13. Atropine poisoning

Question 1

What is Atropine?

Answer 1

Atropine is an antimuscarinic that works through competitive inhibition of postganglionic acetylcholine receptors and direct vagolytic action. This leads to parasympathetic inhibition, allowing the preexisting sympathetic stimulation to predominate creating increased cardiac output and other associated antimuscarinic effects.

Question 2

What are the sources of exposure to atropine?

Answer 2

1. Overdose administration.
2. Datura plant ( Jimson weed and angel’s trumpet found in warmer climates).
3. Accidental ingestion
4. Used as an Hallucinogen: smoked or ingested.

Question 3

What are the symptoms of atropine poisoning/overdose?

Answer 3

1. Dilated pupils
2. Warm and dry skin
3. Tachycardia
4. Tremor
5. Ataxia
6. Delirium
7. Coma

Question 4

What are the treatment options for Atropine overdose?

Answer 4

1. Whole-bowel irrigation ( in case of ingestion ).
2. Avoid phenothiazines.
3. Short-acting barbiturate or diazepam (convulsions or excitement).
4. Antidote: Physostigmine ( to treat delirium and coma)
5. Monitor respiratory effort and supplement, if necessary.