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Atropine

  • September 15, 2014 5:46:48 PM PDT

    1. What is atropine?
    2. How is it used in your profession?
    3. What are the effects of atropine?
    4. From which plant or plant's is atropine obtained?
    5. Where do these plants grow? (Country or countries? Geographical region?)
    6. What does atropine look like?

    • Moderator
    • 1957 posts
    September 15, 2014 11:33:09 PM PDT

    Greetings J

    Thank you for your question. 

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    ---

    1. What is atropine.

    DRUG DESCRIPTION - ATROPINE SULFATE Injection, USP 
    0.1 mg/mI (Adult) 
    0.05 mg/mL (Pediatric)

    Atropine Sulfate Injection, USP is a sterile, nonpyrogenic isotonic solution of atropine sulfate monohydrate in water for injection with sodium chloride sufficient to render the solution isotonic. It is administered parenterally bysubcutaneousintramuscular or intravenous injection.

    Each milliliter (mL) contains atropine sulfate, monohydrate 0.1 mg (adult strength) or 0.05 mg (pediatric strength), and sodium chloride, 9 mg. May contain sodium hydroxide and/or sulfuric acid for pH adjustment 0.308 mOsmol/mL (calc.). pH 4.2 (3.0 to 6.5).

    The solution contains no bacteriostat, antimicrobial agent or added buffer (except for pH adjustment) and is intended for use only as a single-dose injection. When smaller doses are required the unused portion should be discarded.

    Atropine Sulfate Injection is a parenteral anticholinergic agent and muscarinicantagonist.

    Atropine Sulfate, USP is chemically designated 1a H, 5a H-Tropan-3-a ol (±)-tropate(ester), sulfate (2:1) (salt) monohydrate, (C17H23NO3)2 • H2SO4 • H2O, colorless crystals or white crystalline powder very soluble in water. It has the following structural formula:

    Atrop
    Atropine, a naturally occurring belladonna alkaloid, defined as a racemic mixture of (S)-hyoscyamine and (R)-hyoscyamine; a racemic mixture of equal parts of d- and 1evo-hyocyamine, whose activity is due almost entirely to the levo isomer of the drug.

    http://www.sciencedirect.com/science/article/pii/S0731708514001642

    Atropa belladonna (Belladonna)

    2. How is it used in your profession. 

    Well I am a Medical Doctor, more specifically I have more outpatient primary care training than several of the physicians on the medical board. Unlike most students I want to a school that required six years of primary care experience. Thus, when I graduated from medical school, the only thing keeping me working as an attending outpatient primary care doctor was a lack of scientific knowledge. 

    So according to the Centers for Medicare and Medicaid, my profession is medicine, and my specialty is "general practice."

    There are many uses of atropine in the Medical Profession

    http://www.sciencedirect.com/science/article/pii/S1542012414000779

    1. Myopia control

    http://www.sciencedirect.com/science/article/pii/S0965229914000351

    2. Against Snake bite

    Atropa belladonna (Belladonna) Solanaceae Atropene PLA2 of Naja naja Basavarajappa (1992)

    3. As an Antidote against organophosphate poisioning. Why it is quite possible that the Hero, the Medal of Freedom Winner, Joseph Treolar Wearn saved the lives of several allied soldiers in World War II.

    http://emedicine.medscape.com/article/167726-medication

    4. ~To treat watery eyes from surgery: Epiphora (tears overflowing from the eye) Secondary to Submandibular Gland Transplantation: Transcutaneous Atropine Gel. -


    This post was edited by DrSocial Admin at March 27, 2015 9:45:57 AM PDT
    • Moderator
    • 1957 posts
    September 16, 2014 12:19:54 AM PDT

    Dosing Forms & Strengths

    Anesthesia Premedication

    0.4-0.6 mg IV/IM/SC 30-60 minutes before anesthesia; repeat q4-6hr PRN

    Sinus Bradycardia (ACLS)

    0.5-1 mg or 0.04 mg/kg IV q5min, no more than 3 mg

    ET: Some experts suggest 2-2.5x IV dose diluted in 5-10 mL sterile water for injection/NS (sterile water for injection may facilitate absorption better than NS, but may produce more negative effect on arterial oxygen pressure)

    Bronchospasm

    0.025 mg/kg in 2.5 mL NS q6-8hr via nebulizer; no more than 2.5 mg/dose 

    Asystole/Pulseless Electrical Activity (ACLS)

    1 mg IV q3-5min PRN if asystole persist up to 0.04 mg/kg

    Cholinesterase Inhibitors (Organophosphates, Carbamates)

    AtroPen: 2 mg/dose IM

    Mild symptoms: 1 AtroPen

    If severe symptoms develop (eg, strange or confused behavior, wheezing, sialorrhea, muscle fasciculations, involuntary urination/defecation, convulsion, unconsciousness) give 2 additional AtroPen injections in rapid succession 10 minutes after initial dose

    Initial severe symptoms: give 3 AtroPen doses in rapid succession

    http://www.sciencedirect.com/science/article/pii/014067369290733J#

    Other Indications & Uses

    General anesthesia, seizures with epilepsy, GI radiography

    Off-label: cerebral hypoxia, cerebral ischemia, AMI

    http://reference.medscape.com/drug/atropen-atropine-iv-im-343093

     

    --------------------------

    3. Effets of ATropine:

    • Moderator
    • 1957 posts
    September 16, 2014 12:44:18 AM PDT

     

    Atropine effects one of two from http://www.rxlist.com/script/main/mobileart-rx.asp?drug=atropine&monotype=rx-ad&monopage=3 http://www.usmleforum.com/files/forum/2010/1/555448.php Atropine blocks M-receptors on sweat glands---->anhydrosis---->Hyperthermia Hyperthermia----->Reflex vasodilation in skin (Flushing) in order to cool off.


    This post was edited by Brett Snodgrass at September 16, 2014 12:49:15 AM PDT
    • Moderator
    • 1957 posts
    September 16, 2014 1:20:55 AM PDT

    Atropine is reportedly not from one of the plants which wikipedia states. Sometimes, misinformation can be so prevalent in society, that it may help to list where atropine isn't, in addition to where it is. 

    http://www.kingcounty.gov/environment/animalsAndPlants/noxious-weeds/weed-identification/bittersweet-nightshade.aspx

    Bittersweet nightshade

    Solanum dulcamara

    Solanaceae Family 

    bittersweet nighshade vines with leaves, flowers and berries - click for larger imageBittersweet nightshade, also known as woody nightshade or European bittersweet, is a perennial vine or scrambling shrub with slender stems in the Nightshade Family. Originally from Europe, it is now widespread throughout North America and commonly found in backyards, along edges of fields, vacant lands, roadsides, and along streams and wetlands where it thrives in moist soil and partial shade.

    Legal status in King County, Washington

    Bittersweet nightshade is not on the Washington State Noxious Weed List and property owners are not required to control this plant.  However, in King County, it is classified as a Weed of Concern and control is recommended, especially in natural areas that are being restored to native vegetation and along stream banks where nightshade can interfere with fish habitat.

    Identification (see below for additional photos)

    • Perennial vine or sprawling shrub; lower stems woody, upper herbaceous branches die back each yearbittersweet nightshade flowers and berries
    • Flowers have star-shaped, purple, backward-pointing petals and stamens fused in a prominent yellow cone; grow in clusters along branches on short stalks extending out from the stems
    • Berries are round or egg-shaped and bright red when ripe with numerous yellow, flattened seeds; unripe berries are green
    • Leaves are dark-green to purplish and often with one or two small ear-like lobes near the base, leaf blades are 1 to 4 inches long
    • Main root grows horizontally just below the surface and suckers frequently
    • Crushed leaves and bark have an unpleasant smell

    Toxicity

    Although this is not the same plant as deadly nightshade or belladonna (an uncommon and extremely poisonous plant), bittersweet nightshade is somewhat poisonous and has caused loss of livestock and pet poisoning and, more rarely, sickness and even death in children who have eaten the berries. Fortunately, bittersweet nightshade has a strong, unpleasant odor, so most animals will avoid it, and poisonings from this plant are not very frequent.

    The entire plant contains solanine, the same toxin found in green potatoes and other members of the nightshade family, and it also contains a glycoside called dulcamarine, similar in structure and effects to atropine, one of the toxins found in deadly nightshade. The toxin amount varies with soil, light, climate and growth stage. Ripe fruits are generally less toxic than the leaves and unripe berries, but even ripe berries can be poisonous.

    Habitat and impact

    Bittersweet nightshade is very common in King County and found everywhere from backyards to pastures, creeks, roadsides and vacant lots. Although it is not usually the dominant weed where it is found, in some local creeks and wetlands it has formed large, dense and damaging infestations. It can become so prolific that it is grows out into the creek, creating a false gravel bed and interfering with fish movement upstream. It is very capable of taking advantage of disturbed, moist habitats and out-competing native shrubs and even small trees such as willows and alders.

    Growth and reproduction

    • Flowers from mid-May to September
    • Fruit and seed production can be abundant; each berry contains about 30 seeds
    • Spreads to new locations by birds eating the ripe berries and by fragments of stem and root moving in soil or water
    • Moves out from a parent plant by way of suckering roots, prostrate stems rooting at nodes, and by growing up and over vegetation or structures like fences and buildings
    • Climbs onto small trees, shrubs and fences or remains low-growing depending on what is available; can climb 30 feet or higher into trees or form thickets along the ground
    • Branches grow and die back 3 to 6 feet or more each year

    Additional information on bittersweet nightshade


    This post was edited by DrSocial Admin at March 27, 2015 10:05:18 AM PDT
    • Moderator
    • 1957 posts
    September 16, 2014 1:54:36 AM PDT

    Atropine DOES come from (produced by the plant itself) Jimson Weed, a member of the Belladona alkaloid. 

    The plant is probably in california, I highlighted the effects of atropine

    1. constipation

    2. dry eyes

    3. warm skin 

    Atropine poisoning from plants


    This post was edited by DrSocial Admin at March 27, 2015 9:58:09 AM PDT
    • Moderator
    • 1957 posts
    September 16, 2014 1:58:09 AM PDT
    This is a study that found Atropine could be present in wheat. It isn't produced by the plant itself, but it can be taken up into the plant. 
    Thus, the plants that it could be found in may include wheat, and there is wheat in many places. 
    The abstract is below. 
    Here is map where wheat is grown in the United States.
    What Harvest 2002
    urnal of Environmental Science and Health, Part B: Pesticides, Food Contaminants, and Agricultural Wastes
    Uptake of 14C-atropine and/or its transformation products from soil by wheat (Triticum aestivum var Kronjet) and their translocation to shoots
    Uptake of 14C-atropine and/or its transformation products from soil by wheat (Triticum aestivum var Kronjet) and their translocation to shoots.
    DOI:10.1080/03601234.2013.824281Zora Jandrića, Mohammad N. Rathora, Sorivan Chhem-Kietha, Joseph Adu-Gyamfib, Leopold Mayrb, Christian Reschb, Souleymane Badoc, Jaroslava Švarc-Gajićd & Andrew Cannavana

    pages 1034-1042

    Received: 10 Mar 2013
    Published online: 05 Sep 2013Abstract

    Plant uptake of toxins and their translocation to edible plant parts are important processes in the transfer of contaminants into the food chain. Atropine, a highly toxic muscarine receptor antagonist produced bySolanacea species, is found in all plant tissues and can enter the soil and hence be available for uptake by crops. The absorption of atropine and/or its transformation products from soil by wheat (Triticum aestivumvar Kronjet) and its distribution to shoots was investigated by growing wheat in soil spiked with unlabeled or 14C-labeled atropine. Radioactivity attributable to 14C-atropine and its transformation products was measurable in plants sampled at 15 d after sowing (DAS) and thereafter until the end of experiment. The highest accumulation of 14C-atropine and/or its transformation products by plants was detected in leaves (between 73 and 90% of the total accumulated) with lower amounts in stems, roots, and seeds (approximately 14%, 9%, and 3%, respectively). 14C-Atropine and/or its transformation products were detected in soil leachate at 30, 60, and 90 DAS and were strongly adsorbed to soil, with 60% of the applied dose adsorbed at 30 DAS, plateauing at 70% from 60 DAS. Unlabeled atropine was detected in shoots 30 DAS at a concentration of 3.9 ± 0.1 μg kg−1 (mean ± SD). The observed bioconcentration factor was 2.3 ± 0.04. The results suggest a potential risk of atropine toxicity to consumers.


    This post was edited by DrSocial Admin at March 27, 2015 9:52:44 AM PDT
    • Moderator
    • 1957 posts
    September 16, 2014 2:03:29 AM PDT

    Atropine looks too small to see with the unaided eye, unless perhaps it is extracted and

    aggregated, but that would not occur naturally, but you can see the plant. 

    Atropine Plant Belladona Big Pupils mydriasis


    This post was edited by DrSocial Admin at March 27, 2015 9:47:36 AM PDT
    • 445 posts
    March 27, 2015 9:40:01 AM PDT

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