Atropine Sulfate

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Parasympatholytic

          Cholinergic blocking agent

    Antidysrhythmic agent

Action:

Inhibits parasympathetic stimulation by blocking

acetycholine receptors

Decreases vagal tone resulting in increase heart rate and AV conduction

Allows bronchial dilation and decreases

respiratory tract secretions

Decreases gastrointestinal secretions 

Indications:

Symptomatic bradycardia

High Degree AV block

Organophosphate poisoning (pesticide/nerve agent)

Contraindications: 

 Neonates

Adverse Effects:      

Cardiovascular

tachycardia  

increased myocardial                     

O2 demand                

Neurological

 seizures

dizziness

dilated pupils

General

hot/dry skin

worsens glaucoma

Gastrointestinal

difficulty swallowing

dry mouth 

Administration:

Bradycardia

0.5 – 1mg IV/IO.  May repeat every 3-5 minutes to a maximum of .04mg/kg.

Organophosphate (pesticide/nerve agent) Poisoning

2mg IV/IO/IM.  May repeat every 5 minutes until patient is breathing adequately and secretions begin to dry.

Pediatrics:

Bradycardia

.02mg/kg IV/IO.  May repeat in 3-5 minutes one time to a maximum of .04mg/kg.

Organophosphate (pesticide/nerve agent) Poisoning

.05mg /kg  IV/IO/IM.  May repeat every 5 minutes until patient is breathing adequately and secretions begin to dry.  (maximum single dose 2mg)

Onset:             

Duration:       

Onset:             2-5 minutes  

Duration:       20 minutes

Precautions:

Administer supplemental O2 and monitor rhythm

frequently. The increased heart rate may increase myocardial 

O2 demand and result in ischemia and dysrhythmias.

Note:

May cause paradoxical slowing of heart rate if less than the therapeutic dose is given. 

(0.3 mg in adults and 0.1 mg in pediatric patients)

Worsens glaucoma due to pupillary dilation.

Pupil reaction may not be a reliable indicator for  

hypoxic brain damage after atropine administration

High doses of atropine may be required in  

organophosphate poisoning.

Rule out hypoxia as cause of bradycardia in pediatric

patients prior to administration