruct the patient to avoid drugs or stop nursing until their medication is finished because drugs can decrease milk flow.
• Don't let the patient drink or use any other CNS-depressants while they are taking medication.
• Describe how mouthwash, good oral care, and sugarless gum or candy can all help to prevent dry mouth.
• Instruct the patient to seek emergency medical attention if they experience any of the following while taking this medication: perhaps headache, visual loss, or seeing haloes around lights, along with a red and irritated eye The doctor needs to conduct an immediate investigation into these symptoms, which could be brought on by an increase in pressure inside the eyeball.
• Keep an eye out for the signs and symptoms of an overdose, such as an irregular heartbeat, drowsiness, reddened skin, and so forth.