Atropine Sulphate

About these monographs

Category:

Cardiac and Antidote

 

Description:

Parasympatholytic and anticholinergic

Indications:

Hemodynamically significant or symptomatic bradycardia, organophosphate, cholinergic or nerve agent exposure,

secondary pharmacology in asystole or PEA, premedication or symptom control with ketamine and anaesthetics

Mechanism of Action:

Blocks muscarinic acetylcholine receptors leading to reduced parasympathetic stimulation of target organs

Pharmacokinetics:

Route: IV

Onset: 1-2 minutes

Peak Effects: 15-50 minutes

Duration: Up to 5 hours

Route: IM

Onset: 2-10 minutes

Peak Effects: 100 minutes

Duration: Up to 4 hours

Contraindications:

Allergy or adverse drug reaction

Adverse Effects:

Dry mouth, flushing, hot skin, blurred vision, dilated pupils, agitation, hallucinations, tachycardia, reduced

bronchial and gastric secretions, dry skin, rebound bradycardia, ataxia

Precautions and Facts:

Glaucoma, atrial flutter, atrial fibrillation, and ACS. Caution should be exercised with use in patients with heart

blocks.

Presentation:

500 mcg, 600 mcg, 1 mg or 1.2 mg/mL ampoules, 1 mg and 2.5 mg minijets. Additional preparations come

combined with an "-oxime".

Dosages:

Indication: Bradycardia (Adults)

Route: IV/IO

Initial Dose: 600 mcg

Dose Intervals: Repeat after 2 minutes

Maximum Dose: 1.2 mg (two doses)

Indication: Bradycardia (Paediatric)

Route: IV/IO

Initial Dose: 20 mcg/kg (not to exceed 600 mcg)

Dose Intervals: Repeat after 2 minutes

Maximum Dose: 40 mcg/kg

Indication: Envenomation (Adults)

Route: IV/IO/IM

Initial Dose: 1.2 mg

Dose Intervals: Repeat at 5-minute intervals

Maximum Dose: No maximum dose (titrate to effect)

Indication: Envenomation (Paediatric)

Route: IV/IO/IM

Initial Dose: 20 mcg/kg (up to 600 mcg)

Dose Intervals: Repeat at 5-minute intervals

Maximum Dose: No maximum dose (titrate to effect)

Indication: Hypersalivation (Adults and Paeds)

Route: IV

Initial Dose: 20 mcg/kg (up to 600 mcg)

Dose Intervals: Repeat once as needed

Maximum Dose: 600 mcg

Indication: Organophosphate Toxicity (Adults)

Route: IV/IO/IM

Initial Dose: 1.2 mg 

Dose Intervals: Repeat at 5-minute interval

Maximum Dose: No maximum dose (titrate to effect)

Indication: Organophosphate Toxicity (Paediatric)

Route: IV/IO/IM

Initial Dose: 20 mcg/kg (up to 600 mcg)

Dose Intervals: Repeat at 5-minute interval

Maximum Dose: No maximum dose (titrate to effect)

Cite as: Maria, S., Colbeck, M., & Caffey, M. (Eds.). (2020). Atropine Sulphate. In Paramedic & Emergency Pharmacology Guidelines (2nd ed.). Melbourne, Victoria: Pearson.

This book is for information purposes only and is designed as a general reference for paramedics, students and healthcare professionals  No responsibility will be taken for inaccuracies, omissions or errors  The authors do not accept liability to any person or organization for the information that may result in loss or damages incurred as a result of reliance upon the material in this guide While every effort has been made to ensure that the information in this text is up to date, accurate and in accordance with current clinical recommendations and practice, the dynamic nature of healthcare and pharmaceutical information requires any student or health professional to exercise independent clinical judgement when referring, using or providing information from this book

 

A body of evidence for the development of this guide has been collected by the authors to support the pharmacokinetics, indication, contraindications, adverse effects and dosage behind each medication  This body reflects information provided by Australia’s Therapeutic Goods Administration, Monthly Index of Medical Specialities, the United States’ Food and Drug Administration, and both peer-reviewed studies and clinical trials demonstrating the approved efficacy, usage and current understanding of each medication  Additionally, the Australian Resuscitation Council guidelines and each state ambulance service’s clinical practice guidelines in Australia and New Zealand were reviewed and applied in order to maximize the clinical application of this reference guide  Lastly, this guide’s information is not endorsed, nor does it reflect preferences by any particular pharmaceutical company or ambulance service as this reference was compiled only to the most current and universal information available from the above listed, publicly available resources

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