Talk:Atropine/Archives/2020/February

Mnemonic for Side Effects

It would be helpful is the side effects that this mnemonic references are listed. It is not at all obvious, even given the rest of the article. Also a citation for the quote would be nice, or reference to the presence to a source such as a medical school textbook, would be helpful.

167.80.244.204 13:25, 21 May 2007 (UTC)chevalier3

Hyoscyamine

I haven't edited anything, but atropine does NOT occur in nature. (-)-Hyoscyamine does. When an acid-base method is used to isolate this alkaloid it racemises to give the NOT naturally occurring atropine. Atropine is an extraction ARTIFACT.

DMS —Preceding unsigned comment added by 202.180.119.8 (talk) 03:21, 27 December 2010 (UTC)

I removed this:

It is a racemic mixture of d- and l-hyocyamine.

First, I believe the word is hyoscyamine. Also, I believe hyoscyamine is an alkaloid different from atropine, both being derived from belladonna. AxelBoldt 20:17 Dec 15, 2002 (UTC)

Hyoscyamine comes in two optical isomers (D and L). When people say hyoscyamine they are usually refering to L-hyoscyamine, when people say atropine they are refering to a (racemic) mixture of both D- and L-hyoscyamine. Chemically, atropine and hyoscyamine are the same. Physiologically, most of atropine's effects can be attributed to L-hyoscyamine.Matt 00:38, 19 Jun 2004 (UTC)

Putting hyoscyamine back, because it is an important information. --Mykhal 16:00, 1 Jan 2005 (UTC)

Atropine time of effectiveness

How does the "effect of atropine [to dilate the pupils] last two or three days" while it's half-life in the body is 2 hours? Is that due to the time it takes to dissociate from the ACh receptors? (version as of 2006 Aug 30, 0600 UTC)

So what's the opposite of Atropine?

If Atropine is used by eye doctors to dilate the pupils, then what do they use to constrict the pupils?

This is not really necessary. Pilocarpine would antagonise the anticholinergic effects, but atropine lasts much longer; this is why tropicamide is preferred over atropine. JFW | T@lk 16:26, 22 September 2005 (UTC)

Dapiprazole (e.g. Rev-Eyes) is sometimes used to counteract the effects of pupillary dilation to improve visual comfort (i.e. make it easier to drive home after the eye exam). I agree that topical atropine is not preferred as a mydriatic, but it is preferred over tropicamide for other indications. Edwardian 17:57, 22 September 2005 (UTC)

Incorrect or not?

I just happened to notice that the "elimination halflife listed" on the side of this Wikipedia page says "2 hours." However, the body of the article states "Atropine degrades slowly, typically wearing off in 2 to 3 days." Is this correct?

Half life

A half life and degradation time are not the same. Something with a half life of two hours, in the quantity given that wouldn't kill you, would take about two days to fully wear off. The effects would still be present, if rather reduced, during this time.

Official Indication of Atropine

Isn't the official indication for Atropine anesthetic induction/premedication for surgery? StudentNurse 05:04, 25 February 2006 (UTC).

I'm not a doctor or anything, but I would assume it would be pre-medication for surgery because of it's ability to dry secretions, namely sweat. However, surgeons generally use glycopyrrolate (Robinul, an anticholingeric just like atropine) as pre-medication for secretions. It's their medication of choice because it doesn't cross the blood brain barrier as easily as atropine does. Hope this helps. - Russ

In the old days atropine is used as a premed to produce sedation AND to dry up the secretion. But today in most cases it is used in surgery (by anaesthetists, not surgeons) to treat reflex-mediated bradycardia or used in combination with anticholinesterases (the combination is used at the end of a case to speed up recovery from muscle relaxants). I doubt it is used to dry up sweat though. BTW, atropine is also routinely used by some anaesthetists when doing a rapid sequence induction in paediatric cases. It is to counteract the bradycardic effect of suxamethonium (succinylcholine) which can be very pronounced in the paediatric population. Ld99 12:57, 17 February 2007 (UTC)

....................................

atropine can abolish the action of morphine on the RC which deepress it in the CNS i.e ++ RC --> ++ ventilation i guess such action is needed during surgy ! so crossing the BBB could be an andvantage —Preceding unsigned comment added by 41.232.186.40 (talk) 03:58, 21 October 2010 (UTC)

Yes I agree. I am 90% sure it is completely wrong. See my post below

70.63.230.6 (talk) 17:58, 8 March 2014 (UTC)artman77

Cleopatra

The history section says:

Atropine extracts from the Egyptian henbane were used by Cleopatra in the last century B.C. to dilate her pupils, in the hope that she would appear more alluring.

Perhaps a source could be provided or the line deleted. Eric 19:33, 10 April 2006 (UTC)

Atropine, when you get it in a bottle, isn't pure atropine, is it? I think it's worth noting, say, whether it's just plain atropine, or maybe atropine methylnitrate in an aqueous vehicle.

Or maybe it's sold differently between human and veterinary medical markets, I don't know. Still worth noting. Where do you look for this kind of stuff? (Other than Wikipedia.)

I'm sure atropine sulfate is used as a nerve agent antidote. cyclosarin 08:43, 22 December 2006 (UTC)

........................ atropine can abolish the action of morphine on the RC which deepress it in the CNS i.e ++ RC --> ++ ventilation i guess such action is needed during surgy ! so crossing the BBB could be andvantage —Preceding unsigned comment added by 41.232.186.40 (talk) 03:56, 21 October 2010 (UTC)

Muscle Spasm

Is Atropine likely to cause muscle spasms when used on small animals? I know this is not a forum, but this is the only font of information I trust. Thank yous Leo McAllister 16:48, 26 November 2006 (UTC)

I've never seen it do so... Dlh-stablelights 16:40, 15 June 2007 (UTC)

It should not on its own, but at high doses it can cause myoclonic jerks. Respiration falls, the brain sees a dying body, and it sends signals throughout the body causing muscle contraction and relaxation. This is mostly harmless, though high doses of atropine are not. I don't know what part of the brain is responsible, but I would expect to see this in all mammals. 68.154.235.251 (talk) 08:20, 26 January 2009 (UTC)

good article but layperson-averse

Can't the article be more accessible to a layperson trying to understand this substance? For example, I don't know what a heart block is, although I've heard the term any number of times--and I certainly had no idea of various degrees of this definition. The unexplained use of these terms assumes familiarity by the reader with material known mostly by physicians or biologists. Furthermore, there is no link to help explain, either to wiki or elsewhere. Even if there were, it becomes repressively tiresome to have to gloss every few words. I think further explanations--within the text--of abstruse terminology would go a long way to improving the article. It is my belief that Wiki is for laypeople. Why would a physician or medical student look at Wiki for a better understanding of atropine? For that matter, why would a student or professional chemist or pathologist? Thanks. NaySay 21:28, 11 May 2007 (UTC)

I've tried to add links to relevant articles in the section you mentioned. Fvasconcellos (t·c) 21:50, 11 May 2007 (UTC)

I agree. A number of medical articles on Wiki suffer from this same problem. On the Gunning fog index, this Atropine article has a very poor readability rating. For example, instead of simply saying "eye injury," the article uses the obtuse term "direct globe trauma." How many laypersons, when injured in the eye, call in sick to work and say, "I can't come in today; I experienced direct globe trauma"? --McPoet 02:41, 22 May 2007 (UTC)

I agree Wikipedia should be understandable by lay people, but you are in-correct in saying physicians and medical students would not use wiki for better understanding. Annecdotally, I know for a fact that many such people do (I do and I am a doctor). Of course they (I) always bear in mind that the information needs to be verified.124.182.246.135 (talk) 00:31, 20 May 2008 (UTC)

Muscarinic vs Nicotinic actions

From what I can tell, the page was edited in error by 121.208.241.50 - as the article lead suggests (and all other sources I have to hand) atropine is a competitive antagonist for the muscarinic acetylcholine receptor, not nicotinic ACh receptors as suggested here. I've changed the information back, but feel free to give some references if I'm in error. Thanks, Firetrap (talk • contribs) 19:00, 5 November 2008 (UTC)

Atropinic Shock Therapy

Are there any references for this? I just did a PubMed and Elsiveir search for it and found nothing on theraputic protocols. It has been indicated as an old treatment for depression in the same way that insulin shock therapy was for schizophrenia but I can only find a few spurious and poorly designed websites that state this. — Preceding unsigned comment added by PyromaniaPatient (talk • contribs) 12:01, 24 December 2010 (UTC)

121.208.241.50 please stop reverting the article without commenting on the talk page. Both this and this support atropine's antimuscarinic properties. If you have any references to support your edits, please mention them here first. Thanks, Firetrap (talk • contribs) 11:00, 6 November 2008 (UTC)

Atropine in popular culture?

Seems relevant? Yes? No? —Preceding unsigned comment added by 69.183.143.42 (talk) 22:08, 23 May 2011 (UTC)

etymology

From the article; "The name comes from the original use in deadly nightshade as a way of dilating women's pupils to make them beautiful."

"Belladonna" means beautiful woman. But the sentence, as phrased, seems to refer to "atropine." Editing to make things less confusing.--Ryan W (talk) 08:00, 18 October 2011 (UTC)

"Natural sources"

The section mentioned in the headline should be rewritten. There are no natural sources of atropine! Species of Atropa, Datura, Hyoscyamus and some other genera produce only S-(-)-hyoscyamine. --Sven Jähnichen (talk) 14:10, 18 November 2011 (UTC)

Wiki For Everyone

I cannot agree entirely with the writer who states: "It is my belief that Wiki is for laypeople", although he/she makes some valid points. Wikipedia articles should be useful to readers of all levels of expertise. Many high-school and college students, as well as "laypeople" use Wikipedia. And it is not true that scientists don't look at Wiki articles, but it is true that they tend not to get involved in writing them. What happens then is that technical terminology gets parroted without being properly understood or explained. However, if you read an article on a subject like atropine, you should expect some specialized terms like, for example, "muscarinic antagonist". The point a lot of readers and contributors to Wikipedia seem to miss is that, because of its internal hyperlinks, it has the potential to become the world's greatest free textbook/reference source. With time, iterative editing should improve many of the shortcomings that exist in any given article. It's extremely myopic (sorry, short-sighted) to aim for a "dumbed-down" version of what is already an impressive, and, for all its faults, incomparable resource. Xprofj (talk) 18:07, 3 May 2012 (UTC)

Agree. Excellent comments. David Spector (talk) 17:25, 11 August 2017 (UTC)

mnemonic author citation?

the article states that the well known mnemonic by jon blinkey "hot as a hare, red as a beet, ....". The linking article doens tnot seem to mention jon blinkey. who is he and is he really the author of this mnemonic? the only thing that comes up in google is the exact quote form this article. The revision history shows that this line "as per jon blinkey" was added march 28th 2011 and was the sole edit by that IP address. it came with no explanation or citation and seems rather suspicious. The article already cited seems to list the author of the mnemonic coming from a 1974 pharmacology textbook by Charles Thomas.

— Preceding unsigned comment added by 96.244.177.79 (talk) 18:28, 12 June 2012 (UTC)

I think the "blinkey" reference is the result of vandalism, so I have removed it. -- Ed (Edgar181) 19:43, 12 June 2012 (UTC)

Intro Too Complicated

Simplify the intro, the second paragraph is way too specific for an intro. What's the plant used for? What symptoms does it induce? This intro sounds like two experts talking over drinks.

Pb8bije6a7b6a3w (talk) 21:58, 9 April 2013 (UTC)

Completely Wrong

I agree with the post "Official Indication of Atropine" and would go much further. I am 90% sure the whole pharmacology thing is really wrong. Here is a quote from this article followed by a quote from the page "Vagus Nerve". I have seen a LOT of sources say atropine is one of the best known vagolytic.

"Increases in vagal activities to the SA node decreases the firing rate of the pacemaker cells by decreasing the slope of the pacemaker potential (phase 4 of the action potential); this decreases heart rate (negative chronotropy). The change in phase 4 slope results from alterations in potassium and calcium currents, as well as the slow-inward sodium current that is thought to be responsible for the pacemaker current (If). By hyperpolarizing the cells, vagal activation increases the cell's threshold for firing, which contributes to the reduction in the firing rate. Similar electrophysiological effects also occur at the AV node; however, in this tissue, these changes are manifested as a reduction in impulse conduction velocity through the AV node (negative dromotropy). In the resting state, there is a large degree of vagal tone on the heart, which is responsible for low resting heart rates. There is also some vagal innervation of the atrial muscle, and to a much lesser extent, the ventricular muscle. Vagus activation, therefore, results in modest reductions in atrial contractility (inotropy) and even smaller decreases in ventricular contractility. Muscarinic receptor antagonists bind to muscarinic receptors thereby preventing ACh from binding to and activating the receptor. By blocking the actions of ACh, muscarinic receptor antagonists very effectively block the effects of vagal nerve activity on the heart. By doing so, they increase heart rate and conduction velocity."

From "Vagus Nerve" and other

"Drugs that inhibit the muscarinic cholinergic receptor (anticholinergics) such as atropine and scopolamine are called vagolytic because they inhibit the action of the vagus nerve on the heart, gastrointestinal tract, and other organs. Anticholinergic drugs increase heart rate and are used to treat bradycardia (slow heart rate)."

Furthermore I think it's M1 not M2 that affects vagus. Either way atropine is well-known for decreasing action of vagus nerve. Im not changing it because it seems so sure. I really should have just corrected.

70.63.230.6 (talk) 17:58, 8 March 2014 (UTC)artman77

cleanup

started working on this and got waylaid. needs to be written in plain english per WP:MEDMOS. Needs more thorough sourcing, and updated. will try to work on it more tomorrow. Jytdog (talk) 02:08, 2 November 2014 (UTC)

First sentence

IMO the first sentence need to be easy to understand. Thus I have removed "Atropine is an anticholinergic compound that works as a competitive antagonist for the muscarinic acetylcholine receptors (acetylcholine being the main neurotransmitter used by the parasympathetic nervous system)." as the first sentence. This content belongs in the body of the article IMO. Doc James (talk · contribs · email) 05:06, 21 August 2015 (UTC)

Atropine is a medication used to treat certain types of nerve agent and pesticide poisonings, some types of slow heart rate, and to decrease saliva production during surgery[1], does work better for the common reader,the more specifics of this anticholinergic can be discussed in any section (appropriate section)later in the article itself.--Ozzie10aaaa (talk) 21:38, 22 August 2015 (UTC)

Yes and we do discuss it lower in the article right now. Doc James (talk · contribs · email) 21:57, 22 August 2015 (UTC)

At the same time, shouldn't there be a description of the item referenced in the page early on in the article? Users shouldn't need to read the entire article to get to the important information about atropine. If the first sentence is to be very easy to read, the important info should be put shortly after that.FrozenMan (talk) 22:39, 22 August 2015 (UTC)

We have "It is an antimuscarinic that works by inhibiting the parasympathetic nervous system." at the end of the 2nd paragraph. Doc James (talk · contribs · email) 22:51, 22 August 2015 (UTC)

"Atropine is a medication" constitutes "a description of the item". I support using plain, non-technical English for the first sentence. "Atropine is a medication that you care about for the following practical reasons:" will benefit a greater variety of readers than "Atropine is a crustimony proseedcake complication that works as a test for making me feel stupid again". Non-professionals are not going to get any value out of the technical description. Most people would require several years of biology and chemistry classes to understand what the original said. WhatamIdoing (talk) 00:05, 25 August 2015 (UTC)

I agree. The current sentence (recommended by Ozzie?) is good. Axl ¤ [Talk] 10:11, 25 August 2015 (UTC)

• Remembering that the lead is supposed to summarize the whole article, I would be inclinded to start summarizing the stuff in "mechanism" and "chemistry" in the lead, where there is room for an extra para. But certainly the easily-comprehensible non-technical stuff should come first. Johnbod (talk) 11:00, 25 August 2015 (UTC)

We already have " It is an antimuscarinic that works by inhibiting the parasympathetic nervous system." Doc James (talk · contribs · email) 20:29, 25 August 2015 (UTC)

Amblyopia

I just saw a parent administer it to a child with amblyopia, to blur vision in the good eye. It was prescribed for this purpose by a doctor in the US and covered for that use by the pharmaceutical plan. So why does this article say "Atropine eye drops have been shown to be effective in slowing the progression of myopia in children in several studies, but it is not available for this use, and side effects would limit its use.[26]" Maybe this one published article says it is a bad idea, but it is inaccurate to state that it is not used for this purpose. See [2], [3]. The present text seems unbalancced and misleading, but I defer to those with medical training to review the recent peer-reviewed journal and medical textbook coverage of the use of atropine for amblyopia. Edison (talk) 16:03, 7 September 2015 (UTC)

Amblyopia and myopia are different conditions. We DO state it is useful for amblyopia already. Best Doc James (talk · contribs · email) 21:00, 7 September 2015 (UTC)

Thanks, Doc. I totally misread "myopia" as "amblyopia." Actually, I have both. Edison (talk) 16:44, 8 September 2015 (UTC)

Assessment comment

The comment(s) below were originally left at Talk:Atropine/Archives/2020/Comments, and are posted here for posterity. Following several discussions in past years, these subpages are now deprecated. The comments may be irrelevant or outdated; if so, please feel free to remove this section.

I am being rather generous with this B-Class rating. For a real full blown B-Class it could do with quite some more chemistry. Wim van Dorst (Talk) 20:47, 11 April 2007 (UTC).

Last edited at 20:47, 11 April 2007 (UTC). Substituted at 08:33, 29 April 2016 (UTC)

Side Effects

The first part of the section on side effects has no citations, and is simply drivel where it speaks of " Most of available ampules are carried on sulphate which can cause histamine release and anaphylaxis to susceptible patients or patients with allergy to sulpha products." The drug is supplied as the sulphate salt, not "carried on sulphate", and 1mg of atropine sulphate contains less than 1/4 mg of sulphate. Sulphate does not cause histamine release, and sulpha products are not sulphates. The sulphate ion is constantly present in the body. The paragraph I quote above should be removed. At least I try (talk) 14:33, 23 August 2016 (UTC) At least I try (talk) 14:33, 23 August 2016 (UTC)

Identical with hyoscyamine?

The chemical formulas, diagrams, and chemical properties seem identical for atropine and hyoscyamine. Is it possible that we have two terms (articles) for the same compound? --Riventree (talk) 09:07, 9 May 2017 (UTC)

No, we don't. As stated in Atropine#Chemistry_and_pharmacology "Atropine is a enantiomeric mixture of d-hyoscyamine and l-hyoscyamine ...". Regards --Zinnmann (talk) 19:34, 12 May 2017 (UTC)

Atropine 0.05% is MORE effective in slowing the progression of myopia and is just as well tolerated as the lower concentration of 0.01% as published in a recent study referred to as the LAMP trial

A recent study published in Ophthalmology the journal of the American Academy of Ophthalmology in January of 2019, "low-concentration Atropine for Myopia Progression (LAMP) study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025% and 0.01% Atropine Eye Drops in Myopia Control" studied 438 children age 4-12 with myopia of at least -1.0 diopter (D) and astigmatism of -2.5 D or less. The children were randomly assigned in a 1:1:1:1 ratio to receive atropine strengths of 0.05%, 0.025% and 0.01% atropine eye drops or placebo for 1 year with measurements at baseline, 2 weeks, 4 months, 8 months and 12 months. Based on the results observed the atropine eye drops reduced myopia progression along a concentration-dependent response, of the 3 concentrations atropine 0.05% was most effective at controlling SE progression and was just as well tolerated as the lower concentrations.

Ophthalmology. 2019 Jan;126(1):113-124. doi: 10.1016/j.ophtha.2018.05.029. Epub 2018 Jul 6.