Atropine Sulfate

Question 1

Class (2)

Answer 1

• Parasympatholytic

- Anticholonergic (vagolytic)

Question 2

Actions (5)

Answer 2

• Blocks effects of parasympathetic innervation to the heart which enhances both sinus node automaticity and AV conduction
• Relaxes smooth muscle in bronchial tree=bronchodilation
• Inhibits glandular secretion in respiratory tract
• Inhibits secretions from sweat and salivary glands
• Decreases GI motility

Question 2

Dose/Route

Answer 2

• 0.5 mg IV every 3-5 min up to 3 mg max
• ACLS: Follow ACLS algorithm for bradycardia and PEA poisoning large doses IV
• Other: Resp. Diff. 1.0 mg via neb with a beta-2 agonist for adults
• Usual routes IV, ET

Question 3

Indications (5)

Answer 3

• Symptomatic bradyarrhythmias
• Symptomatic conduction defects, ie. Stokes-Adams syndrome
• CPA (asystole, PEA algorithm)
• Organophosphate (cholinergic) poisoning
• Status asthmaticus (aerosol nebulizer route)

Question 4

Standard Preps

Answer 4

1 mg/10 CC preloaded syringe

Question 5

Peds dose

Answer 5

• 0.02 mg/kg (minimum dose: 0.1 mg, max dose: 1 mg)

- PALS algorithm poisoning as directed by base station

Question 6

Precautions

Answer 6

• Monitor VS, EKG, and mental status
• May increase myocardial O2 demand in MI pts and aggravate CP
• Too low a dose may cause paradoxical bradycardia
• Exacerbation of glaucoma
• Can cause acute urinary retention in males with enlarged prostate

Question 7

Side Effects (5)

Answer 7

• Acute psychosis
• Vasodilation
• Dehydration
• Elevated surface temperature
• Mydriasis
• Mad as a hatter, red as a beet, dry as a bone, hot as a hare, blind as a bat

Question 8

Note

Answer 8

ACLS: Atropine has been reported to be harmful in some pts with AV block at the HIS-Purkinje level (type II AV block and third-degree AV block with a new wide-QRS complex). Atropine may be used in these situations, but watch closely for paradoxical slowing.