Atropine Sulfate

Question 1

Classification

Answer 1

Anticholinergic (anitmuscarinic)

Question 2

Action

Answer 2

Competes reversible with acetylcholine at the site of the muscarinic receptor. Receptors affected, in order from the most sensitive to the least sensitive, include salivary, bronchial, sweat glands, eye, heart, and GI tract

Question 3

Indications

Answer 3

Symptomatic bradycardia, nerve agent exposure, organophosphate poisoning

Question 4

Adverse effects

Answer 4

Decreased secretions resulting in dry mouth and hot skin temperature, intense facial flushing, blurred vision or dilation of the pupils with subsequent photophobia, tachycardia, restlessness. May cause paradoxical bradycardia if the dose administered is too low or if the drug is administered too slowly

Question 5

Contraindications

Answer 5

Acute MI; myasthenia gravis; GI obstruction,; closed-angle glaucoma; known sensitivity to atropine, belladonna alkaloids, or sulfites. Will not be effective for infranodal (type II) AV block and new third-degree block with wide QRS complex

Question 6

Adult dosage (symptomatic bradycardia)

Answer 6

0.5 mg IV, IO every 3-5 mins to a maximum dose of 3 mg

Question 7

Adolescent dosage (symptomatic bradycardia)

Answer 7

0.02 mg/kg (minimum 0.1 mg/dose;maximum 1 mg/dose) IV, IO up to a total dose of 2 mg

Question 8

Peds dosage (symptomatic bradycardia)

Answer 8

0.01 mg/kg (minimum 0.1 mg/dose;maximum 0.5 mg/dose) IV, IO up to a total dose of 1 mg

Question 9

Dosage (asystole)

Answer 9

1 mg IV, IO, every 3-5 mins, to a maximum dose of 3 mg. May be administered via ET tube at 2-2.5 mg diluted in 5-10 mL of water or normal saline

Question 10

Adult dosage (nerve agent or organophosphate poisoning)

Answer 10

2 to 4 mg IV, IM; repeat if needed every 20-30 mins until symptoms dissipate. In severe cases, the initial dose can be as large as 2 to 6 mg administered IV. Repeat doses of 2 to 6 mg can be administered IV, IM every 5-60 mins

Question 11

Peds dosage (nerve agent or organophosphate poisoning)

Answer 11

0.05 mg/kg IV, IM every 10-30 mins as needed until symptoms dissipate

Question 12

Infant

Answer 12

0.05 mg/kg IV, IM, every 5-20 mins as needed until symptoms dissipate

Question 13

Special considerations

Answer 13

Half-life 2.5 hrs; pregnancy class c; possibly unsafe in lactating mothers