Atropine Sulfate

Question 1

Indications - Atropine

Answer 1

• Symptomatic sinus bradycardia
• Organophosphate poisoning (antidote)
• Peds indicated for symptomatic bradycardia where increased vagal tone or primary AV block is suspected*

PALS recommends pre-dosing with atropine prior to intubation with succinylcholine in patients 1-5 y/o. Consult OLMC to discuss

Question 2

Adult dosing for Atropine

Answer 2

Symptomatic Bradycardia:
1mg IV/IO q3-5min PRN to total max 3mg

Organophosphate Poisoning:
2mg IV/IO q5min PRN, titrate until reversal of toxicity (SLUDGEM/BBB)

Question 3

Contraindications - Atropine

Answer 3

Hypersensitivity

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

Question 4

Pediatric dosing for Atropine

Answer 4

Symptomatic bradycardia:
0.02mg/kg IV/IO to a single max dose of 0.5mg q3-5min PRN to a total max of 0.04mg/kg or 1mg, whichever is less
Single min dose is 0.1mg to avoid paradoxical bradycardia

Organophosphate poisoning:
0.05mg/kg IV/IO. Double dose q5min PRN until reversal of toxicity (SLUDGEM-BBB)