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Critical care, neurology and analgesia
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Psycholergic emergence reactions can cause distress. These can be ameliorated by the benzodiazepines. An antisialagogue may be required to diminish copious secretions [51]. Tolerance in children is described with repeated use [52]. Keta-mine generally maintains good airway tone, but this is not guaranteed.
Paediatrics
Published in Elizabeth Combeer, The Final FRCA Short Answer Questions, 2019
Respiratory: assess for possibility of OSA, especially considering that the patient is requiring an adenotonsillectomy. Assess for symptoms and signs of lower respiratory tract infection. Consider antisialagogue premedication with atropine.
Adult Anaesthesia
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Daphne A. Varveris, Neil G. Smart
Premedication was originally introduced in the nineteenth century to reduce the amount of chloroform required and thereby speed the onset of surgical anaesthesia. Morphine and its derivatives were often combined with an anticholinergic antisialagogue such as atropine and this reduced patient anxiety and facilitated anaesthesia. Although now uncommon, the combination of an antisialagogue with or without an opiate can still find use prior to an anticipated fibre-optic or difficult intubation.
Atropine in topical formulations for the management of anterior and posterior segment ocular diseases
Published in Expert Opinion on Drug Delivery, 2021
Ines García Del Valle, Carmen Alvarez-Lorenzo
Atropine is an alkaloid extracted from Atropa belladonna (deadly nightshade), Datura stramonium (jimsonweed), and Hyoscyamus niger (henbane) plants that belong to the Solanaceae family. It is synthetized in the roots, with an alkaloid content that runs between 0.01% and 3% [2]. Atropine acts as a competitive, nonselective muscarinic acetylcholine receptor antagonist, affecting the central and peripheral nervous system by blocking receptors in exocrine glands, smooth and cardiac muscle, ganglia and intramural neurons [3]. According to different studies conducted on animals and humans, this alkaloid is widely distributed in tissues [4] and has a binding affinity constant in the range of 0.4–0.7 nM [5] for all five subtypes of muscarinic acetylcholine receptors (M1 to M5) [6,7]. Therapeutically, atropine has a wide range of indications [2,3]. It is used as premedication for anesthesia and surgical procedures, as antisialagogue to inhibit salivation and excessive secretions, and as antivagal agent to prevent cholinergic effects during surgery [8]. Furthermore, this compound is able to reverse muscle relaxant effects [9].
Comparison of Lidocaine and Atropine on Fentanyl-Induced Cough: A Randomized Controlled Study
Published in Journal of Investigative Surgery, 2019
Muhammet Emin Naldan, Zakir Arslan, Ayşenur Ay, Ahmet Murat Yayık
Atropine, which has antimuscarinic, anticholinergic and spasmolytic effects, is also frequently used to prevent or reduce airway secretions during anesthesia (i.e., as an antisialagogue in preanesthetic medication). Only one study was found in the literature that examined the effectiveness of atropine for fentanyl-induced cough. In that study, the authors found that atropine did not effectively inhibit fentanyl-induced cough, in contrast to our findings that atropine was effective.24
Evaluating revefenacin as a therapeutic option for chronic obstructive pulmonary disease
Published in Expert Opinion on Pharmacotherapy, 2020
Sabina Antonela Antoniu, Ruxandra Rajnoveanu, Ruxandra Ulmeanu, Florin Mihaltan, Mihaela Grigore
In the latter category of animals, the selectivity of the three LAMAs was evaluated with the antisialagogue effect and lung selectivity index. Antisialagogic effects of TD-4208 were found to be dose dependent and had an estimated potency of 794 mg/mL with repeated dosing. Lung selectivity indexes were found to be comparable with both single and repeated dosing (26 versus 22) [8,9].