Atropine Sulfate Flashcards
Actions (4)
- Inhibits parasympathetic stimulation by blocking acetylcholine receptors
- Decreases vagal tone resulting in increased heart rate and AV conduction
- Dilates bronchioles and decrease respiratory tract secretions
- Decrease gastrointestinal secretion
Drug classification (3)
- Parasympathetic blocker
- anticholinergic
- vagolytic
Indication (2)
- Symptomatic Bradydysrhythmias
2. Insecticide poisoning (organophosphates) (if HR < 60, respiratory depression, and/or extreme salivation)
Contraindication
Not significant in indications
Adverse effects - Cardiovascular (2)
Tachycardia
Increased oxygen demand
Adverse effects - respiratory
Mucus plugs
Adverse effects - gastrointestinal (2)
Dry mouth
Difficulty swallowing
Adverse effects - neurological (5)
Pupillary dilation Blurred vision Dizziness Confusion/restlessness Seizures
Adverse effects - other (2)
Hot, dry skin
Worsens glaucoma
Administration - Bradydysrhythmias
0.5 mg rapid IVP or IO.
May repeat dose every 3-5 minutes to a maximum of 3 mg
Repeat until heart rate > 60 or signs of adequate perfusion
Administration - insecticides
2 mg rapid IVP, IM.
May repeat dose every 5 minutes until patient is asymptomatic
Symptomatic: HR
Pediatrics (>1month) - Bradydysrhythmias
Epinephrine and oxygen are the initial medications. If no response to epinephrine:
0.02 mg/kg rapid IVP or IO. Minimum single dose is 0.1mg
Peds insecticide
R
Onset
2-5 minutes
Duration
20 minutes
Precaution
Administer supplemental oxygen
Rationale
Increased heart rate may increase myocardial oxygen demand
Precaution
Give rapid IVP
Rationale
May cause paradoxical slowing of the heart rate if given slowly - or if less than a therapeutic dose is given - for adults that is
Precaution
Monitor ECG rhythms
Rationale
Increased myocardial ischemia may cause dysrhythmias
Precaution
Monitor vital signs
Rationale
Observe for signs/symptoms of increased perfusion, other treatments may be required
Note
If atropine is ineffective, TCP or Dopamine may be indicated.
Not recommended in asymptomatic bradycardia due to possibility of increasing myocardial oxygen demand, including or extending a myocardial infarction.
May dilate pupils - so pupils are not a reliable indicator of hypoxic brain damage after the administration of atropine. Pupils should however still react to light which may help in separating atropine effect from brain damage.
Worsens glaucoma due to papillary dilation.
Standard dosing may be exceeded in organophosphates poisoning.
2-3 mg of atropine may be given down the ET
Do not administer to neonates
Increased bagel tone may be caused by increased intracranial pressure, or betablockers, calcium channel blockers overdose, infection, congenital heart disease, sleep apnea, infection, hypothyroidism, or hypoglycemia