Atropine Flashcards

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1
Q

What is the mechanism of action of atropine?

A

Muscarinic acetylcholine antagonist that blocks vagal input to SA and AV nodes

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2
Q

How does atropine counteract bradycardia?

A

By increasing cardiac conduction

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3
Q

What effect can atropine have on the AV block?

A

It can reverse AV block and restore normal sinus rhythm

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4
Q

How long is the effect of atropine?

A

Short-lived

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5
Q

Why is the effect of atropine short lived?

A

Due to short half life

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6
Q

What are the routes of delivery of atropine?

A

PO
IV
IM

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7
Q

Who should administer IV atropine?

A

Only those trained in its use

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8
Q

What are the indications for the use of atropine?

A
  • Bradycardia
  • Organophosphorus poisoning
  • GI smooth muscle spasm
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9
Q

What dose of atropine is used for bradycardia following beta-blocker overdose?

A

3mg IV

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10
Q

What does of atropine is used for intra-operative bradycardia?

A

300-600mcg IV, larger in emergency

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11
Q

What dose of atropine is used for bradycardia following MI?

A

500mcg IV

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12
Q

When is atropine contraindicated?

A
  • Myasthenia gravis
  • Narrow-angle glaucoma
  • Pyloric stenosis
  • Prostatic hypertrophy
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13
Q

Who should atropine be avoided in?

A
  • Children
  • Elderly
  • Down syndrome
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14
Q

Who should atropine be used with caution in?

A
  • Cardiovascular disease
  • Arrhythmias
  • Autonomic neuropathy
  • Individuals susceptible to angle-closure glaucoma and hypertension
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15
Q

What might atropine interact with?

A
  • SSRIs
  • TCAs
  • Haloperidol
  • Other anti-muscarinic agents
  • Codeine
  • Levodopa
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16
Q

What might happen if atropine is given with SSRIs?

A

Increased antimuscarinic side effects of atropine

17
Q

What might happen if atropine is given with TCAs?

A

Increased antimuscarinic side effects of atropine

18
Q

What might happen if atropine is given with haloperidol?

A

Increased antimuscarinic side effects of atropine

19
Q

What might happen if atropine is given with other anti-muscarinic agents?

A

Increased antimuscarinic side effects of atropine

20
Q

What might happen if atropine is given with codeine?

A

Increased antimuscarinic side effects of atropine

21
Q

What might happen if atropine is given with levodopa?

A

Reduced absorption of atropine

22
Q

What monitoring is required with atropine?

A

Close monitoring of vital signs and ECG in emergency use of atropine during bradycardia

23
Q

Why is close monitoring required when atropine is being used for bradycardia?

A

The effects of atropine wear off quickly due to its short half life

24
Q

What are the common side effects of atropine?

A
  • Increased HR
  • Reduction in secretions, e.g. dry mouth
  • Urinary retention
  • Dilated pupils resulting in blurred vision
  • Constipation
25
Q

Why is patient counselling sometimes not possible in atropine?

A

As the drug is given in emergency situations, e.g. life threatening bradycardia

26
Q

What counselling should be given to patients started on atropine in a non-emergency setting?

A

Inform patient atropine tablets should be swallowed whole, and warn patients about the anti-muscarinic side-effects