Atropine

Question 1

Atropine
Type

Answer 1

Parasympathetic blocking agent

Question 2

Atropine
Presentations

Answer 2

600mcg in 1ml plastic ampoule

1200mcg in 1ml plastic ampoule (new)

Question 3

Atropine
Actions

Answer 3

Large number of actions, those important in the pre-hospital setting:
BIIR
1. blocks the actions of the vagus nerve on the heart
2. increases the rate of the sinus node
3. increases speed of conduction through the AV node
4. reduces the amount of secretions from some glands (e.g. tear and salivary glands)

Onset IV: 2min. Max effect: 5min
IV half0life: adult: 2-3hours; Paed - approx 6.5hrs.

Question 4

Atropine
Uses

Answer 4

• Organophosphate poisoning/nerve agent poisoning
• Big black spider bite with cholinergic symptoms

ICP: bradyarrhythmias with poor perfusion

Question 5

Atropine
Adverse effects

Answer 5

TBCUPID
1. Tachycardia
2. Palpitations
3. Blurred vision
4. Confusion
5. Dry mouth
6. Urinary retention
7. Increased body temperature (by decreasing perspiration)

Question 6

Atropine
Contraindication/s

Answer 6

Known hypersensitivity

Question 7

Atropine
Precautions

Answer 7

1. Care needed in patients with glaucoma
2. aim not to increase HR above 100/min

Question 8

Atropine
Dose for organophosphate/nerve agent poisoning

Answer 8

Adult
IV/IO/IM: initial dose 2400mcg fast push.
Repeat every 3-5mins
Double each dose as required
No upper limit on doses until all management end goals achieved
Note: give IM while IV/IO access is being obtained

Paed:
IV/IO/IM: initial dose 50mcg/kg (max 2400mcg) fast push.
Repeat every 3-5mins
Double each dose as required
No upper limit on doses until all management end goals achieved
Note: give IM while IV/IO access is being obtained

Question 9

Atropine
Dose for Big black spider bite with cholinergic symptoms

Answer 9

Adult
IV/IO/IM: 600mcg - fast push
No repeat

Paed
IV/IO/IM: 20mcg/kg (max 600) - fast push
No repeat