Poor medication adherence is a global problem that compromises the benefit of a given treatment. 1 It also increases the rate of mortality, morbidity and healthcare costs. 2 In the United States, direct medical cost of chronic diseases reached a trillion dollar, while nonadherence costs over $170 billion annually. 2,3 Furthermore, in transplant recipients, the non-adherence to immunosuppressants results in 1319 cases of renal transplant failure annually. 4 The achievement of the total benefit from medication is determined by patient adherence to their treatment regimens. 5 Adherence is defined as the "extent to which a patient acts in accordance with the prescribed interval and dose and dosing regimen". 6 Half of the prescribed medications for chronic diseases are not taken as prescribed by their healthcare providers. 2 Hypertension is one of the chronic medical conditions that affects a great percentage of people all over the globe. In 2000, the estimated number of adults with hypertension was 972 million and

Atropa belladonna (AB), commonly known as deadly nightshade is a poisonous plant which contains several alkaloids such as atropine and scopolamine etc. Any deliberate as well as unintentional ingestion of AB fruits, roots or leaves may result toxicity. Aim of the study: This study aims to present the clinical uses of atropine alongwith the adverse effects and toxicity associated with the use of atropine in the form of conventional or as herbal medication. A retrospective (2003-2017) literature was searched in various databases such as web of science, PubMed, google scholar, Scopus, E-Resource Portal of Imam Abdulrahman bin Faisal University etc. using the keywords i.e. AB, clinical uses of AB, adverse effects and cases reported with AB. Ten (10) cases met the eligibility criteria where the toxicity was mostly associated with the use of AB fruit, tablets and AB contaminated drinks. Major symptoms observed in these cases were related to Anticholinergic syndrome (ACS); tachycardia, dilated pupils, confusion, fl ushed dry skin, hallucinations and seizures in some cases alongwith a toxic megacolon. Furthermore, the treatment protocol used widely for ACS consisted of; gastric lavage and the use of Physostigmine as an antidote (antagonizes the central as well as peripheral toxicity of atropine). AB fruit revealed a vital role as anticholinergic drug, mydriatic agent and as an antidote for OP poisoning, however, its use deprived of medical supervision or in a large quantity, it may cause severe toxicity.