Atropine

Question 1

Atropine Sulfate

Class

Answer 1

Parasympatholytic / Anticholinergic

Question 2

Atropine Sulfate

Action

Answer 2

BIG C

• Blocks vagal effects on SA node which increases Chronotropy, AV conduction, Cardiac output and Blood pressure.
• Increased intraocular pressure (pupil dilation).
• GI anticholinergic: Decreases gastric secretion, GI motility, Salivation, Sweating and drying of mucous membranes.
• Competitive inhibitor of acetylcholine at parasympathetic postganglionic fibers.

Question 3

Atropine Sulfate

Indication

Answer 3

Symptomatic bradycardia
PEA
Asystole
Organophosphate poisoning

Question 4

Atropine Sulfate

Dose/route

Answer 4

Bradycardia, PEA and Asystole:
1 mg Rapid IVP/IO. MR q 3-5 min to max .04 mg/kg.

Organophosphate poisoning:
2-4 mg Rapid IVP/IO. MR 2mg q 5 min until asymptomatic.

Question 5

Atropine Sulfate

Peds dose

Answer 5

0.02 mg/kg IVP/IO. MR q 5 min (min dose: 0.1mg. Max dose: 1mg)

Question 6

Atropine Sulfate

Onset

Answer 6

1 min IV

Question 7

Atropine Sulfate

Contra

Answer 7

None in emergency setting

Question 8

Atropine Sulfate

Adverse effects

Answer 8

CNS: h/a, restlessness, dizziness.
CV: increased HR and myocardial o2 demand, arrhythmias.
EENT: pupil dilation, worsens glaucoma, dry mouth, thirst, thickens airway secretions.

Question 9

Atropine Sulfate

Precautions

Answer 9

• Use EKG monitor and supplemental o2.
• Incompatible with Bicarbonate and Valium.
• Initial paradoxical bradycardia may occur when IV administered slowly (over 1 min), or when less than 0.5 mg is used.
• May worsen myocardial ischemia in acute MI.

Question 10

Atropine Sulfate

Supplied

Answer 10

1 mg / 10 ml preload
1 mg / 1 ml vial
8 mg / 20 ml vial