Atropine

Question 1

Pharmacology and presentation of Atropine?

Answer 1

0.6mg/1ml Ampoule

Atropine is an anticholinergic (antimuscarinic) agent which works by competitively inhibiting acetylcholine’s actions on the parasympathetic nervous system’s post ganglionic nerves at neuroeffector sites (eg vagus). For the heart this results in an increased heart rate by improved sinoatrial node firing, and increased conduction velocity through the atrioventricular node. It is also used as an antidote to the effects of cholinesterase inhibitors (e.g. organophosphate insecticides); its action in this regard relates to reducing excessive salivation, sweat, gastrointestinal tract and bronchial secretions. It can be used in the management of secretions post-Ketamine administration. It also has the ability to assist with relaxation of smooth muscle.

Question 2

Indicators of Atropine?

• KOBE

Answer 2

• Bradycardia with poor perfusion
• Organophosphate toxicity
• Envenomation with parasympathetic activity
• Hypersalivation secondary to Ketamine administration.

Question 3

Contraindications of Atropine?

• TA

Answer 3

• Known allergy
• Heart transplant.

Question 4

Cautions of Atropine?

-GAA

Answer 4

• AMI
• Atrial flutter or fibrillation
• Glaucoma.

Question 5

Side Effects of Atropine?

-DR PATH

Answer 5

• Agitation, confusion, visual blurring
• Hallucinations
• Dilated pupils
• Dry mouth, warm dry skin, reduced bronchial and gastric secretions
• Tachycardia and palpitations
• Urinary retention.

Question 6

Dosing Regimes of Atropine?

Answer 6

Adults Bradycardia with poor perfusion
- 0.6mg IV/IO repeat dose once at 2mins if required, max of 1.2mg

Adults Organophosphate Toxicity or Envenomation with Parasympathetic Activity
- 1.2mg IV/IO, repeating 5 minutely as required, no max

Question 7

Onset and duration of Atropine?

Answer 7

• Onset = 1–2 minutes
• Duration = 5 hours