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Pharmacokinetics and Effects on Saliva Flow of Sublingual and Oral Atropine in Clozapine-Treated and Healthy Adults: An Interventional Cross-Over Study.
Mubaslat, Omar; Fitzpatrick, Michael; McLachlan, Andrew J; Lambert, Tim.
Afiliación
  • Mubaslat O; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Missenden Mental Health Services, Royal Prince Alfred Hospital, NSW, Australia.
  • Fitzpatrick M; Senior Hospital Scientist, Department of Chemical Pathology, Royal Prince Alfred Hospital, NSW, Australia.
  • McLachlan AJ; Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
  • Lambert T; Sydney Medical School, Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, NSW, Australia.
Psychiatry Clin Psychopharmacol ; 32(1): 17-27, 2022 Mar.
Article en En | MEDLINE | ID: mdl-38764898
ABSTRACT

Background:

Sublingual atropine is an effective treatment of clozapine-induced hypersalivation. This study aims to investigate the pharmacokinetics of atropine after sublingual and oral administration and study the dose effect of atropine on saliva secretion.

Methods:

An interventional cross-over clinical trial where participants received 0.6 mg and 1.2 mg atropine sulfate sublingual solution and 0.6 mg oral tablet. Atropine plasma concentration was measured over 9 hours with validated LC-MS/MS method. Atropine effects on saliva secretion rate, visual acuity and accommodation, and vital signs were assessed.

Results:

Four clozapine-treated and three healthy participants were enrolled in the study. The area under the atropine plasma concentration-time curve (AUC0-∞) was highest after the 1.2 mg sublingual solution administration in comparison with 0.6 mg tablet or sublingual solution (8.58±1.66 µg.L-1.h vs. 4.65±1.29 vs. 2.98±0.73 µg.L-1.h, respectively). The Cmax for the 0.6 mg and 1.2 mg sublingual solutions was 1.11±0.99 and 1.76±0.62 µg.L-1, and tmax was 2.18±0.59 and 1.9±0.71 h, respectively. In comparison with the 0.6 mg sublingual solution dose, the saliva secretion reduction was larger after the oral tablet administration (-40% (-59, -22%) vs. -69% (-80, -57)) and largest after the 1.2 mg sublingual solution administration (-79% (-93,-64)).

Conclusion:

Both the sublingual and oral atropine are effective in reducing the saliva secretion however at a lower plasma concentration after sublingual administration, with a dose-dependent effect. Both have significantly reduced the blood pressure and pulse rate over 3 hours without significant changes in vision. No major safety concerns were reported.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Psychiatry Clin Psychopharmacol Año: 2022 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Psychiatry Clin Psychopharmacol Año: 2022 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido