Atropine is a medical substance that is obtained from plants such as belladonna, dope, henbane. It is a parasympathetic agent, that is, it is capable of inhibiting the activity of the nerves of the parasympathetic group.
Atropine action
Atropine belongs to the group of alkaloids. Any component of this group in small doses has a therapeutic effect. However, exceeding the allowable dosage leads to severe poisoning, which, if untimely medical care is provided, leads to death.
In medicine, atropine is used in various ways, since the spectrum of its effects is very large:
- relaxes smooth muscles;
- relieves pain from intestinal and biliary colic;
- increases heart rate;
- reduces the secretion of glands: bronchial, salivary, gastric, intestinal, sweat and pancreas;
- used in the treatment of ulcers that have formed in the stomach orduodenum.
Also, atropine is used in ophthalmology to dilate 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. Odorless and dissolves quickly.
Use of atropine in OP poisoning
Organophosphorus compounds (OPs) are actively used in agriculture and everyday life for the destruction of insects, rodents, weeds, etc. Poisoning of OPs can be both single and massive.
At the time of the appearance of the first symptoms of organophosphate poisoning, it is necessary to carry out antidote therapy with 0.1% atropine solution:
- mild degree of poisoning - 1-2 ml intramuscularly;
- average degree of poisoning - 2-4 ml intravenously or intramuscularly;
- severe poisoning - 4-6 ml IV or IM and repeat at intervals of 3-8 minutes until the initial symptoms of atropinization (dilated pupils, dry mucous membranes) begin to appear.
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 one's he alth becomes the cause of more and more such situations.
Acute atropine poisoning canarise in the process of taking drugs based on it or as a result of taking henbane, belladonna, dope, etc. An overdose of drugs with atropine can be judged by dilated pupils, which is due to an increase in intraocular pressure.
Eating fruits, berries and other parts of a poisonous plant containing toxins, a person risks getting intoxicated with this alkaloid. The main methods of penetration of toxic substances into the body include:
- ingestion;
- through the skin;
- during vapor inhalation;
- through the mucous membrane.
Fatal outcome from poisoning will occur if a child takes 100 mg of atropine sulfate, and an adult - 130 mg.
Main symptoms of poisoning
Intoxication is very fast. Although it all depends on the size of the alkaloid dose, the main symptomatology begins to appear after 20 minutes. There is a reaction 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 are no longer excreted from the body with urine.
If the victim is not given first aid in time, he develops a strong thirst, the swallowing function is disturbed, and the voice may disappear.
Subsequently, the following symptoms of atropine poisoning appear:
- dry and flaky skin;
- face and body blush, hives may appear;
- breathing quickens, tachycardia occurs;
- a strong cough begins,which turns into "barking";
- body temperature rises;
- pupils do not react to light and remain dilated, vision drops;
- dizzy.
When monitoring the patient's condition, you should not focus solely on the pulse rate, since upon reaching 160 beats per minute, it practically does not change.
When atropine poisoning progresses to a severe form, the symptoms of the disease are similar to those of 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 a severe form of atropine intoxication are sharp cries, throwing in bed, increased anxiety. A person does not orient himself in space, constantly collides with objects that are in his path, tries to catch objects in the air that do not exist. The patient behaves more and more inadequately. There are abrupt shifts between crying and laughing.
All these symptoms occur in parallel with severe headaches, visual hallucinations appear, and muscle tone increases. The appearance of pathological reflexes is possible. In case of increased severity of the form of poisoning, seizures and convulsions begin.
Second phase
To the next phase, intoxication passes 6-10 hours after the moment of poisoning. The second phase is allocated in those cases when the patient managed to enter the antidote. After that, the patient is in a depressed state, possibly periodicallyloses consciousness. In the second phase, the patient is likely to fall into a coma.
First aid for atropine intoxication
How to help with atropine poisoning? Depends on the cause of intoxication.
In the case when the cause of poisoning is an overdose of pills, it is necessary to start washing the stomach. To do this, the patient should drink about three liters of a 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% solution of tannin to drink and an enema with the same tannin, but 0.5% concentration.
After such manipulations, the patient must be immediately placed in the toxicological or intensive care unit of a medical institution, where he will be provided with full assistance.
Inpatient treatment of atropine poisoning
In a medical institution, the patient first of all needs to enter an antidote, the pharmacological action of which will be opposite to atropine. The choice of antidote for atropine poisoning depends on the patient's symptoms.
Oral and parenteral (intramuscular, intravenous, ophthalmic, inhalation) pathways of atropine into the body that result in arrhythmia, coma, hallucinations, severe hypertension or seizures are 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 pass through severalminutes.
The antidote for atropine poisoning is administered subcutaneously and the dosage is 1 ml.
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. For this, the patient is given water with diuretic drugs (for example, furosemide). If the intoxication syndrome is severe, 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 particularly severe cases, when the patient has tremors, convulsions or psychomotor agitation, neuroleptics may be prescribed by doctors.
To lower body temperature, analgin injections are administered, ice is applied to the groin and head, and constant wet rubbing of the skin is carried out.
To eliminate deep breathing disorders, it is necessary to carry out artificial ventilation of the lungs.
After atropine is completely eliminated from the body, the attention of doctors should be focused on symptomatic therapy. It consists of a whole range of activities. How well and quickly the drugs will work will depend entirely on the promptness of the administration of the antidote.
Prevention of atropine poisoning
Prevention of atropine poisoning is divided into two areas, depending on the "carrier" of the poisonous component (plants, medicines).
Measures aimed at preventing poisoning with medicines containing belladonna extract, first of all, consist in carefully following the instructions from the annotation. In no case should you overdose, and even more so, do not try to make your own medicine from a poisonous plant at home.
During outdoor recreation, you need to bypass, and even more so, do not eat berries of unfamiliar plants. Small children on the street must be watched very carefully so that they do not eat poisonous fruits. For older children, prevention consists of introducing dangerous plants and explaining the reason why they should not be eaten.
Consequences
Intoxication causes great harm to the body. Its degree depends on the volume of the alkaloid that has entered the bloodstream, the individual characteristics of the patient and the method of penetration of the poison.
The most common consequences include:
- glaucoma, retinal detachment and other visual impairments;
- disruption of the central nervous system;
- problems with the gastrointestinal tract;
- prolonged coma, leading to irreversible consequences in the brain and possibly death.
