散瞳、治療弱視 Amblyopia, Mydriasis, Cycloplegia
1. Penalization of the healthy eye in the treatment of amblyopia
2. Produce mydriasis and/or cycloplegia

Anticholinergic Agent, Ophthalmic
Blocks the action of acetylcholine that induces mydriasis and allows the radial pupillary dilator muscle to contract resulting in dilation of the pupil; induces cycloplegia by paralysis of the ciliary muscle.

Absorption
1. Well absorbed from all dosage forms
2. Bioavailability: Ophthalmic solution: 64% ± 29%
Metabolism Hepatic via enzymatic hydrolysis
Excretion Urine (13% to 50% as unchanged drug and metabolites)
Pharmacodynamics
1. Onset of action: Within minutes; maximum effect: within hours (3 hours).
2. Duration: Multiple days; visual acuity near normal at 4 days postadministration.
3. Half-life elimination: 2.5 ± 0.8 hours
4. Time to peak: 28 ± 27 minutes

1. Hypersensitivity to atropine or any component of the formulation
2. Primary glaucoma or tendency toward angle-closure glaucoma (narrowing or closure of the anterior chamber angle)

C(FDA)
If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease potential exposure to the fetus

Compatible with breastfeeding. Monitor infant for side effects.(WHO)
Infant risk cannot be ruled out.(MDX)

Cardiovascular: Delirium, flushing, hypotension, increased blood pressure
Central nervous system: Irritability, restlessness
Dermatologic: Contact dermatitis, xeroderma
Gastrointestinal: Xerostomia
Ophthalmic: Blurred vision, decreased lacrimation, eye irritation, eyelid edema, eye pain, papillary conjunctivitis, photophobia, stinging of eyes, superficial keratitis
Respiratory: Dry throat, respiratory depression

Amblyopia
Instill 1 drop in the conjunctiva of the sound eye (nonamblyopic eye) once daily on weekends or daily
Mydriasis/cycloplegia
Instill 1 drop in the conjunctiva 40 minutes prior to intended maximal dilation time; may repeat up to twice daily as needed

For children<3 years, maximum dose: 1 drop per eye per day