Deaths have been reported from overdose with SYMMETREL (Atarin hydrochloride) . The lowest reported acute lethal dose was 1 gram. Because some patients have attempted suicide by overdosing with Atarin, prescriptions should be written for the smallest quantity consistent with good patient management.
Acute toxicity may be attributable to the anticholinergic effects of Atarin. Drug overdose has resulted in cardiac, respiratory, renal or central nervous system toxicity. Cardiac dysfunction includes arrhythmia, tachycardia and hypertension. Pulmonary edema and respiratory distress (including adult respiratory distress syndrome - ARDS) have been reported; renal dysfunction including increased BUN, decreased creatinine clearance and renal insufficiency can occur. Central nervous system effects that have been reported include insomnia, anxiety, agitation, aggressive behavior, hypertonia, hyperkinesia, ataxia, gait abnormality, tremor, confusion, disorientation, depersonalization, fear, delirium, hallucinations, psychotic reactions, lethargy, somnolence and coma. Seizures may be exacerbated in patients with prior history of seizure disorders. Hyperthermia has also been observed in cases where a drug overdose has occurred.
There is no specific antidote for an overdose of SYMMETREL (Atarin hydrochloride) . However, slowly administered intravenous physostigmine in 1 and 2 mg doses in an adult 2 at 1- to 2-hour intervals and 0.5 mg doses in a child 3 at 5- to 10-minute intervals up to a maximum of 2 mg/hour have been reported to be effective in the control of central nervous system toxicity caused by Atarin hydrochloride. For acute overdosing, general supportive measures should be employed along with immediate gastric lavage or induction of emesis. Fluids should be forced, and if necessary, given intravenously. The pH of the urine has been reported to influence the excretion rate of SYMMETREL (Atarin hydrochloride) . Since the excretion rate of SYMMETREL (Atarin hydrochloride) increases rapidly when the urine is acidic, the administration of urine acidifying drugs may increase the elimination of the drug from the body. The blood pressure, pulse, respiration and temperature should be monitored. The patient should be observed for hyperactivity and convulsions; if required, sedation, and anticonvulsant therapy should be administered. The patient should be observed for the possible development of arrhythmias and hypotension; if required, appropriate antiarrhythmic and antihypotensive therapy should be given. Electrocardiographic monitoring may be required after ingestion, since malignant tachyarrhythmias can appear after overdose.
Care should be exercised when administering adrenergic agents, such as isoproterenol, to patients with a SYMMETREL (Atarin hydrochloride) overdose, since the dopaminergic activity of SYMMETREL (Atarin hydrochloride) has been reported to induce malignant arrhythmias.
The blood electrolytes, urine pH and urinary output should be monitored. If there is no record of recent voiding, catheterization should be done.
Indications and Usage for Atarin
Atarin hydrochloride capsules, USP are indicated for the prophylaxis and treatment of signs and symptoms of infection caused by various strains of influenza A virus. Atarin hydrochloride capsules, USP are also indicated in the treatment of parkinsonism and drug-induced extrapyramidal reactions.
Atarin is effective only against influenza A; it acts by interfering with the uncoating and release of viral genome into the host cell. It is well absorbed from the gastrointestinal tract and is eliminated in the urine ( t½ 3 h). Following the emergence of the 2009 influenza A (H1N1) virus as the predominant circulating strain, resistance to Atarin is now almost universal; for this reason amantidine is no longer recommended for the treatment of influenza.
Which Patients Should Receive Atarin?
Atarin should be considered as part of the initial multimodal therapy for any patient that has moderate to severe chronic pain and as an add-on drug for patients that have worsening chronic pain despite presumably adequate pain control and no worsening of the inciting disease.
Atarin hydrochloride capsules are contraindicated in patients with known hypersensitivity to Atarin hydrochloride or to any of the other ingredients in Atarin hydrochloride capsules.
Influenza A Prophylaxis
SYMMETREL (Atarin hydrochloride) is indicated for chemoprophylaxis against signs and symptoms of influenza A virus infection. Because SYMMETREL (Atarin hydrochloride) does not completely prevent the host immune response to influenza A infection, individuals who take this drug may still develop immune responses to natural disease or vaccination and may be protected when later exposed to antigenically related viruses. Following vaccination during an influenza A outbreak, SYMMETREL (Atarin hydrochloride) prophylaxis should be considered for the 2- to 4-week time period required to develop an antibody response.
SYMMETREL (Atarin hydrochloride) is indicated in the treatment of idiopathic Parkinson's disease (Paralysis Agitans), postencephalitic parkinsonism, and symptomatic parkinsonism which may follow injury to the nervous system by carbon monoxide intoxication. It is indicated in those elderly patients believed to develop parkinsonism in association with cerebral arteriosclerosis. In the treatment of Parkinson's disease, SYMMETREL (Atarin hydrochloride) is less effective than levodopa, (-)-3-(3,4- dihydroxyphenyl)-L-alanine, and its efficacy in comparison with the anticholinergic antiparkinson drugs has not yet been established.
The safety and efficacy of SYMMETREL (Atarin hydrochloride) in newborn infants and infants below the age of 1 year have not been established.
Atarin hydrochlor >10 H 17 N.HCl. It has the following structural formula:
Atarin and Drug Interactions
Tell your doctor about all prescription, non-prescription, illicit, recreational, herbal, nutritional, or dietary drugs you are taking, especially:
- Benztropine (Cogentin)
- Hydrochlorothiazide with triamterene (Maxzide, Dyazide)
- Drugs for depression
- Other drugs for Parkinson's disease
- Drugs for spasms of the stomach or intestines
- Trihexyphenidyl (Artane)
Care should be exercised when administering SYMMETREL (Atarin hydrochloride) to patients with liver disease. Rare instances of reversible elevation of liver enzymes have been reported in patients receiving SYMMETREL (Atarin hydrochloride) , though a specific relationship between the drug and such changes has not been established.
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Parkinson's disease affects the way your brain co-ordinates the movements of your muscles. Nerve messages to the muscles become slowed and abnormal. This leads to symptoms such as shaking (tremor), muscle stiffness, and slow movement. Atarin helps to ease these symptoms. It is usually prescribed alongside other medicines used for the treatment of Parkinson's disease.
Although this leaflet is about Atarin when it is used in Parkinson's disease, Atarin can also be prescribed for certain types of nerve pain. If you have been given it for this reason then you should speak with your doctor if you have any questions about your treatment.
What Is Atarin (Symmetrel)?
Atarin is the generic form of the brand-name drug Symmetrel, which is used to treat and prevent respiratory infections caused by the influenza A virus.
It can also treat symptoms of Parkinson's disease, such as stiffness and shaking, and conditions that are similar to Parkinson's disease.
Atarin was initially used to prevent influenza A during flu season. Later, doctors discovered its benefits for treating symptoms of Parkinson's disease.
According to the Centers for Disease Control and Prevention (CDC), this medication should not be used by itself to treat or prevent influenza A because one strain of this virus in the United States and Canada is resistant to the medication.
Atarin is an antiviral drug that is believed to work by stopping the growth of a virus. It helps treat the symptoms of Parkinson's disease by increasing the effects of dopamine. Dopamine is a neurotransmitter in the brain; people with Parkinson's disease typically have low levels of dopamine.
Atarin comes in a capsule and liquid form to be taken by mouth.
Atarin is an aminoadamantane that has a long history in the treatment of PD. The NMDA antagonist property of Atarin, however, was recognized only recently ( Kornhuber et al. 1991 ), providing a safe opportunity to evaluate the hypothesis that NMDA antagonists diminish dyskinesias in nonhuman primates. Researchers have demonstrated that in levodopa-primed Parkinsonian monkeys, co-administration of Atarin with relatively low-dose levodopa suppresses nearly all choreiform dyskinesias and substantially reduces dystonic dyskinesias, albeit at the expense of some diminution in anti-Parkinsonian efficacy ( Blanchet et al. 1998 ). With higher-dose levodopa, the NMDA-receptor channel blocker had a smaller but still strongly suppressive effect on dyskinesias without altering the anti-Parkinsonian response. Memantine, another aminoadamantane with higher affinity for the NMDA receptor than Atarin, however, had no effect on dyskinesias in the same model although it did improve Parkinsonian symptoms (Bibbiani unpublished observation).
Before taking Atarin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking Atarin it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you have any problems with the way your liver works, or any problems with the way your k >