ring to lactating women because infants may be particularly sensitive to the anticholinergic effects of the drug. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA.
Dental disease
Atropine may aggravate dental disease with chronic use because the anticholinergic effects may decrease salivary flow.
Anticholinergic medications, geriatric
Systemic forms of atropine should be used with caution in geriatric patients. The elderly are more likely to have medical conditions aggravated by the use of this drug, or to experience paradoxical CNS stimulation or anticholinergic effects from antimuscarinics. The anticholinergic effects of atropine may be significant and are additive with other anticholinergic medications. According to the Beers Criteria, anti-spasmodics such as oral or parenteral atropine are considered potentially inappropriate medications (PIMs) in geriatric patients and should be avoided due to high anticholinergic activity and uncertain effectiveness. The Beers expert panel also recommends avoiding drugs with strong anticholinergic properties, including oral or parenteral atropine, in geriatric patients with the following disease states or symptoms due to the potential for exacerbation of the condition or increased risk of adverse effects: dementia/cognitive impairment (adverse CNS effects), delirium/high risk of delirium (possible new-onset or worsening delirium), or lower urinary tract symptoms/benign prostatic hyperplasia in men (possible urinary retention or hesitancy). The federal Omnibus Budget Reconciliation Act (OBRA) regulates medication use in residents of long-term care facilities (LTCFs). According to the OBRA guidelines, medications with anticholinergic properties, such as atropine, may cause mental status changes, constipation, drowsiness, dizziness, dryness of mucus membranes, blurred vision, urinary retention, or other adverse effects that are common and problematic, especially in older individuals. The use of multiple medications with anticholinergic properties may be particularly problematic because of cumulative effects.
ADVERSE REACTIONS
Severe
laryngospasm / Rapid / Incidence not known
ileus / Delayed / Incidence not known
asystole / Rapid / Incidence not known
bradycardia / Rapid / Incidence not known
atrial fibrillation / Early / Incidence not known
ventricular fibrillation / Early / Incidence not known
respiratory arrest / Rapid / Incidence not known
pulmonary edema / Early / Incidence not known
anaphylactic shock / Rapid / Incidence not known
Stevens-Johnson syndrome / Delayed / Incidence not known
seizures / Delayed / Incidence not known
coma / Early / Incidence not known
Moderate
oral ulceration / Delayed / Incidence not known
blepharitis / Early / Incidence not known
cycloplegia / Early / Incidence not known
blurred vision / Early / Incidence not known
photophobia / Early / Incidence not known
dysphagia / Delayed / Incidence not known
constipation / Delayed / Incidence not known
hypertension / Early / Incidence not known
ST-T wave changes / Rapid / Incidence not known
supraventricular tachycardia (SVT) / Earl
