Atropin
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Atropin adolah ubek nan dipakai untuak maatasi danyuik jantuang nan malambek jo otot polos paruik nan tagang, malapangan pupil mato pado uveitis atau ambliopia, sarato untuak maubek karacunan pestisida jo agen saraf (gas saraf). Salain itu, dipakai pulo dalam tindakan pambadahan untuak maalangi produksi aia liua. Ubek ko biasonyo diagiah dalam bantuak suntik sacaro intravena atau intramuskular. Tasadio pulo dalam bantuak tetes mato. Atropin tamasuak ubek wajib nan paralu ado di satiok klinik atau fasilitas kasihatan manuruik WHO dek kagunaannyo nan pantiang.[3][4][5][6]
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| Data klinis | |
|---|---|
| Namo dagang | Atropen, lainnyo |
| Namo lain | Daturin [1] |
| AHFS/Drugs.com | |
| MedlinePlus | a682487 |
| Kategori pado kahamilan | |
| Rute masuak ubek | malalui muluik, IV, IM, rektal |
| Kelas ubek | antimuskarinik (antikolinergik) |
| Kode ATC | |
| Farmakokinetik data | |
| Bioavailabilitas | 25% |
| Metabolisme | ≥50% tahidrolisis manjadi tropin jo asam tropik |
| Awitan aksi | kurang labiah saminik[2] |
| Eliminasi wakatu paruah | 2 jam |
| Durasi aksi | 30 sampai 60 minik[2] |
| Ekskresi | 15–50% tabuang malalui urin |
| Pangenal | |
(RS)-(8-Methyl-8-azabicyclo[3.2.1]oct-3-yl) 3-hydroxy-2-phenylpropanoate
| |
| Nomor CAS | |
| PubChem CID | |
| IUPHAR/BPS | |
| DrugBank | |
| ChemSpider | |
| UNII | |
| KEGG | |
| ChEBI | |
| ChEMBL | |
| ECHA InfoCard | 100.000.096  |
| Data kimia jo fisika | |
| Formula | C17H23NO3 |
| Molar mass | 289.369 g/mol g·mol−1 |
| 3D model (JSmol) | |
CN3[C@H]1CC[C@@H]3C[C@@H](C1)OC(=O)C(CO)c2ccccc2 | |
InChI=1S/C17H23NO3/c1-18-13-7-8-14(18)10-15(9-13)21-17(20)16(11-19)12-5-3-2-4-6-12/h2-6,13-16,19H,7-11H2,1H3/t13-,14+,15+,16?  Key:RKUNBYITZUJHSG-SPUOUPEWSA-N | |
 (what is this?) (verify) | |
Atropin tamasuak ubek antimuskarinik (masih dalam kalompok antikolinergik) nan bakarajo jo maambek saraf parasimpatis.[7] Karajo atropin ko dapek mamunculkan efek sampiang yaitu muluik kariang, pupil maleba, urin tatahan, kabobolan, sarato danyuik jantuang capek. Dek efek sampiangnyo nan ado pado mato, ubek ko indak buliah diagiah pado urang jo glukoma suduik tatutuik. Untuak mandeh nan manganduang alun ado panalitian nan manjalehan bahayonyo, tapi buliah diagiah untuak mandeh nan manyusui.[8]
Indikasi
suntiangAtropin marupokan ubek antimuskarinik sainggo dapek dipakai untuak maambek produksi aia liua katiko pambadahan. Hal iko batujuan supayo pasien pambadahan nan sadang dibius sarato diintubasi (mamakai alaik bantu angok) indak taaspirasi atau tamasuak aia liau ka saluran angoknyo.[9][10]
Atropin baguno juo untuak maatasi karacunan, baiak dek gas saraf ataupun dek pestisida, walau indak sadoalah pestisida bisa. Pado kondisi karacunan, atropin bakarajo jo maambek asetilkolin pado reseptor muskarinik. Atropin diagiah sabagai respon capek maatasi karacunan. Pado kondisi parang, tantara kadang bahadapan jo ko sarangan gas saraf cando tabun, sarin, soman, sainggo digunakan atropin suntiak dalam wujuik autoinjektor (alaik suntik nan lansuang pakai jo dosis nan tasadio). Atropin acok digunokan basamoan jo pralidoksim klorida. Pado karacunan nan maakibatkan gangguan lokal, cando gangguan mato atau saluran angoko, atropin indak diindikasikan.[9]
Atropin dipakai juo pado kondisi danyuik jantuang malambek (bradikardi) sabagai terapi garih partamo. Diindikasikan katiko ado gangguan struktur pado sistem infranodul atau kok danyuik jantuang kurang dari 50 kali/minik jo tando vital indak stabil. Rato-rato 20% urang bradikardia disababkan dek gangguan hantaran listrik dalam jantuang. Atropin buliah dipakai barulang pado pasien ko asalai ado pabaikan. Pado anak-anak, paralu dicari tau panyabab bradikardianyo. Umumnyo jarang disababkan kalainan jantuang, labiah acok disababkan dek hipoksia atau hipoventilasi. Kok pasian anak maalami bradikardia jo angok nan cukuik rancak, atropin dapek diindikasi.[10][11][12]
Atropin dipakai pulo untuak masalah mato. Pasien nan tibo jo kaluahan padiah di mato dek uveitis atau mato taraso buran dek ambliopia, buliah diagiah atropin. Atropin maagiah efek pupil maleba sainggo baguno pulo untuak tindakan diagnostik. Efek pupil maleba ko disabuik jo efek midriatik. Dek efek iko, pasien jo glukoma suduik tatutuik dikontraindikasikan dek efeknyo nan mampaburuak.[13][14][15]
Mekanisme karajo
suntiangAtropin adolah ubek antimuskarinik nan bakarajo untuak maambek reseptor asetilkolin postganglion sarato vagolitik lansuang (direct vagolytic). Hal iko mambuek efek parasimpatis taambek pado otot polos. Efek akhianyo maningkekan ransangan simpatis nan ditandoi jo maningkeknyo kaluaran jantuang (cardiac output) sarato efek sampiang lain takaik antimuskarinik.[3]
Efek sampiang
suntiangEfek sampiang atropin pado umumnyo bahubuangan jo sipaiknyo nan antimuskarinik di antaronyo muluik kariang (xerostomia), pandangan buram, silau dek cahayo (photophobia), danyuk jantuang capek (takikardia), kulik sirah jo angek. Kabobolan, kanciang tatahan, sarato indak bakaringek (anhidrosis) dapek tajadi khususnyo pado populasi barisiko cando urang-urang gaek. Pado kasus nan sarik, delirium (pikun) atau koma dapek tajadi. Reaksi hipersensitivitas dapek tajadi dan biasonyo tabateh pado kulik.[16][17]
Atropin dapek mangurangi absorpsi dari mexiletin nan dapek ditagah jo kombinasi metoklopramid jo atropin sabalun tindakan anestesi.[18]
Rujuakan
suntiang- ↑ Rafinesque, Constantine Samuel (1828). Medical Flora; Or, Manual of the Medical Botany of the United States of ... - Constantine Samuel Rafinesque - Google Books. https://books.google.com/?id=amgVAAAAYAAJ&pg=PA148. Diakses pado 1 Pebruari 2020.
- ↑ a b Barash, Paul G. (2009). Clinical anesthesia (edisi ke-6th). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. p. 525. ISBN 9780781787635. https://books.google.ca/books?id=-YI9P2DLe9UC&pg=PA525.
- ↑ a b "Atropine". The American Society of Health-System Pharmacists. Diarsipkan dari versi asli tanggal 2015-07-12. Diakses tanggal Mar, 2020.
- ↑ design, Richard J. Hamilton ; Nancy Anastasi Duffy, executive editor ; Daniel Stone, production editor ; Anne Spencer, cover (2014). Tarascon pharmacopoeia (edisi ke-15). p. 386. ISBN 9781284056716. https://books.google.ca/books?id=F6YdAwAAQBAJ&pg=PA386.
- ↑ "Amblyopia (Lazy Eye)". National Eye Institute. 2019-07-02. Diakses tanggal 2020-01-31.
Putting special eye drops in the stronger eye. A once-a-day drop of the drug atropine can temporarily blur near vision, which forces the brain to use the other eye. For some kids, this treatment works as well as an eye patch, and some parents find it easier to use (for example, because young children may try to pull off eye patches).
- ↑ World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. 29 Nopember 2019. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- ↑ "Atropine". The American Society of Health-System Pharmacists. Diarsipkan dari versi asli tanggal 2015-07-12. Diakses tanggal Mar, 2020.
- ↑ "Atropine Pregnancy and Breastfeeding Warnings". Diarsipkan dari versi asli tanggal 6 September 2015. Diakses tanggal 14 Maret 2020.
- ↑ a b "Death Rattle and Oral Secretions, 2nd ed". eperc.mcw.edu. Diarsipkan dari versi asli tanggal 2014-04-14. Diakses tanggal 2019-10-20.
- ↑ a b de Caen, AR; Berg, MD; Chameides, L; Gooden, CK; Hickey, RW; Scott, HF; Sutton, RM; Tijssen, JA; Topjian, A; van der Jagt, ÉW; Schexnayder, SM; Samson, RA (3 November 2015). "Part 12: Pediatric Advanced Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S526–42. doi:10.1161/cir.0000000000000266. PMC 6191296
. PMID 26473000.
- ↑ * Bryan E, Bledsoe; Robert S. Porter; Richard A. Cherry (2004). "Ch. 3". Intermediate Emergency Care. Upper Saddle River, NJ: Pearson Prentice Hill. p. 260. ISBN 0-13-113607-0.
- ↑ Field JM, Hazinski MF, Sayre MR, et al. (November 2010). "Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S640–56. doi:10.1161/CIRCULATIONAHA.110.970889. PMID 20956217.
- ↑ Walline JJ, Lindsley K, Vedula SS, Cotter SA, Mutti DO, Twelker JD (2011). "Interventions to slow progression of myopia in children". Cochrane Database Syst Rev (12): CD004916. doi:10.1002/14651858.CD004916.pub3. PMC 4270373 . PMID 22161388.
- ↑ Georgievski Z, Koklanis K, Leone J (2008). "Fixation behavior in the treatment of amblyopia using atropine". Clinical and Experimental Ophthalmology. 36 (Suppl 2): A764–A765.
- ↑ Fricke, T; Hurairah, H; Huang, Y; Ho, SM (2019). "Pharmacological interventions in myopia management". Community Eye Health. 32 (105): 21–22. PMC 6688412 . PMID 31409953.
- ↑ "Atropine Drug Information". uptodate.com. Diarsipkan dari versi asli
tanggal 2014-02-20. Diakses tanggal 2020-02-02.
- ↑ * "Ch. 10". Rang and Dale's Pharmacology. Elsevier Churchill Livingstone. 29 Nopember 2007. p. 153. ISBN 978-0-443-06911-6.
- ↑ * Goodman E (2010). Historical Contributions to the Human Toxicology of Atropine. Eximdyne. p. 120. ISBN 978-0-9677264-3-4.
