Naturally occurring tertiary amine which competitively antagonises ACh at the muscarinic receptor, causing parasympatholytic effects.
|Class||Naturally occurring tertiary amine. Muscarinic antagonist.|
|Uses||Bradycardia, organophosphate poisoning, antisialogogue, treatment of PDPH|
|Presentation||Clear, colourless solution at 600μg.ml-1. Racemic mixture, with only the L-isomer active|
|Route of Administration||IV|
|Distribution||50% protein bound, VD 3L.kg-1. Crosses BBB.|
|Metabolism||Extensive hepatic hydrolysis|
|Elimination||Renal elimination of metabolites and unchanged drug|
|Resp||Bronchodilation, ↓ secretions|
|CVS||↑ HR due to ↑ AV nodal conduction, peaks within 2-4 minutes and lasts 2-3 hours|
|CNS||Central anticholinergic syndrome, confusion, ↑ IOP, ↑ CSF secretion in choroid, cerebral vasoconstriction|
|GIT||↓ LoS tone|
- Smith S, Scarth E, Sasada M. Drugs in Anaesthesia and Intensive Care. 4th Ed. Oxford University Press. 2011.
- Peck TE, Hill SA. Pharmacology for Anaesthesia and Intensive Care. 4th Ed. Cambridge University Press. 2014.
- Mahmoud, Ahmed Abdelaal Ahmed, Amr Zaki Mansour, Hany Mahmoud Yassin, Hazem Abdelwahab Hussein, Ahmed Moustafa Kamal, Mohamed Elayashy, Mohamed Farid Elemady, et al. ‘Addition of Neostigmine and Atropine to Conventional Management of Postdural Puncture Headache: A Randomized Controlled Trial’ 127, no. 6 (2018): 6.