Atropine is a medical substance that is obtained from plants such as belladonna, datura, and henbane. It is a parasympathetic agent, that is, it is able to inhibit the activity of the nerves of the parasympathetic group.
Action of atropine
Atropine is a member of the alkaloids group. Any component of this group in small doses has a therapeutic effect. However, exceeding the allowable dosage leads to severe poisoning, which in case of untimely medical care renders a fatal outcome.
In medicine, atropine is used in various directions, since the spectrum of its effects is very large:
- relaxes smooth muscles;
- relieves pain with intestinal and biliary colic;
- increases the number of heart contractions;
- reduces the intensity of secretion of glands: bronchial, salivary, gastric, intestinal, sweat and pancreas;
- used in the treatment of ulcers that have formed in the stomach or duodenum.
In addition, atropine is used in ophthalmology in order to dilate the pupils.
It is taken orally, injected, used as eye drops.
In medicine, such a chemical compound as atropine sulfate has found application. Outwardly, it is a white powder consisting of crystals. It is odorless and dissolves quickly.
Use of atropine for poisoning with FOS
Organophosphorus compounds (FOS) are actively used in agriculture and everyday life for the destruction of insects, rodents, weeds, etc. FOS poisonings can be either single or massive.
At the time of the onset of the first symptoms of poisoning with organophosphorus compounds, it is necessary to conduct antidote therapy with a 0.1% solution of atropine:
- mild poisoning - 1-2 ml intramuscularly;
- the average degree of poisoning is 2-4 ml intravenously or intramuscularly;
- severe poisoning - 4-6 ml intravenously or intramuscularly and repeated with a frequency of 3-8 minutes until the initial symptoms of atropination begin to appear (dilated pupils, dry mucous membranes).
In severe acute poisoning, the dose of atropine administered can reach 30 ml.
Possible causes of poisoning
Atropine poisoning occurs in several cases. Each of them can be avoided, but neglect of their health becomes the reason for all new similar situations.
Acute poisoning with atropine can occur during the administration of drugs based on it or as a result of taking belens, belladonna, dope, etc. Overdose of drugs with atropine can be judged by dilated pupils, due to increased intraocular pressure.
Eating fruits, berries and other parts of a poisonous plant containing toxins, a person runs the risk of getting intoxication with this alkaloid. The main methods of penetration of toxic substances into the body include:
- ingestion in the stomach;
- through the skin;
- during inhalation of vapors;
- through the mucous membrane.
A fatal outcome from poisoning will occur if the child takes 100 mg of atropine sulfate, and an adult - 130 mg.
The main symptoms of poisoning
Intoxication is very fast. Although it all depends on the size of the alkaloid dose, the main symptomatology begins to manifest itself after 20 minutes. A reaction occurs between chemical compounds and liver proteins, resulting in the formation of metabolites. The functional activity of the kidneys decreases - blood filtration stops, and metabolic products cease to be excreted in the urine.
If the victim is not given first aid on time, he develops a strong thirst, swallowing function is disturbed, and the voice may disappear.
Subsequently, the following symptoms of atropine poisoning appear:
- the skin is dry and flaky;
- the face and body blush, hives may appear;
- breathing quickens, tachycardia occurs;
- a strong cough begins, which goes into barking;
- body temperature rises;
- the pupils do not respond to light and remain dilated, vision falls;
- dizzy.
When monitoring the patient's condition, you should not focus exclusively on the heart rate, since after reaching 160 beats a minute it practically does not change.
When atropine poisoning goes into a severe form, the symptoms of the disease are similar to damage to the central nervous system. This process is divided into two phases.
First phase
Characteristic features in the behavior of a patient in the first phase of severe atropine intoxication are sharp screaming, throwing in bed, and increased anxiety. A person does not navigate in space, constantly encounters objects in his path, trying to catch objects in the air that do not exist. The patient behaves more and more inadequately. Sudden shifts crying with laughter.
All this symptomatology occurs in parallel with severe headaches, visual hallucinations appear, and an increase in muscle tone occurs. Perhaps the appearance of pathological reflexes. In case of increased severity of the form of poisoning, seizures and convulsions begin.
Second phase
Intoxication proceeds to the next phase 6-10 hours after the moment of poisoning. The second phase is distinguished in those cases when the patient managed to enter an antidote. After this, the patient is in a depressed state, possibly periodically losing consciousness. In the second phase, the probability of the patient falling into a coma is high.
First aid for atropine intoxication
How to help with atropine poisoning? Depends on the cause of intoxication.
In the case where the cause of the poisoning is an overdose of tablets, it is necessary to start washing the stomach. For this, the patient should drink about three liters of warm solution, which is prepared with the addition of activated carbon or potassium permanganate (potassium permanganate) in a ratio of 1: 1000.
You can also give the patient a 1-2% tannin solution and put an enema with the same tannin, but with a 0.5% concentration.
After such manipulations, the patient must immediately be placed in the toxicological or resuscitation department of a medical institution, where they will receive full assistance.
Inpatient treatment with atropine poisoning
In a medical institution, a patient must first enter an antidote, the pharmacological effect of which will be opposite to atropine. The selection of an antidote for atropine poisoning depends on the patient's symptoms.
The oral and parenteral (intramuscular, intravenous, ophthalmic, inhalation) route of entry of atropine into the body, which leads to arrhythmias, coma, hallucinations, severe hypertension or epileptic seizures, is neutralized by physostigmine. If there are no other lesions of the central nervous system and the mixture of drugs does not work, then all of the above symptoms disappear after a few minutes.
In the case of atropine poisoning, the antidote is administered subcutaneously, and the dosage is 1 ml.
In order to stabilize the patient's condition and reduce intoxication, it is necessary to cleanse the body of toxins that were not excreted by the affected kidneys. To do this, the patient is given water with diuretic drugs (for example, with furosemide). If the intoxication syndrome is very pronounced, it is necessary to apply forced diuresis using the following solutions:
- glucose 5%;
- sodium bicarbonate 4%;
- sodium chloride.
It will take a day to completely remove poisons from the body.
In especially severe cases, when the patient has tremor, convulsions or psychomotor agitation, antipsychotics may be prescribed by doctors.
To lower the body temperature, injections of analgin are injected, ice is applied to the inguinal region and to the head, and a constant wet wiping of the skin is performed.
To eliminate deep breathing disorders, it is necessary to carry out artificial ventilation of the lungs.
After atropine is completely excreted, the attention of doctors should be focused on symptomatic therapy. It consists of a whole range of activities. How well and quickly the drugs work will depend entirely on the speed with which the antidote is administered.
Atropine Poisoning Prevention
Prevention of atropine poisoning is divided into two directions, depending on the "carrier" of the toxic component (plants, medicines).
Measures aimed at preventing poisoning with medical preparations with belladonna extract, primarily consist in carefully following the instructions from the annotation. In no case do not allow overdoses and even more so do not try to independently make a medicine from a poisonous plant at home.
During outdoor recreation, you need to bypass the side and even more so do not eat berries of unfamiliar plants. Young children on the street must be watched very carefully so that they do not eat poisonous fruits. For older children, prevention consists of getting to know dangerous plants and explaining why they should not be eaten.
Effects
Intoxication causes great harm to the body. Its degree depends on the volume of the alkaloid that has fallen into the blood, the individual characteristics of the patient, and the way the poison penetrates.
The most common consequences include:
- glaucoma, retinal detachment and other visual impairment;
- violation of the central nervous system;
- the occurrence of problems with the gastrointestinal tract;
- prolonged coma, leading to irreversible effects in the brain and, possibly, fatal outcome.