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Frontiers in veterinary science2022; 9; 951300; doi: 10.3389/fvets.2022.951300

Plasma atropine concentrations associated with decreased intestinal motility in horses.

Abstract: Atropine is an essential part of the treatment protocol for equine uveitis. Topical atropine administration has been associated with decreased intestinal motility and abdominal pain in horses. Experimental studies have indicated that frequent dosing is associated with a higher risk than dosing every 6 h. Unfortunately, no quantitative pharmacodynamic data for inhibition of the equine gut are published. Unassigned: Eight standardbred horses were assigned to receive either atropine or saline (control) to be infused over 30 min in a two-treatment cross-over design. Atropine concentrations in plasma were measured using ultra-high-performance liquid chromatography-tandem mass spectrometry. Intestinal motility was measured using borborygmi frequency and electrointestinography (EIG). Experimental data were analyzed using a non-linear mixed effects model. The model was then used to simulate different dosing regimens. Unassigned: Atropine significantly decreased borborygmi response and EIG response. Six horses developed clinical signs of abdominal pain. The pharmacokinetic typical values were 0.31, 1.38, 0.69, and 1.95 L/kg·h for the volumes of the central, the highly perfused, the scarcely perfused compartments, and the total body clearance, respectively. The pharmacodynamic typical values were 0.31 μg/L and 0.6 and 207 nV7 cpm for the plasma concentration at 50% of the maximum response and the maximum response and the baseline of cecal EIG response, respectively. Six different dosing regimens of topical atropine sulfate to the eye (0.4 and 1 mg every hour, every 3 h, and every 6 h) were simulated. Unassigned: The IV PK/PD data coupled with simulations predict that administration of 1 mg of topical atropine sulfate administered to the eye every hour or every 3 h will lead to atropine accumulation in plasma and decreased intestinal myoelectric activity. Administration every 6 h predicted a safe dosing regimen in full-sized horses. Clinical studies would be valuable to confirm the conclusions. For smaller equids and horses put at risk for colic due to othercauses, droplet bottles that deliver 40 μl of 1% atropine sulfate per drop or less may be used to lower the risk further.
Publication Date: 2022-09-02 PubMed ID: 36118347PubMed Central: PMC9478751DOI: 10.3389/fvets.2022.951300Google Scholar: Lookup
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  • Journal Article

Summary

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This research examines the effect of atropine, a medication commonly used in treating eye inflammation in horses, on the intestinal motility of the animal. The study reveals that frequent and high dosage of atropine can harm intestinal activity and cause abdominal discomfort in horses, but suggests safer dosing regimes.

Research Methodology

  • The research involved eight standardbred horses which were equally divided to either receive atropine or a saline solution as a control
  • The administered substance was infused over a period of 30 minutes in a cross-over design, allowing the horses to receive both treatments in alternating periods.
  • The concentrations of atropine in the plasma of the horses were determined via ultra-high-performance liquid chromatography and tandem mass spectrometry
  • Intestinal motility was evaluated using both borborygmi frequency, a measure of horses’ gut sounds, and electrointestinography (EIG), an electrical monitoring of the intestinal tract.
  • The recorded data was then analyzed through a non-linear mixed-effects model to understand the relationship between atropine concentrations and intestinal motility.

Research Findings

  • The results indicated that atropine significantly reduced both borborygmi and EIG responses which effectively translates to reduced intestine movement in horses.
  • Six out of the eight horses developed visible signs of abdominal pain, showing the potential negative impact atropine has on the animals’ comfort and wellbeing.
  • The pharmacokinetic results represented normalized rates of atropine dispersion and elimination in the horse’s body.
  • Similarly, pharmacodynamic findings indicated at what plasma concentration the drug triggers 50% of its maximum effect as well as the upper limit of the drug’s effect on cecal (attachment of large intestine to appendix) EIG response.
  • Through the use of this research data, six potentially safer dosing regimens, employing different frequency and dosage of topical atropine sulfate, were simulated.

Predictive Modelling and Suggestions

  • Using a combination of the research’s intravenous pharmacokinetic and pharmacodynamic data and the simulated dosing regimens, it was predicted that the administration of 1mg of topical atropine sulfate to the eye every hour or every 3 hours will result in the accumulation of atropine in the plasma, leading to a decrease in intestinal activity
  • Contrarily, the administration of the same amount every 6 hours was predicted to follow a safer dosing regimen for full-sized horses.
  • However, the conclusions rely heavily on clinical studies for full validation.
  • The research suggests alterations of the current treatment practices, encouraging the use of smaller droplet bottles to administer the topical atropine sulfate, reducing the risk of colic and similar conditions in smaller equids and horses.

Cite This Article

APA
Ekstrand C, Michanek P, Gehring R, Sundell A, Källse A, Hedeland M, Ström L. (2022). Plasma atropine concentrations associated with decreased intestinal motility in horses. Front Vet Sci, 9, 951300. https://doi.org/10.3389/fvets.2022.951300

Publication

ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 9
Pages: 951300
PII: 951300

Researcher Affiliations

Ekstrand, Carl
  • Department of Biomedicine and Veterinary Public Health, Division of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Michanek, Peter
  • Department of Biomedicine and Veterinary Public Health, Division of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Gehring, Ronette
  • Department of Biomedicine and Veterinary Public Health, Division of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
  • Department of Population Health Sciences, Division of Veterinary and Comparative Pharmacology, Utrecht University, Utrecht, Netherlands.
Sundell, Anna
  • Department of Biomedicine and Veterinary Public Health, Division of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Källse, Annika
  • Department of Biomedicine and Veterinary Public Health, Division of Pharmacology and Toxicology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Hedeland, Mikael
  • Department of Medicinal Chemistry, Division of Analytical Pharmaceutical Chemistry, Uppsala University, Uppsala, Sweden.
Ström, Lena
  • Department of Clinical Sciences, Division of Large Animal Surgery, Swedish University of Agricultural Sciences, Uppsala, Sweden.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor JM declared a past collaboration with the author RG.

References

This article includes 31 references
  1. Ali-Melkkilä T, Kanto J, Iisalo E. Pharmacokinetics and related pharmacodynamics of anticholinergic drugs.. Acta Anaesthesiol Scand 1993 Oct;37(7):633-42.
  2. Gerding JC, Gilger BC. Prognosis and impact of equine recurrent uveitis.. Equine Vet J 2016 May;48(3):290-8.
    doi: 10.1111/evj.12451pubmed: 25891653google scholar: lookup
  3. Williams MM, Spiess BM, Pascoe PJ, O'Grady M. Systemic effects of topical and subconjunctival ophthalmic atropine in the horse.. Vet Ophthalmol 2000;3(2-3):193-199.
  4. Wehrman RF, Gemensky-Metzler AJ, Zibura AE, Nyhart AB, Chandler HL. Objective evaluation of the systemic effects of topical application of 1% atropine sulfate ophthalmic solution in healthy horses.. J Am Vet Med Assoc 2017 Dec 1;251(11):1324-1330.
    doi: 10.2460/javma.251.11.1324pubmed: 29154707google scholar: lookup
  5. Ström L, Dalin F, Domberg M, Stenlund C, Bondesson U, Hedeland M, Toutain PL, Ekstrand C. Topical ophthalmic atropine in horses, pharmacokinetics and effect on intestinal motility.. BMC Vet Res 2021 Apr 7;17(1):149.
    doi: 10.1186/s12917-021-02847-4pmc: PMC8028730pubmed: 33827566google scholar: lookup
  6. Sutton GA, Dahan R, Turner D, Paltiel O. A behaviour-based pain scale for horses with acute colic: scale construction.. Vet J 2013 Jun;196(3):394-401.
    doi: 10.1016/j.tvjl.2012.10.008pubmed: 23141961google scholar: lookup
  7. Adams SB, Lamar CH, Masty J. Motility of the distal portion of the jejunum and pelvic flexure in ponies: effects of six drugs.. Am J Vet Res 1984 Apr;45(4):795-9.
    pubmed: 6731996
  8. Ducharme NG, Fubini SL. Gastrointestinal complications associated with the use of atropine in horses.. J Am Vet Med Assoc 1983 Feb 1;182(3):229-31.
    pubmed: 6826443
  9. Roberts MC, Argenzio A. Effects of amitraz, several opiate derivatives and anticholinergic agents on intestinal transit in ponies.. Equine Vet J 1986 Jul;18(4):256-60.
  10. Donnellan CM, Page PC, Nurton JP, van den Berg JS, Guthrie AJ. Comparison of glycopyrrolate and atropine in ameliorating the adverse effects of imidocarb dipropionate in horses.. Equine Vet J 2013 Sep;45(5):625-9.
    doi: 10.1111/evj.12032pubmed: 23461655google scholar: lookup
  11. Menozzi A, Pozzoli C, Poli E, Bontempi G, Serventi P, Meucci V, Intorre L, Bertini S. Role of muscarinic receptors in the contraction of jejunal smooth muscle in the horse: An in vitro study.. Res Vet Sci 2017 Dec;115:387-392.
    doi: 10.1016/j.rvsc.2017.07.012pubmed: 28711697google scholar: lookup
  12. VanderBroek AR, Reef VB, Aitken MR, Stefanovski D, Southwood LL. Assessing gastrointestinal motility in healthy horses comparing auscultation, ultrasonography and an acoustic gastrointestinal surveillance biosensor: a randomised, blinded, controlled crossover proof of principle study.. Equine Vet J 2019 Mar;51(2):246-251.
    doi: 10.1111/evj.12990pubmed: 29975422google scholar: lookup
  13. Curtis L, Burford JH, England GCW, Freeman SL. Risk factors for acute abdominal pain (colic) in the adult horse: A scoping review of risk factors, and a systematic review of the effect of management-related changes.. PLoS One 2019;14(7):e0219307.
  14. Curtis L, Burford JH, Thomas JS, Curran ML, Bayes TC, England GC, Freeman SL. Prospective study of the primary evaluation of 1016 horses with clinical signs of abdominal pain by veterinary practitioners, and the differentiation of critical and non-critical cases.. Acta Vet Scand 2015 Oct 6;57:69.
    doi: 10.1186/s13028-015-0160-9pmc: PMC4596518pubmed: 26444675google scholar: lookup
  15. Jones DL. Clinical effects of detomidine with or without atropine used for arthrocentesis in horses.. Can Vet J 1993 May;34(5):296-300.
    pmc: PMC1686527pubmed: 17424223
  16. Rezende ML, Grimsrud KN, Stanley SD, Steffey EP, Mama KR. Pharmacokinetics and pharmacodynamics of intravenous dexmedetomidine in the horse.. J Vet Pharmacol Ther 2015 Feb;38(1):15-23.
    doi: 10.1111/jvp.12138pubmed: 25066475google scholar: lookup
  17. Tapio HA, Raekallio MR, Mykkänen A, Mama K, Mendez-Angulo JL, Hautajärvi H, Vainio OM. Effects of MK-467 hydrochloride and hyoscine butylbromide on cardiorespiratory and gastrointestinal changes induced by detomidine hydrochloride in horses.. Am J Vet Res 2018 Apr;79(4):376-387.
    doi: 10.2460/ajvr.79.4.376pubmed: 29583040google scholar: lookup
  18. Ehrhardt EE, Lowe JE. Observer variation in equine abdominal auscultation.. Equine Vet J 1990 May;22(3):182-5.
  19. Sasaki N, Mizuno Y, Yoshihara T. The application of electrocecography for evaluation of cecum motility in horses.. J Vet Med Sci 1998 Nov;60(11):1221-6.
    doi: 10.1292/jvms.60.1221pubmed: 9853303google scholar: lookup
  20. Sasaki N, Lee I, Ayukawa Y, Yamada H. Clinical applications of electrointestinography in the horse. J Equine Sci (2004) 15:85–92.
    doi: 10.1294/jes.15.85google scholar: lookup
  21. Koenig JB, Martin CE, Nykamp SG, Mintchev MP. Use of multichannel electrointestinography for noninvasive assessment of myoelectrical activity in the cecum and large colon of horses.. Am J Vet Res 2008 Jun;69(6):709-15.
    doi: 10.2460/ajvr.69.6.709pubmed: 18518649google scholar: lookup
  22. Cohen ND, Matejka PL, Honnas CM, Hooper RN. Case-control study of the association between various management factors and development of colic in horses. Texas Equine Colic Study Group.. J Am Vet Med Assoc 1995 Mar 1;206(5):667-73.
    pubmed: 7744689
  23. Ross MW, Cullen KK, Rutkowski JA. Myoelectric activity of the ileum, cecum, and right ventral colon in ponies during interdigestive, nonfeeding, and digestive periods.. Am J Vet Res 1990 Apr;51(4):561-6.
    pubmed: 2327615
  24. Koenig J, Cote N. Equine gastrointestinal motility--ileus and pharmacological modification.. Can Vet J 2006 Jun;47(6):551-9.
    pmc: PMC1461410pubmed: 16808227
  25. Mitchell CF, Malone ED, Sage AM, Niksich K. Evaluation of gastrointestinal activity patterns in healthy horses using B mode and Doppler ultrasonography.. Can Vet J 2005 Feb;46(2):134-40.
    pmc: PMC1082861pubmed: 15825515
  26. Hinderling PH, Gundert-Remy U, Schmidlin O. Integrated pharmacokinetics and pharmacodynamics of atropine in healthy humans. I: Pharmacokinetics.. J Pharm Sci 1985 Jul;74(7):703-10.
    doi: 10.1002/jps.2600740702pubmed: 4032240google scholar: lookup
  27. Hinderling PH, Gundert-Remy U, Schmidlin O, Heinzel G. Integrated pharmacokinetics and pharmacodynamics of atropine in healthy humans. II: Pharmacodynamics.. J Pharm Sci 1985 Jul;74(7):711-7.
    doi: 10.1002/jps.2600740703pubmed: 4032241google scholar: lookup
  28. European Medicinal Agency . Comittee for Veterinary Medicinal Products. Atropine Summary Report. (1998). Available from: https://www.ema.europa.eu/en/documents/mrl-report/atropine-summary-report-committee-veterinary-medicinal-products_en.pdf1998 (accessed May 22, 2022).
  29. Kumar S, Karki R, Meena M, Prakash T, Rajeswari T, Goli D. Reduction in drop size of ophthalmic topical drop preparations and the impact of treatment.. J Adv Pharm Technol Res 2011 Jul;2(3):192-4.
    doi: 10.4103/2231-4040.85540pmc: PMC3217709pubmed: 22171317google scholar: lookup
  30. McMullen RJ Jr, Fischer BM. Medical and Surgical Management of Equine Recurrent Uveitis.. Vet Clin North Am Equine Pract 2017 Dec;33(3):465-481.
    doi: 10.1016/j.cveq.2017.07.003pubmed: 28985983google scholar: lookup
  31. Patipa LA, Sherlock CE, Witte SH, Pirie GD, Berghaus RD, Peroni JF. Risk factors for colic in equids hospitalized for ocular disease.. J Am Vet Med Assoc 2012 Jun 15;240(12):1488-93.
    doi: 10.2460/javma.240.12.1488pubmed: 22657933google scholar: lookup

Citations

This article has been cited 2 times.
  1. Munsterman AS, Dias Moreira AS, Kottwitz J. Evaluation of the Effects of Detomidine on Equine Myoelectrical Activity Using Electrointestinography. J Vet Emerg Crit Care (San Antonio) 2025 Mar-Apr;35(2):120-130.
    doi: 10.1111/vec.13464pubmed: 40254911google scholar: lookup
  2. Jodzio D, DeNotta S, Plummer C, Sanchez C. Pain scoring systems in hospitalized horses with ocular disease. J Vet Intern Med 2024 Jan-Feb;38(1):388-397.
    doi: 10.1111/jvim.16933pubmed: 37982362google scholar: lookup