Atropine Sulfate

Question 1

Generic name for Atropine?

Answer 1

Atropine Sulfate

Question 2

Trade name for Atropine Sulfate?

Answer 2

Atropine

Question 3

Classification - Atropine

Answer 3

Anticholinergic

Question 4

How is Atropine supplied?

Answer 4

• preload: 1 mg/10 ml (0.1 mg/ml)

- amp: 0.4 mg/1ml or 0.6 mg/1ml

Question 5

Pharmacodynamics (MOA) - Atropine

Answer 5

❑ Antiarrhythmic: nonselective muscarinic acetylcholinergic antagonist, thereby increasing the SA firing and AV conduction resulting in increased heart rate.
❑Opposes the actions of the vagus nerve
❑ negligible effects on the His-Purkinge system.
❑Doses less than 0.5 mg may lead to paradoxical bradycardia, which may be followed by a more rapid rate.
❑ Anticholinergic: decreases the action of the parasympathetic nervous system on certain glands (bronchial, salivary and sweat), decreasing secretions.

Question 6

Indications - Atropine

Answer 6

❑ First drug for symptomatic sinus bradycardia
❑ May be beneficial in presence of AV nodal block
❑ Organophosphate poisoning (antidote)
❑ Pre-medicate with atropine prior to intubation when using succinylcholine in:
• Pediatrics 1 to 5 years (use pediatric dosing in as per PALS)
• If second dose of succinylcholine is required

Question 7

Dosages - Atropine

Answer 7

Symptomatic Bradycardia: 0.5 mg IVP; q 3-5 minutes, Max 0.04 mg/kg to a total of 3 mg

Pre-medicate MFI: 0.5 mg IVP

Organophosphate Poisoning: 2-4 mg IVP q 5 min until reversal of toxicity; SLUDGEM

PEDs:
Brady/MFI: 0.01 - 0.02 mg/kg to a max of 0.5 mg IV/IO q 5 min. Min dose 0.1mg (too low of dose may induce paradoxical bradycardia). Organophosphate poisoning: 0.05mg to max 1mg IV/IO q5 minutes.

Question 8

Contraindications (3) - Atropine

Answer 8

❑ Hypersensitivity
❑ Tachycardia
❑ Glaucoma

***❑ Not effective for 2nd degree type II or 3rd degree block (not technically contraindication but…contra-logical)

Question 9

Precautions - Atropine

Answer 9

❑ May exacerbate an existing myocardial infarction; treat the MI first when possible.
❑ Avoid in bradycardia due to:
-hypothermia
-MI
-head injuries
❑ Not effective for 2nd-degree type II or 3rd-degree block

Question 10

Noteworthy notes - Atropine

Answer 10

❑ don’t delay pacing, for Atropine, on patients with poor perfusion
❑ Signs of organophosphate poisoning SLUDGEM (Salivation, Lacrimation, Urination, Defecation, GI Upset, Emesis, Miosis)
❑ Heart transplant: The heart is denervated, atropine won’t work

Question 11

Onset and duration of Atropine

Answer 11

IV:
onset: 2-4 mins
duration: approximately 4-6 hours
(Davis Drug Guide 16 ed.)