Atropine Flashcards
Atropine Class
Parasympatholytic, Anticholinergic
Atropine MOA
Potent parasympathetic blocker used to increase the heart rate by decreasing vagal influences on the heart. Increase myocardial oxygen demand. Dilates pupils. Stops SLUDGE BOB.
SLUDGE BOB acronym
Salivation, lacrimation, urination, defecation, gastric emptying, Emesis/ erection, Bradycardia, ocular constriction, bronchoconstriction.
Atropine Indications
Hemodynamically significant bradycardia, organophosphate poisoning, RSI/ pediatric intubation, beta blocker overdose.
Atropine contraindications
Tachycardia, glaucoma, hypothermic bradycardia, bradycardia due to increased ICP.
Atropine adverse reactions
Blurred vision, dilated pupils, dry mouth, tachycardia, drowsiness, urinary retention, and confusion
Atropine drug interactions
Few
Atropine dosage
Adult:
Bradycardia: 0.5 mg IV/IO repeated every 3-5 minutes maximum of 3mg
Organophosphate exposure: 2-4 mg IV/IO, no maximum, extremely large doses may be required, stop with drying of airway secretions.
Pediatric:
0.02 mg/kg, max single dose 0.5 mg IV/IO
Atropine duration of action
Onset: immediate
Duration: 4 hours
Atropine special considerations
- doses less than 0.5 mg can cause paradoxical slowing of the heart rate.
- use cautiously in patients with CAD as increased HR and myocardial O2 demand may worsen ischemia.
- Atropine May worsen the bradycardia associated with high degree heart blocks. Pacing should be available.
- Acts at the AV node- will not work for a block at or below the bundle of His. Does not work in transplanted hearts.
- Common household organophosphates: flea and tick collars/ sprays, ant and roach sprays, bug bombs, garden pesticides.
Atropine pregnancy category
C
Atropine how supplied
1mg in 10 mL prefilled syringe, 8 mg in 20 mL vial.
