Tropin Special Precautions

Patients Over 40 Years: Atropine should be used cautiously in patients over 40 years old as they may be more susceptible to adverse effects, particularly those with any severe heart disease, hypertension, ulcerative colitis, ileus, chronic lung disease, hyperthyroidism, autonomic neuropathy, hepatic or renal disease or prostatic hypertrophy, oesophageal reflux or hiatus hernia.
Elderly patients may react with excitement, agitation, drowsiness or confusion to even small doses of atropine. Changes in dosage should be gradual.
Debilitated Patients: Atropine should be used with caution in debilitated patients. These patients, especially those with chronic pulmonary disease, may be susceptible to the formation of bronchial mucous plugs due to decreased bronchial secretions.
Glaucoma: In patients over 40 years, conventional parenteral doses of atropine may precipitate acute glaucoma in susceptible individuals.
Myasthenia Gravis: Atropine should be used with extreme caution in patients with myasthenia gravis.
Cardiovascular Status: In conditions characterized by tachycardia, such as cardiac insufficiency or failure, extreme caution must be exercised (see Contraindications). Care is also required in patients with acute myocardial infarction or ischaemia as atropine may worsen the symptoms.
Patients with known cardiac problems have developed angina following administration of atropine.
Atropine has been associated with the development of arrhythmias in adult and paediatric patients. Accelerated heart rate and intraventricular conduction delays have been associated with the development of ventricular fibrillation.
Use in Pregnancy & Lactation: See Use in Pregnancy & Lactation section for further information.
Use in Children: Atropine should be used with caution in infants and small children.