Atropine Sulfate

Question 1

Atropine- Name

Answer 1

Atropine

Question 2

Atropine- Class

Answer 2

Parasympatholytic (Anticholinergic)

Question 3

Atropine- MoA

Answer 3

Inhibits parasympathetic stimulation by blocking acetylcholine receptors

Decreases vagal tone which may increase heart rate and AV conduction

Dilates bronchioles and decreases respiratory tract secretions (Anti-secretory action suppresses sweating, lacrimation, and salivation)

Question 4

Atropine- Indications

Answer 4

Symptomatic bradycardia (primarily vagally mediated)

Organophosphate poisoning

Prior to RSI in pediatrics

Question 5

Atropine- Contra

Answer 5

No absolute contraindications

Question 6

Atropine- S/E

Answer 6

Cardiovascular: tachycardia, VTAC/VFIB, AFIB

Neurological: seizures, dizziness, irritability, hallucinations

Respiratory: mucus plugs

Other: increases intraocular pressure, worsens glaucoma, blurred vision

Question 7

Atropine- Routes

Answer 7

IV, IO, IM

Question 8

Atropine- A. Dose

Answer 8

Bradycardia 0.5-1.0 mg IVP/IO

May repeat dose every 3-5 minutes to a maximum of 3 mg

Pesticides 2 mg IVP/IO/IM

May repeat dose every 5 minutes until patient is asymptomatic or shows signs of atropinization

Question 9

Atropine- P. Dose

Answer 9

RSI 0.01-0.02 mg/kg IVP/IO

Minimum single dose is 0.1 mg and max single dose is 0.5 mg

All Cardiac 0.02 mg/kg IVP/IO

Minimum single dose is 0.1 mg and maximum single dose is 0.5 mg

May repeat one time in 5 minutes

Pesticides 0.02-0.05 mg/kg IVP/IO/IM < 12 years of age

May repeat dose every 20-30 minutes until patient is asymptomatic or shows signs of atropinization

2 mg > 12 years of age

May repeat 1-2 mg every 20-30 mins until asymptomatic or shows signs of atropinization

Question 10

Atropine- EXTRAs

Answer 10

Precautions: May cause paradoxical slowing of the heart rate if less than the therapeutic dose is given or dose given too slowly

Not recommended in asymptomatic bradycardias due to the possibility of inducing or increasing a myocardial infarction

May worsen AV blocks

Interactions: Tricyclic antidepressants, antihistamines, and procainamide can all potentiate the anticholinergic effects of atropine.

Onset in 2-5 minute and may last 20 minutes

Signs of atropinization: Blind as a bat, mad as a hatter, red as a beet, dry as a bone, hot as hell.