Atropine

 


Other Names

Atropine Sulfate


Classification

Anticholinergic


Action

  1. •Decreases action of the parasympathetic nervous system increasing conduction velocity (dromotropy) and heart rate (chronotropy), enhances conduction through the AV junction

  2. •Decrease bodily secretions (anticholinergic effect)


Indications

  1. • Symptomatic bradycardia, bradyarrythmias

  2. •Asystole

  3. •Organophospate poisoning

  4. •Pre-intubation in children under 5 years of age requiring airway manipulation to prevent vagotonic bradycardia response

  5. •Pre succinylcholine administration in children under 10 and adults getting a second dose


Contraindications

Tachycardia


Precautions

  1. •Hypersensitivity to the medication

  2. •Known or suspected MI since it may promote arrhythmias or increase the size of the infarct.

  3. •Overdose will cause antichoinergic toxidrome ("red as a beet, dry as a bone, blind as a bat, mad as a hatter, and hot as a hare.")


Adverse Reactions

  1. •Palpitations

  2. •Headache

  3. •Blurred vision

  4. •Dry mouth

  5. •Dilated pupils

  6. •Drowsiness

  7. •Anxiety


Interactions/Compatibility/Stability

  1. •Stable at room temperature

  2. •Decomposition occurs with alkaline solutions

  3. •Incompatible with sodium bicarbonate (NaHCO3), norepinephrine and aminophylline

  4. •Using Atropine with other anticholinergics may result in a synergistic effect which increases vagal blockade


Special Considerations

None noted


Dosages

Preparation: 1 mg in 10 ml preloaded syringe

Adult: 0.5 - 1 mg (1 - 2 mg ETT)

Pediatric: 0.02 mg/kg

Minimum dose: 0.1 mg

Maximum dose:

    child - 0.5 mg IV/IO (1 to 8 yrs of age),

    adolescent - 1 mg IV (9 to 16 yrs of age)


Kinetics

Onset           Immediate

Peak             2-4 minutes

Duration      4 hours



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