Question
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- (a) Signs and symptoms of Atropine toxicity. Briefly outline the management. ( 4 mark(s)
- (b) Uses of Prostaglandins 4 mark(s)
Answer
a) Signs and symptoms of atropine toxicity, and management Signs/symptoms: dry mouth, blurred vision, photophobia, tachycardia, urinary retention, constipation, hyperthermia (suppressed sweating — “atropine fever,” especially dangerous in children), flushed dry skin, and CNS excitement, confusion, or delirium in severe toxicity — the classic mnemonic “hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter.”
Management: supportive care (cooling for hyperthermia, catheterization for urinary retention, IV fluids); physostigmine — a tertiary amine anticholinesterase that crosses the blood-brain barrier, reversing both central and peripheral antimuscarinic effects, is the specific antidote for severe toxicity with CNS involvement.
b) Uses of prostaglandins
- Obstetric: Dinoprostone (PGE2) and Misoprostol (PGE1 analogue) for cervical ripening and labour induction; Carboprost (PGF2α analogue) for postpartum hemorrhage.
- Cardiovascular: Alprostadil (PGE1) to maintain ductal patency in neonates with ductus-dependent congenital heart disease.
- Gastric protection: Misoprostol, co-prescribed with NSAIDs to counteract COX-1-mediated loss of protective mucosal prostaglandin.
- Ophthalmic: Latanoprost lowers intraocular pressure in open-angle glaucoma by increasing uveoscleral outflow.