Atropine is contraindicated in:
A. Myasthenia gravis B. Glaucoma C. Diarrhea D. Peptic ulcer
The correct answer and explanation is:
The correct answer is B. Glaucoma.
Atropine is an anticholinergic medication that works by blocking the action of acetylcholine, a neurotransmitter involved in many bodily functions. It is commonly used in situations like bradycardia (slow heart rate), organophosphate poisoning, and to reduce salivation during surgery. However, atropine can have significant adverse effects in certain conditions, especially glaucoma.
In glaucoma, particularly narrow-angle glaucoma (or angle-closure glaucoma), atropine can exacerbate the condition. This happens because atropine causes the pupils to dilate (mydriasis), which can increase intraocular pressure. In people with narrow-angle glaucoma, the iris may be positioned in such a way that the drainage angle of the eye is blocked when the pupil is dilated. This obstruction can lead to a sudden increase in intraocular pressure, potentially causing severe damage to the optic nerve and leading to vision loss. For this reason, atropine and other anticholinergic drugs are contraindicated in individuals with glaucoma.
The other options are not direct contraindications for atropine:
- A. Myasthenia gravis: Atropine does not worsen myasthenia gravis, a condition characterized by weakness of voluntary muscles due to a defect in neuromuscular transmission. However, it can interact with medications used to treat myasthenia gravis, such as acetylcholinesterase inhibitors, but it is not contraindicated for myasthenia gravis itself.
- C. Diarrhea: Atropine can be used in some gastrointestinal conditions, such as for controlling the symptoms of irritable bowel syndrome, so it is not contraindicated in diarrhea. However, it should not be used indiscriminately in cases where there may be an underlying infectious cause.
- D. Peptic ulcer: While atropine may reduce gastric secretions and could theoretically help in reducing acid secretion, it is not generally contraindicated in peptic ulcer disease. However, its use should be monitored carefully in patients with ulcer disease due to potential side effects like reduced gastrointestinal motility.
In summary, atropine is contraindicated in glaucoma due to its potential to increase intraocular pressure and worsen the condition.