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[Side-effects of atropine: pharmacological, allergic, pseudo-allergic or toxic reactions?]
Insights
Atropine eye drops can cause side effects like increased temperature and dry skin in children. Allergy to atropine is rare, but skin tests are recommended if eye irritation occurs.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Dermatology
Context:
- Atropine eye drops are used for refractive error measurement in children.
- Side effects were observed in children aged 1-14 years between 1979-1981.
- Both single and repeated administrations of atropine were studied.
Purpose:
- To document and analyze side effects of atropine eye drops in pediatric patients.
- To assess the incidence of allergic and toxic reactions to atropine eye drops.
- To evaluate the utility of epicutaneous testing for atropine allergy.
Summary:
- 31 children experienced side effects including increased temperature, dry skin, reddened eyes, and periorbital dermatitis.
- Epicutaneous tests with 1% atropine eye drops showed no allergic or toxic reactions in any child.
- Periorbital dermatitis, though rare, suggests potential localized allergic reactions in the eye area.
Impact:
- Highlights the low incidence of true atropine allergy, even with localized reactions.
- Recommends epicutaneous testing for children experiencing ocular side effects before emergency surgery.
- Emphasizes the importance of considering anatomical factors in diagnosing drug allergies.
Abstract:
Between 1979 and 1981 31 children aged from one to 14 years who had been given atropine eye drops to measure refraction presented with the following side-effects: increased temperature (9/31), dry red skin (8/31), reddened eye (3/31) and periorbital dermatitis (2/31) after single (22/31) or repeated (9/31) administration of atropine. In the epicutaneous test with atropine eye drops 1% (readings after 24, 48 and 72 hours) not a single child showed an allergic or toxic reaction. The rarity of an allergy after administration of atropine drops is emphasized by the fact that periorbital dermatitis was observed in only two cases. Clinical experience shows that incipient allergy owing to the anatomical structure of the conjunctiva and eye lids first becomes apparent in the region of the eye, even if the epicutaneous test is not necessarily positive in the dorsum skin. In view of the necessity of administering atropine prior to emergency surgery it is advisable to carry out epicutaneous tests if side-effects have been observed in the eye, to make sure that the patient is not allergic to the drug.