Atropine

Question 1

Drug Class of Atropine

Answer 1

Antichlolinergic (antimuscarinic)

Question 2

Presentation of Atropine

Answer 2

• Ampoule, 1.2 mg/1 mL atropine

Question 3

Schedule of Atropine

Answer 3

• S4 (Restricted drugs).

Question 4

Pharmacology of Atropine

Answer 4

Atropine works by inhibiting the action of the parasympathetic 
 nervous system allowing for an unchallenged sympathetic response. 
 It successfully blocks the action of the vagus nerve on the heart, 
 increases the rate of the SA node, conduction through the AV node 
 and blocks exocrine gland activity.

Question 5

Metabolism of Atropine

Answer 5

Atropine is metabolised by the liver and excreted mainly by 
 the kidneys.

Question 6

Indications of Atropine

Answer 6

• Bradycardia (with poor perfusion)
• Envenomation (with increased parasympathetic
activity)
• Hypersalivation (secondary to ketamine administration)
• Organophosphate toxicity (with cardiac AND/OR respiratory compromise)

Question 7

Contraindications of Atropine

Answer 7

• KSAR or hypersensitivity to atropine

Question 8

Precautions of Atropine

Answer 8

• Atrial flutter
• Atrial fibrillation
• AMI
• Glaucoma

Question 9

Side Effects of Atropine

Answer 9

• Agitation
• Hallucinations
• Dilated pupils
• Dry mouth/dry skin/reduced bronchial and 
 gastric secretions
• Tachycardia

Question 10

Routes of Administration for Atropine

Answer 10

Intramuscular injection (IM)
Intravenous injection (IV)
Intraosseous injection (IO)
Intravenous infusion (IV INF)

Question 11

Adult Dose of Atropine IV

Bradycardia (with poor perfusion)

Answer 11

600 mcg
Repeated once after 2 minutes.
Total maximum dose 1.2 mg.

Question 12

Adult Dose of Atropine IO

Bradycardia (with poor perfusion)

Answer 12

600 mcg
Repeated once after 2 minutes.
Total maximum dose 1.2 mg.

Question 13

Adult Dose of Atropine IM

Envenomation (with increased parasympathetic activity)

Answer 13

1.2 mg
Repeated at 5 minute intervals.
No maximum dose.

Question 14

Adult Dose of Atropine IV

Envenomation (with increased parasympathetic activity)

Answer 14

1.2 mg
Repeated at 5 minute intervals.
No maximum dose.

Question 15

Adult Dose of Atropine IO

Envenomation (with increased parasympathetic activity)

Answer 15

1.2 mg
Repeated at 5 minute intervals.
No maximum dose.

Question 16

Adult Dose of Atropine IV

Hypersalivation (secondary to ketamine administration)

Answer 16

600 mcg

Single dose only.

Question 17

Adult Dose of Atropine IM
Organophosphate toxicity 

(with cardiac AND/OR respiratory compromise)

Answer 17

1.2 mg
Repeated at 5 minute intervals.
No maximum dose.

Question 18

Adult Dose of Atropine IV
Organophosphate toxicity 

(with cardiac AND/OR respiratory compromise)

Answer 18

1.2 mg
Repeated at 5 minute intervals.
No maximum dose.

Question 19

Adult Dose of Atropine IO
Organophosphate toxicity 

(with cardiac AND/OR respiratory compromise)

Answer 19

1.2 mg
Repeated at 5 minute intervals.
No maximum dose.

Question 20

Paediatric Dose of Atropine IV

Bradycardia (with poor perfusion)

Answer 20

20 mcg/kg
Single dose not to exceed 600 mcg.
Repeated once after 2 minutes.
Total maximum dose 40 mcg/kg.

Question 21

Paediatric Dose of Atropine IO

Bradycardia (with poor perfusion)

Answer 21

20 mcg/kg
Single dose not to exceed 600 mcg.
Repeated once after 2 minutes.
Total maximum dose 40 mcg/kg.

Question 22

Paediatric Dose of Atropine IM
• Envenomation (with increased parasympathetic activity)
• Organophosphate toxicity (with cardiac AND/OR 

respiratory compromise)

Answer 22

20 mcg/kg
Single dose not to exceed 600 mcg.
Repeated at 5 minute intervals.
No maximum dose.

Question 23

Paediatric Dose of Atropine IV
• Envenomation (with increased parasympathetic activity)
• Organophosphate toxicity (with cardiac AND/OR 

respiratory compromise)

Answer 23

20 mcg/kg
Single dose not to exceed 600 mcg.
Repeated at 5 minute intervals.
No maximum dose.

Question 24

Paediatric Dose of Atropine IO
• Envenomation (with increased parasympathetic activity)
• Organophosphate toxicity (with cardiac AND/OR 

respiratory compromise)

Answer 24

20 mcg/kg
Single dose not to exceed 600 mcg.
Repeated at 5 minute intervals.
No maximum dose.