Pharmacokinetic Studies on Atropine with Special Reference to Age

Virtanen, Raimo; Kanto, J.; Iisalo, E; Salo, Matti; Sjövall, S.

doi:10.1111/j.1399-6576.1982.tb01770.x

Cited by 62 publications

(24 citation statements)

References 15 publications

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“…As a result, atropine has many undesirable side effects including at low doses dry mouth, urinary retention, and accelerated heart rate. In addition, atropine is also able to cross the blood–brain barrier (Virtanen et al 1982). Thus, at high doses side effects include coma, fever, and hallucinations.…”

Section: Effects Of Therapeutic Muscarinic Antagonists In Lung Diseasementioning

confidence: 99%

Muscarinic Receptor Antagonists: Effects on Pulmonary Function

Buels

Fryer

2011

Handbook of Experimental Pharmacology

110

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In healthy lungs, muscarinic receptors control smooth muscle tone, mucus secretion, vasodilation, and inflammation. In chronic obstructive pulmonary disease (COPD) and asthma, cholinergic mechanisms contribute to increased bronchoconstriction and mucus secretion that limit airflow. This chapter reviews neuronal and nonneuronal sources of acetylcholine in the lung and the expression and role of M1, M2, and M3 muscarinic receptor subtypes in lung physiology. It also discusses the evidence for and against the role of parasympathetic nerves in asthma, and the current use and therapeutic potential of muscarinic receptor antagonists in COPD and asthma.

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Section: Effects Of Therapeutic Muscarinic Antagonists In Lung Diseasementioning

confidence: 99%

Muscarinic Receptor Antagonists: Effects on Pulmonary Function

Buels

Fryer

2011

Handbook of Experimental Pharmacology

110

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“…[25] Reductions in RRBBV following atropine administration have been measured in premature neonates awaiting intubation for respiratory distress [26] and normal children undergoing routine anaesthesia. [27] In small children, reductions in RRBBV could be achieved by a single dose of atropine due to its long half-life [28] which is a consequence of the extended elimination phase resulting from its increased distribution volume [29].…”

Section: Discussionmentioning

confidence: 99%

Atropine for Critical Care Intubation in a Cohort of 264 Children and Reduced Mortality Unrelated to Effects on Bradycardia

et al. 2013

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BackgroundAtropine has is currently recommended to facilitate haemodynamic stability during critical care intubation. Our objective was to determine whether atropine use at induction influences ICU mortality.Methodology/Principal FindingsA 2-year prospective, observational study of all first non-planned intubations, September 2007–9 in PICU and Intensive Care Transport team of Hôpital Robert Debré, Paris, 4 other PICUs and 5 NICUs in the Paris Region, France. Follow-up was from intubation to ICU discharge. A propensity score was used to adjust for patient specific characteristics influencing atropine prescription. 264/333 (79%) intubations were included. The unadjusted ICU mortality was 7.2% (9/124) for those who received atropine compared to 15.7% (22/140) for those who did not (OR 0.42, 95%CI 0.19–0.95, p = 0.04). One child died during intubation (1/264, 0.4%). Two age sub-groups of neonates (≤28 days) and older children (>28 days, <8 years) were examined. This difference in mortality arose from the higher mortality in children aged over one month when atropine was not used (propensity score adjusted OR 0.22, 95%CI 0.06–0.85, p = 0.028). No effect was seen in neonates (propensity score adjusted OR 1.3, 95%CI 0.31–5.1 p = 0.74). Using the propensity score, atropine maintained the mean heart rate 45.9 bpm above that observed when no atropine was used in neonates (95%CI 34.3–57.5, p<0.001) and 43.5 bpm for older children (95%CI 25.5–61.5 bpm, p<0.001).Conclusions/SignificanceAtropine use during induction was associated with a reduction in ICU mortality in children over one month. This effect is independent of atropine’s capacity to attenuate bradycardia during intubation which occurred similarly in neonates and older children. This result needs to be confirmed in a study using randomised methodology.

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“…Internal exposures to and effects of atropine appear to be greater in children and the elderly, albeit from different causes (i.e. a higher volume of distribution or decreased clearance, respectively (Virtanen et al, 1982)). Atropine readily crosses the human placenta based on similar concentrations occurring in maternal and fetal blood following i.m.…”

Section: Distributionmentioning

confidence: 99%

Scientific Opinion on Tropane alkaloids in food and feed

2013

EFS2

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The European Food Safety Authority (EFSA) was asked to deliver a scientific opinion on the risks to human and animal health related to the presence of tropane alkaloids (TAs) in food and feed. TAs are secondary metabolites which occur in several plant families. Although more than 200 different TAs have been identified in various plants, respective data on toxicity and occurrence in food and feed are limited. Therefore, the EFSA Panel on Contaminants in the Food Chain (CONTAM Panel) could only perform a risk assessment on (-)-hyoscyamine and (-)-scopolamine, the two TAs for which occurrence and toxicity data were available. Since the pharmacological effects of (-)-hyoscyamine and (-)-scopolamine occur within a short time after administration, the CONTAM Panel concluded that it was appropriate to establish an Acute Reference Dose (ARfD) for these substances. Based on the results for decreased heart rate in a human volunteer study, the CONTAM Panel established a group ARfD of 0.016 µg/kg body weight (b.w.) expressed as the sum of (-)-hyoscyamine and (-)-scopolamine, assuming equivalent potency. Results on TAs in 124 food and 611 feed samples were collected in two Member States. Most of the food and feed samples were left-censored (below limit of detection/limit of quantification). A reliable exposure estimate was only possible for one food and one age class (toddlers). Based on the limited information, the CONTAM Panel concluded that the dietary exposure of toddlers could be up to seven times the group ARfD and could exceed the group ARfD on approximately 11 to 18 % of consumption days. TA toxicosis in livestock and companion animals is relatively rare. © European SUMMARYFollowing a request from the European Commission, the EFSA Panel on Contaminants in the Food Chain (CONTAM Panel) was asked to deliver a scientific opinion on the risks to human and animal health related to the presence of tropane alkaloids (TA) in food and feed.TAs are secondary metabolites which naturally occur in plants of several families including Brassicaceae, Solanaceae (e.g. mandrake, henbane, deadly nightshade, Jimson weed) and Erythroxylaceae (including coca). The TAs are found in all parts of the plants and are responsible for the toxic effects of some of these plants. TAs contain an azabicyclo[3.2.1]octane ring structure. The common structural element is the tropane skeleton, (1R,5S)-8-methyl-8-azabicyclo[3.2.1]octane. The group of TAs comprises more than 200 compounds and the wide range of compounds occurring especially in the Solanaceae family arises from the esterification of tropine with a variety of acids, such as acetic acid, propanoic acid, isobutyric acid, isovaleric acid, 2-methylbutyric acid, tiglic acid, (+)-α-hydroxy-β-phenylpropionic acid, tropic acid, and atropic acid.Although more than 200 different TAs were so far identified in various plants, respective data on their occurrence in food and feed and on toxicity are limited. The most studied TAs are (-)-hyoscyamine and (-)-scopolamine, which in contrast to the (+...

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Pharmacokinetic Studies on Atropine with Special Reference to Age

Cited by 62 publications

References 15 publications

Muscarinic Receptor Antagonists: Effects on Pulmonary Function

Muscarinic Receptor Antagonists: Effects on Pulmonary Function

Atropine for Critical Care Intubation in a Cohort of 264 Children and Reduced Mortality Unrelated to Effects on Bradycardia

Scientific Opinion on Tropane alkaloids in food and feed

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