ATROPINE SULFATE (ATROPINE AND OTHERS)

Class
Description
Onset and Duration
Indications
Contraindications
Adverse Reactions
Drug Interactions
How Supplied
Dosage and Administration
Special Considerations

ATROPINE SULFATE (ATROPINE AND OTHERS)
Class

Anticholinergic agent

ATROPINE SULFATE (ATROPINE AND OTHERS)
Description

Atropine sulfate, a potent parasympatholytic, inhibits actions of acetylcholine at postgnaglionic parasympathetic neuroeffector sites. Small dosed inhibit salivary and bronchial secretions; moderate doses dilate pupils and increase heart rate. Large doses decrease GI motiltiy, inhibit gastric acid secretion, and may block nicotinic receptor sites at the autonomic ganglia and at the neuromuscular junction. Blocked vagal effects result in positive chronotropy and positive dromotropy (limited or no inotropic effect). In emergency care, it is primarily used to increase the heart rate in life-threatening bradycardias.

ATROPINE SULFATE (ATROPINE AND OTHERS)
Onset & Duration

Onset: Rapid
Duration: 2-6 hr

ATROPINE SULFATE (ATROPINE AND OTHERS)
Indications

Hemodynamically significant bradycardia
Asystole
Organophosphate poisoning (drug of choice)
Bronchospastic pulmonary disorders

ATROPINE SULFATE (ATROPINE AND OTHERS)
Contraindications

Tachycardia
Hypersensitivity
Unstable cardiovascular status in acute hemorrhage and myocardial ischemia
Narrow-angle glaucoma

ATROPINE SULFATE (ATROPINE AND OTHERS)
Adverse Reactions

Tachycardia
Paradoxical bradycardia when pushed slowly or when used at doses less than 0.5 mg
Palpitations
Dysrhythmias
Headache
Dizziness
Anticholinergic effects (dry mouth or nose, photophobia, blurred vision, urine retention)
Nausea and vomiting
Flushed, hot, dry skin
Allergic reactions

ATROPINE SULFATE (ATROPINE AND OTHERS)
Drug Interactions

Anticholinergics may increase vagal blockade.
Potential adverse effects when administered in conjunction with digitalis, cholinergics, neostigmine.
The effects of atropine may be enhanced by antihistamines, procainamide, quinidine, antipsychotics, antidepressants, and benzodiazepines.

ATROPINE SULFATE (ATROPINE AND OTHERS)
How Supplied

Tablet:

0.4, 0.6 mg

Parenteral:

There are various injection preparations. In emergency care, atropine is usually supplied in prefilled syringes containing 1.0 mg in 10 ml of solution.

Nebulizer:

0.2% (1 mg in 0.5 ml UD), 0.5% (2.5 mg in 0.5 ml UD)

ATROPINE SULFATE (ATROPINE AND OTHERS)
Dosage and Administration

Adult:

0.5-1.0 mg IV q 3-5 min as needed

Pediatric:

0.02 mg/kg IV (minimum dose of 0.1 mg; maximum sing dose of 0.5 mg for a child and 1.0 for an adolescent)

Adult:

1.0 mg IV (maximum of 0.04 mg/kg)

Pediatric:

Same as for dysrhythmias

ATROPINE SULFATE (ATROPINE AND OTHERS)
Special Considerations