Editing Atropine (section)

==Side effects==
Adverse reactions to atropine include ventricular [[fibrillation]], supraventricular or [[ventricular tachycardia]], [[Vertigo (medical)|dizziness]], [[nausea]], blurred vision, loss of balance, dilated pupils, [[photophobia]], dry mouth and potentially extreme [[confusion]], deliriant [[hallucination]]s, and [[Psychomotor agitation|excitation]] especially among the elderly. These latter effects are because atropine can cross the [[blood–brain barrier]]. Because of the [[Psychedelics, dissociatives and deliriants|hallucinogenic]] properties, some have used the drug [[recreational drugs|recreationally]], though this is potentially dangerous and often unpleasant.{{medcn|date=December 2015}}

In overdoses, atropine is [[poison]]ous.{{medcn|date=March 2022}} Atropine is sometimes added to potentially addictive drugs, particularly antidiarrhea opioid drugs such as [[diphenoxylate]] or [[difenoxin]], wherein the secretion-reducing effects of the atropine can also aid the antidiarrhea effects.{{medcn|date=March 2022}}

Although atropine treats [[bradycardia]] (slow heart rate) in emergency settings, it can cause paradoxical heart rate slowing when given at very low doses (i.e. <0.5&nbsp;mg),<ref>{{cite web |url=http://www.uptodate.com/contents/atropine-drug-information |title=Atropine Drug Information|url-access=subscription |website=uptodate.com|access-date=2014-02-02 |url-status=live |archive-url=https://web.archive.org/web/20140220062212/http://www.uptodate.com/contents/atropine-drug-information?source=search_result&search=atropine&selectedTitle=1~150 |archive-date=2014-02-20 }}</ref> presumably as a result of central action in the CNS.<ref>* {{cite book |vauthors=Rang HP, Dale MM, Ritter JM, Flower RJ | year = 2007| title =  Rang and Dale's Pharmacology |url=https://archive.org/details/rangdalespharmac0006dale |url-access=registration | chapter = Ch. 10| page = [https://archive.org/details/rangdalespharmac0006dale/page/153 153] | publisher = Elsevier Churchill Livingstone| isbn = 978-0-443-06911-6}}</ref> One proposed mechanism for atropine's paradoxical bradycardia effect at low doses involves blockade of inhibitory presynaptic muscarinic [[autoreceptor]]s, thereby blocking a system that inhibits the parasympathetic response.<ref>{{cite book| vauthors = Laurence B |title=Goodman & Gilman's Pharmacological Basis of Therapeutics, 12th Edition|date=2010|publisher=McGraw-Hill|isbn=978-0-07-162442-8}}</ref>

Atropine is incapacitating at doses of 10 to 20&nbsp;mg per person. Its LD<sub>50</sub> is estimated to be 453&nbsp;mg per person (by mouth) with a probit slope of 1.8.<ref>* {{cite book | vauthors = Goodman E | year = 2010| title =  Historical Contributions to the Human Toxicology of Atropine |veditors=Ketchum J, Kirby R | page = 120 | publisher = Eximdyne| isbn = 978-0-9677264-3-4}}</ref>
The antidote to atropine is [[physostigmine]] or [[pilocarpine]].{{medcn|date=March 2022}}

A common [[mnemonic]] used to describe the physiologic manifestations of atropine overdose is: "hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter".<ref name="holzman">{{cite journal | vauthors = Holzman RS | title = The legacy of Atropos, the fate who cut the thread of life | journal = Anesthesiology | volume = 89 | issue = 1 | pages = 241–9 | date = July 1998 | pmid = 9667313 | doi = 10.1097/00000542-199807000-00030 | url = http://www.anesthesiology.org/pt/re/anes/fulltext.00000542-199807000-00030.htm;jsessionid=GSJKLv9vLCdQSmpp6vH3xdhnzWN1hy3s7JqMNFpWkHhLbKJT5vLM!741375937!-949856145!8091!-1#P89 | access-date = 2007-05-21 | s2cid = 28327277 | doi-access = free }} citing J. Arena, Poisoning: Toxicology-Symptoms-Treatments, 3rd edition. Springfield, Charles C. Thomas, 1974, p 345</ref>  These associations reflect the specific changes of warm, dry skin from decreased sweating, blurry vision, decreased lacrimation, vasodilation, and central nervous system effects on [[muscarinic]] receptors, type 4 and 5. This set of symptoms is known as [[toxidrome#Anticholinergic|anticholinergic toxidrome]], and may also be caused by other drugs with anticholinergic effects, such as [[hyoscine hydrobromide]] (scopolamine), [[diphenhydramine]], [[phenothiazine]] [[antipsychotic]]s and [[benztropine]].<ref>{{cite web | url = http://www.intox.org/databank/documents/treat/treate/trt05_e.htm | title = Acute anticholinergic syndrome | vauthors = Szajewski J | year = 1995 | publisher = IPCS Intox Databank | access-date = 2007-05-22| archive-url= https://web.archive.org/web/20070702175337/http://www.intox.org/databank/documents/treat/treate/trt05_e.htm| archive-date= 2 July 2007 | url-status= live}}</ref>