Central Nervous System

Although atropine and scopolamine share many properties, an important difference is the easier entry of scopolamine into the CNS. Typical doses of atropine (0.2-2 mg) have minimal central effects, while larger doses can produce a constellation of responses collectively termed the central anticholinergic syndrome. At intermediate doses (2-10 mg), memory and concentration may be impaired, and the patient may be drowsy. If doses of 10 mg or more are used, the patient may exhibit confusion, excitement, hallucinations, ataxia, asyn-ergia, and possibly coma.

Even low doses of scopolamine have central effects. Sedation, amnesia, and drowsiness are common during the clinical use of this drug. Large doses of scopolamine can produce all of the responses seen with atropine. Other tertiary amine compounds with muscarinic receptor blocking activity have similar central effects.

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