Atropine Flashcards

1
Q

Class

A

Anticholinergic agent

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2
Q

Mechanism of action

A

Inhibits action of acetylcholine at postganglionic parasympathetic receptor sites. (Increases heart rate);
Antagonizes excess muscarinic receptor stimulation caused by organophosphate insecticides and chemical nerve agents

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3
Q

Onset and duration

A

Onset: Rapid
Duration: 2-6 hours

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4
Q

Indications

A

Hemodynamically significant bradycardia; organophosphate or nerve gas poisoning

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5
Q

Contraindications

A

Tachycardia; Hypersensitivity; use with caution in patients with myocardial ischemia and hypoxia; hypothermic bradycardia; obstructive disease of the GI tract; obstructive uropathy; unstable cardiovascular status in acute hemorrhage; narrow-angle glaucoma; thyrotoxicosis

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6
Q

Adverse reactions

A

Tachycardia; paradoxical bradycardia when pushed to slowly or when adult dose is <0.5mg; palpitations; dysrhythmias; headache; dizziness; dry mouth/nose/skin; nausea and vomiting; flushed, hot, dry skin; allergic reactions

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7
Q

Drug interactions

A

Use with other anticholinergic agents may increase Vagal blockade; adverse effects may occur when administered with digitalis, cholinergics, or neostigmine; effects may be enhanced by antihistamines, antipsychotics and antidepressants

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8
Q

How supplied

A

Usually supplied in prefilled syringes containing 1mg in 10mL

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9
Q

Bradycardia dosage and administration

A

Adult: 0.5mg q3-5 minutes(max total dose 3mg)
Pediatric: 0.02 mg/kg IV/IO minimum dose of 0.1mg max dose 0.5, may be repeated once, max total dose 1mg for child; 3mg adolescent; ET dose is 0.04-0.06 mg/kg

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10
Q

Anticholinesterase poisoning dosage and administration

A

Adult: 1-2mg IV push q 5-15 minutes until atropine effects are observed.
Pediatric: <12 years 0.05mg/kg Iv/IO, may be repeated doubling the dose q 20-30 minutes until symptoms reverse;

> 12 years 1mg Iv/IO, then doubling dose q 5minutes until symptoms reverse

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11
Q

Special considerations

A

Atropine dilates pupils, rendering them nonreactive.

Atropine is not effective in heart transplantation patients

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