زائر
atpine sfate
(a' te peen)
Paentea and a pepaatins:
Minims (AN), Sa-Tpine
phthami stin:
Atpine Sfate S..P., Atpis, Ispt-Atpine phthami
Pegnany ategy
Dg asses
Antihinegi
Antimsaini
Paasympathyti
Antipakinsnism dg
Antidte
Diagnsti agent (phthami pepaatins)
Beadnna akaid
Theapeti atins
mpetitivey bks the effets f aetyhine at msaini hinegi eepts that mediate the effets f paasympatheti pstgangini impses, depessing saivay and bnhia seetins, diating the bnhi, inhibiting vaga infenes n the heat, eaxing the GI and G tats, inhibiting gasti aid seetin (high dses), eaxing the ppi f the eye (mydiati effet), and peventing ammdatin f nea visin (ypegi effet); as bks the effets f aetyhine in the NS.
Indiatins
Systemi administatin
· Antisiaagge f peanestheti mediatin t pevent ede espiaty tat seetins
· Teatment f pakinsnism; eieves tem and igidity
· estatin f adia ate and ateia pesse ding anesthesia when vaga stimatin pded by inta-abdmina tatin ases a deease in pse ate, essening the degee f AV bk when ineased vaga tne is a fat (eg, sme ases de t digitais)
· eief f badyadia and synpe de t hypeative atid sins efex
· eief f pyspasm, hypetniity f the sma intestine, and hypemtiity f the n
· eaxatin f the spasm f biiay and etea i and bnhspasm
· eaxatin f the tne f the dets mse f the inay badde in the teatment f inay tat disdes
· nt f ying and aghing episdes in patients with bain esins
· Teatment f sed head injies that ase aetyhine eease int SF, EEG abnmaities, stp, negi signs
· eaxatin f teine hypetniity
· Management f pepti e
· nt f hinhea f ate hinitis hay feve
· Antidte (with extena adia massage) f V apse fm vedse f paasympathmimeti (hinegi) dgs (hine estes, piapine), hinestease inhibits (eg, physstigmine, isfphate, ganphsphs insetiides)
· Antidte f pisning by etain speies f mshm (eg, Amanita msaia)
phthami pepaatins
· Diagnstiay t pde mydiasis and ypegia-ppiay diatin in ate infammaty nditins f the iis and vea tat
ntaindiatins and atins
· ntaindiated with hypesensitivity t antihinegi dgs.
· Systemi administatin: ntaindiated with gama, adhesins between iis and ens, stensing pepti e, pyddena bsttin, paayti ies, intestina atny, sevee eative itis, txi megan, symptmati pstati hypetphy, badde nek bsttin, bnhia asthma, PD, adia ahythmias, tahyadia, myadia ishemia, impaied metabi, ive, kidney fntin, myasthenia gavis.
· se atisy with Dwn syndme, bain damage, spastiity, hypetensin, hypethyidism, atatin.
· phthami stin: ntaindiated with gama tendeny t gama.
Avaiabe fms
Tabets--0.4 mg; injetin--0.05, 0.1, 0.3, 0.4, 0.5, 0.8, 1 mgm; phthami intment--1%; phthami stin--0.5%, 1%, 2%
Dsages
ADTS
· Systemi administatin: 0.4–0.6 mg P, IM, S, IV.
· Hyptni adigaphy: 1 mg IM.
· Sgey: 0.5 mg (0.4–0.6 mg) IM ( S, IV) pi t indtin f anesthesia; ding sgey, give IV; ede dse t < 0.4 mg with yppane anesthesia.
· Badyahythmias: 0.4–1 mg (p t 2 mg) IV evey 1–2 h as needed.
· Antidte: F pisning de t hinestease inhibit insetiides, give age dses f at east 2–3 mg paenteay, and epeat nti signs f atpine intxiatin appea; f apid type f mshm pisning, give in dses sffiient t nt paasympatheti signs befe ma and V apse intevene.
phthami stin
· F efatin: Insti 1–2 dps int eye(s) 1 h befe efating.
· F veitis: Insti 1–2 dps int eye(s) qid.
PEDIATI PATIENTS
Systemi administatin
efe t the fwing hat:
Weight
Dse (mg)
7–16 b (3.2–7.3 kg)
0.1
16–24 b (7.3–10.9 kg)
0.15
24–40 b (10.9–18.1 kg)
0.2
40–65 b (18.1–29.5 kg)
0.3
65–90 b (29.5–40.8 kg)
0.4
> 90 b (> 40.8 kg)
0.4–0.6
· Sgey: 0.1 mg (newbn) t 0.6 mg (12 y) injeted S 30 min befe sgey.
GEIATI PATIENTS
Me ikey t ase seis advese eatins, espeiay NS eatins, in edey patients; se with atin.
Phamakinetis
te
nset
Peak
Datin
IM
10–15 min
30 min
4 h
IV
Immediate
2–4 min
4 h
S
Vaies
1–2 h
4 h
Tpia
5–10 min
30–40 min
7–14 days
Metabism: Hepati; T12: 2.5 h
Distibtin: sses paenta; passes int beast mik
Exetin: ine
IV fats
Pepaatin: Give ndited dite in 10 m steie wate.
Infsin: Give diet IV; administe 1 mg ess ve 1 min.
Advese effets
Systemi administatin
· NS: Bed visin, mydiasis, ypegia, phtphbia, ineased intaa pesse, headahe, fshing, nevsness, weakness, dizziness, insmnia, menta nfsin exitement (afte even sma dses in the edey), nasa ngestin
· V: Papitatins, badyadia (w dses), tahyadia (highe dses)
· GI: Dy mth, ateed taste peeptin, nasea, vmiting, dysphagia, heatbn, nstipatin, bated feeing, paayti ies, gastesphagea efx
· G: inay hesitany and etentin; imptene
· the: Deeased sweating and pedispsitin t heat pstatin, sppessin f atatin
phthami pepaatins
· a: Tansient stinging
· Systemi: Systemi advese effets, depending n amnt absbed
Inteatins
Dg-dg
· Ineased antihinegi effets with the dgs that have antihinegi ativity: etain antihistamines, etain antipakinsnian dgs, TAs, MA inhibits
· Deeased antipsyhti effetiveness f hapeid with atpine
· Deeased effetiveness f phenthiazines, bt ineased inidene f paayti ies
Nsing nsideatins
Assessment
· Histy: Hypesensitivity t antihinegi dgs; gama; adhesins between iis and ens; stensing pepti e, pyddena bsttin, paayti ies, intestina atny, sevee eative itis, txi megan, symptmati pstati hypetphy, badde nek bsttin, bnhia asthma, PD, adia ahythmias, myadia ishemia, impaied metabi, ive, kidney fntin, myasthenia gavis, Dwn syndme, bain damage, spastiity, hypetensin, hypethyidism, atatin
· Physia: Skin , esins, texte; T; ientatin, efexes, biatea gip stength; affet; phthami exam; P, BP; , adventitis snds; bwe snds, nma GI tpt; nma inay tpt, pstate papatin; ive and kidney fntin tests, EG
Inteventins
· Ense adeqate hydatin; pvide envinmenta nt (tempeate) t pevent hypepyexia.
· Have patient vid befe taking mediatin if inay etentin is a pbem.
Teahing pints
· When sed pepeativey in the ate sitatins, inpate teahing abt the dg with teahing abt the pede; the phthami stin is sed mainy atey and wi nt be sef-administeed by the patient; the fwing appy t a mediatin f tpatients:
· Take as pesibed, 30 min befe meas; avid exessive dsage.
· Avid ht envinments; y wi be heat inteant, and danges eatins may .
· These side effets may : dizziness, nfsin (se atin diving pefming hazads tasks); nstipatin (ense adeqate fid intake, ppe diet); dy mth (sgaess zenges, feqent mth ae may hep; may be tansient); bed visin, sensitivity t ight (evesibe; avid tasks that eqie ate visin; wea sngasses in bight ight); imptene (evesibe); diffity in inatin (empty the badde pi t taking dg).
· ept ash; fshing; eye pain; diffity beathing; tems, ss f dinatin; iega heatbeat, papitatins; headahe; abdmina distentin; hainatins; sevee pesistent dy mth; diffity swawing; diffity in inatin; nstipatin; sensitivity t ight.
Advese effets in Itai ae mst mmn; thse in Bd ae ife-theatening.
(a' te peen)
Paentea and a pepaatins:
Minims (AN), Sa-Tpine
phthami stin:
Atpine Sfate S..P., Atpis, Ispt-Atpine phthami
Pegnany ategy
Dg asses
Antihinegi
Antimsaini
Paasympathyti
Antipakinsnism dg
Antidte
Diagnsti agent (phthami pepaatins)
Beadnna akaid
Theapeti atins
mpetitivey bks the effets f aetyhine at msaini hinegi eepts that mediate the effets f paasympatheti pstgangini impses, depessing saivay and bnhia seetins, diating the bnhi, inhibiting vaga infenes n the heat, eaxing the GI and G tats, inhibiting gasti aid seetin (high dses), eaxing the ppi f the eye (mydiati effet), and peventing ammdatin f nea visin (ypegi effet); as bks the effets f aetyhine in the NS.
Indiatins
Systemi administatin
· Antisiaagge f peanestheti mediatin t pevent ede espiaty tat seetins
· Teatment f pakinsnism; eieves tem and igidity
· estatin f adia ate and ateia pesse ding anesthesia when vaga stimatin pded by inta-abdmina tatin ases a deease in pse ate, essening the degee f AV bk when ineased vaga tne is a fat (eg, sme ases de t digitais)
· eief f badyadia and synpe de t hypeative atid sins efex
· eief f pyspasm, hypetniity f the sma intestine, and hypemtiity f the n
· eaxatin f the spasm f biiay and etea i and bnhspasm
· eaxatin f the tne f the dets mse f the inay badde in the teatment f inay tat disdes
· nt f ying and aghing episdes in patients with bain esins
· Teatment f sed head injies that ase aetyhine eease int SF, EEG abnmaities, stp, negi signs
· eaxatin f teine hypetniity
· Management f pepti e
· nt f hinhea f ate hinitis hay feve
· Antidte (with extena adia massage) f V apse fm vedse f paasympathmimeti (hinegi) dgs (hine estes, piapine), hinestease inhibits (eg, physstigmine, isfphate, ganphsphs insetiides)
· Antidte f pisning by etain speies f mshm (eg, Amanita msaia)
phthami pepaatins
· Diagnstiay t pde mydiasis and ypegia-ppiay diatin in ate infammaty nditins f the iis and vea tat
ntaindiatins and atins
· ntaindiated with hypesensitivity t antihinegi dgs.
· Systemi administatin: ntaindiated with gama, adhesins between iis and ens, stensing pepti e, pyddena bsttin, paayti ies, intestina atny, sevee eative itis, txi megan, symptmati pstati hypetphy, badde nek bsttin, bnhia asthma, PD, adia ahythmias, tahyadia, myadia ishemia, impaied metabi, ive, kidney fntin, myasthenia gavis.
· se atisy with Dwn syndme, bain damage, spastiity, hypetensin, hypethyidism, atatin.
· phthami stin: ntaindiated with gama tendeny t gama.
Avaiabe fms
Tabets--0.4 mg; injetin--0.05, 0.1, 0.3, 0.4, 0.5, 0.8, 1 mgm; phthami intment--1%; phthami stin--0.5%, 1%, 2%
Dsages
ADTS
· Systemi administatin: 0.4–0.6 mg P, IM, S, IV.
· Hyptni adigaphy: 1 mg IM.
· Sgey: 0.5 mg (0.4–0.6 mg) IM ( S, IV) pi t indtin f anesthesia; ding sgey, give IV; ede dse t < 0.4 mg with yppane anesthesia.
· Badyahythmias: 0.4–1 mg (p t 2 mg) IV evey 1–2 h as needed.
· Antidte: F pisning de t hinestease inhibit insetiides, give age dses f at east 2–3 mg paenteay, and epeat nti signs f atpine intxiatin appea; f apid type f mshm pisning, give in dses sffiient t nt paasympatheti signs befe ma and V apse intevene.
phthami stin
· F efatin: Insti 1–2 dps int eye(s) 1 h befe efating.
· F veitis: Insti 1–2 dps int eye(s) qid.
PEDIATI PATIENTS
Systemi administatin
efe t the fwing hat:
Weight
Dse (mg)
7–16 b (3.2–7.3 kg)
0.1
16–24 b (7.3–10.9 kg)
0.15
24–40 b (10.9–18.1 kg)
0.2
40–65 b (18.1–29.5 kg)
0.3
65–90 b (29.5–40.8 kg)
0.4
> 90 b (> 40.8 kg)
0.4–0.6
· Sgey: 0.1 mg (newbn) t 0.6 mg (12 y) injeted S 30 min befe sgey.
GEIATI PATIENTS
Me ikey t ase seis advese eatins, espeiay NS eatins, in edey patients; se with atin.
Phamakinetis
te
nset
Peak
Datin
IM
10–15 min
30 min
4 h
IV
Immediate
2–4 min
4 h
S
Vaies
1–2 h
4 h
Tpia
5–10 min
30–40 min
7–14 days
Metabism: Hepati; T12: 2.5 h
Distibtin: sses paenta; passes int beast mik
Exetin: ine
IV fats
Pepaatin: Give ndited dite in 10 m steie wate.
Infsin: Give diet IV; administe 1 mg ess ve 1 min.
Advese effets
Systemi administatin
· NS: Bed visin, mydiasis, ypegia, phtphbia, ineased intaa pesse, headahe, fshing, nevsness, weakness, dizziness, insmnia, menta nfsin exitement (afte even sma dses in the edey), nasa ngestin
· V: Papitatins, badyadia (w dses), tahyadia (highe dses)
· GI: Dy mth, ateed taste peeptin, nasea, vmiting, dysphagia, heatbn, nstipatin, bated feeing, paayti ies, gastesphagea efx
· G: inay hesitany and etentin; imptene
· the: Deeased sweating and pedispsitin t heat pstatin, sppessin f atatin
phthami pepaatins
· a: Tansient stinging
· Systemi: Systemi advese effets, depending n amnt absbed
Inteatins
Dg-dg
· Ineased antihinegi effets with the dgs that have antihinegi ativity: etain antihistamines, etain antipakinsnian dgs, TAs, MA inhibits
· Deeased antipsyhti effetiveness f hapeid with atpine
· Deeased effetiveness f phenthiazines, bt ineased inidene f paayti ies
Nsing nsideatins
Assessment
· Histy: Hypesensitivity t antihinegi dgs; gama; adhesins between iis and ens; stensing pepti e, pyddena bsttin, paayti ies, intestina atny, sevee eative itis, txi megan, symptmati pstati hypetphy, badde nek bsttin, bnhia asthma, PD, adia ahythmias, myadia ishemia, impaied metabi, ive, kidney fntin, myasthenia gavis, Dwn syndme, bain damage, spastiity, hypetensin, hypethyidism, atatin
· Physia: Skin , esins, texte; T; ientatin, efexes, biatea gip stength; affet; phthami exam; P, BP; , adventitis snds; bwe snds, nma GI tpt; nma inay tpt, pstate papatin; ive and kidney fntin tests, EG
Inteventins
· Ense adeqate hydatin; pvide envinmenta nt (tempeate) t pevent hypepyexia.
· Have patient vid befe taking mediatin if inay etentin is a pbem.
Teahing pints
· When sed pepeativey in the ate sitatins, inpate teahing abt the dg with teahing abt the pede; the phthami stin is sed mainy atey and wi nt be sef-administeed by the patient; the fwing appy t a mediatin f tpatients:
· Take as pesibed, 30 min befe meas; avid exessive dsage.
· Avid ht envinments; y wi be heat inteant, and danges eatins may .
· These side effets may : dizziness, nfsin (se atin diving pefming hazads tasks); nstipatin (ense adeqate fid intake, ppe diet); dy mth (sgaess zenges, feqent mth ae may hep; may be tansient); bed visin, sensitivity t ight (evesibe; avid tasks that eqie ate visin; wea sngasses in bight ight); imptene (evesibe); diffity in inatin (empty the badde pi t taking dg).
· ept ash; fshing; eye pain; diffity beathing; tems, ss f dinatin; iega heatbeat, papitatins; headahe; abdmina distentin; hainatins; sevee pesistent dy mth; diffity swawing; diffity in inatin; nstipatin; sensitivity t ight.
Advese effets in Itai ae mst mmn; thse in Bd ae ife-theatening.