· Treatment of uveal inflammations

Anterior uveitis (iritis, iridocyclites) and subsequently

O uveal reactions secondary to aggression or surgical treatment

Cycloplegia for refraction (essential in the strabic child) especially in the presence of an accommodative strabismus

· In some cases use for optical penalisation in the treatment of amblyopia in particular unilateral.

Dosage

1 drop of eye drops contains 93 μg of active principle (atropine).

1 to 2 drops, 2 to 4 times a day.

The maximum dose for the child from 30 months to 15 years corresponds to the instillation of 3 times 2 drops and atropine to 0.30 per 24 hours.

Administration mode

As for all eye drops, carry out the following operations in the order

· Wash hands thoroughly.

· Avoid touching the eye or eyelids with the tip of the vial.

· To instill this eye drops, look up and shoot, slightly lower eyelid downward.

· With the eye closed, wipe the excess cleanly, especially on the cheek.

· To avoid inhalation, especially in children, see section 4.4 Precautions and Precautions
In order to avoid the systemic effects induced by the passage of atropine into the general circulation by the lacrimal tract and by oral ingestion, it is recommended, especially in the elderly child and subject, The internal angle of the eye for 1 minute after each instillation and to wipe the excess on the cheek.

· Close the bottle after use.

· If concomitant treatment with another eye drops, space instillations for 15 minutes.

Pharmacotherapeutic class

MYDRIATICS AND CYCLOPLEGICS

ANTICHOLINERGICS: ATC code: S01FA 01

Atropine blocks the responses to cholinergic stimulations of the irien sphincter and the ciliary muscle responsible for accommodation

It produces a dilation of the pupil (mydriasis) and a paralysis of accommodation (cycloplegia).

The instillation of atropine into eye drops causes mydriasis, which is troublesome for a few hours. Accordingly, after instilling, the driving of vehicles and / or the use of machinery should be discouraged during the whole duration of the visual disturbances.
· In case of hypersensitivity to atropine or to any of the excipients of eye drops (especially derivatives, mercurials).

· In patients at risk of glaucoma by closure of the angle

· When breast-feeding

Atropine 1% in eyedrops is reserved for teenagers and adults (over 12 years) .The forms "eye drops" 0.3% and 0.5% are suitable for children under 12 years. >

· Keep out of reach of children as there is a risk of acute intoxication due to accidental ingestion

· With eye drops, there is a passage of atropine in the general circulation.


In order to avoid the systemic effects induced by the passage of atropine into the general circulation by the lacrimal tract and by oral ingestion, it is recommended, especially in the elderly child and subject, The internal angle of the eye for 1 minute after each instillation and wiping the excess on the cheek (see Dosage and Mode of Administration)
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In order to avoid overdosage, repeat instillations should be avoided and the recommended maximum dosages should not be exceeded in a given time interval (see Dosage and Method of Administration "Dosage"). Code>
· Atropine is likely to trigger an acute glaucoma attack by mechanical obstruction of the pathways, elimination of aqueous humor in subjects with a narrow iridocorneal angle

· Open angle glaucoma: atropine eye drops may be used in chronic glaucoma after having checked that the angle is open.
· Atropine eye drops should be administered with caution in patients with symptoms of central nervous system involvement, which may cause central nervous system disorders, especially in young children. >

· Atropine eye drops should be used with caution in case of prostatic adenoma

· This eye dropper contains an organomercurial compound, nitrate, phenylmercuric, which can cause allergic reactions.
Associations, to be taken into account

Other anti-depressants, anti-depressants, imipraminic drugs, most antihistamines H1 atropinic, antiparkinsonian anticholinergic, antispasmodic, atropinic, disopyramide, phenothiazine neuroleptics, as well as clozapine.
Addition of effects, atropinic adverse retention type, urinary, constipation, dry mouth, etc ...

2 Situations are possible

· Or overdosage when administering eye drops (especially during repeated instillations)

· Or because of an accidental ingestion of a vial of eye drops, multidose, in particular by the child

The signs "redness of the face, dryness, mouth and mydriasis" help in diagnosis. Severity is related to regulatory disorders, thermal, neurological and psychiatric toxicity: convulsions, delirium or even coma.


Pregnancy

Studies in animals have demonstrated a teratogenic effect of atropine in a single species and at very high doses

In clinical use, the use of atropine in a limited number of pregnancies has apparently revealed no malformative or fetotoxic effects, particularly to date.

However, additional studies are needed to assess the consequences of exposure during pregnancy.

Therefore, as a precautionary measure, it is preferable not to use atropine during pregnancy.


The passage of atropine into breast milk may result in an overdose in the infant, including signs of neurological toxicity. In addition, atropine decreases, milky secretion. Therefore, if the intake of this medication really appears, it is essential that breast-feeding is contraindicated.


· Risk of acute glaucoma by closing the angle (see section Contraindications)

· Mydriasis, disturbances of accommodation, prolonged.

· Local irritation, tingling, possibility of allergic reaction

Related to excipient

Due to the presence of phenylmercuric nitrate: risk of contact dermatitis, depigmentation.

Systemic undesirable effects

Atropine in eyedrops passes into the general circulation and may cause systemic effects, particularly in children and the elderly (see sections Dosage and Mode of Administration, "Mode of Administration" and "Warnings" And precautions for use).

The adverse effects are mainly neurological and psychiatric

· In particular: agitation, hyperexcitability or drowsiness, brutal, confusion

· More rarely at therapeutic dosages, convulsions and hallucinations

· The child and the elderly have answers, variable with atropine eye drops

Other signs of atropinic impregnation are frequent

· Redness of the face, tachycardia, dry mouth.

· Fever in children, rarely severe except in case of overdose

· Digestive disorders

O, constipation especially in the elderly

O: in the newborn premature: Distension, abdominal, ileus, occlusion.
A great caution of administration is indispensable in this population of newborns, preterm.