Atropine Sulfate

Question 1

Atropine - Class

Answer 1

Anticholinergic (muscarinic receptor antagonist)

Question 2

Atropine - Actions

Answer 2

• Blocks parasympathetic response by competing with ACh at muscarinic receptors
• Increases electrical conduction through the heart
• Increases HR in hemodynamically significant bradycardia
• Inhibits secretion

Question 3

Atropine - Indications

Answer 3

• Symptomatic sinus bradycardia with a pulse (CP, SOB, decreased LOC, BP < 90 systolic, pulmonary congestion)
• AV nodal block or ventricular asystole, NOT effective for infranodal Mobitz Type II
• Organophosphate poisoning

Question 4

Atropine - Dosage/Route 1

Answer 4

Symptomatic sinus bradycardia with a pulse - hemodynamically significant

• 0.5 mg IVP
• May repeat q 3-5 min to a max of 0.04 mg/kg (3mg total)
• Use shorter dosing interval (q 3 min) & higher doses in severe clinical conditions

Question 5

Atropine - Dosage/Route 2

Answer 5

AV nodal block or ventricular asystole

• 0.5 mg IVP
• May repeat q 3-5 min to a max of 0.04 mg/kg (3mg total)

Question 6

Atropine - Dosage/Route 3

Answer 6

Organophosphate poisoning

• 2 mg IVP or IM (if no IV)
• May repeat q min until symptoms relieved

Question 7

Atropine - Side Effects

Answer 7

• Tachycardia
• Dries mucous membranes
• Mydriasis & blurred vision

Question 8

Atropine - Toxicity

Answer 8

• Flushed skin
• Restlessness
• Decreased LOC
• Irritability
• Hallucinations

Question 9

Atropine - Contraindications

Answer 9

• Known hypersensitivity to drug

* Glaucoma

Question 10

Atropine -Special Information

Answer 10

• Use with caution in pts with MI & hypoxia - increases myocardial O2 demand & can extend infarct
• Avoid using in hypothermic bradycardia
• Will not reverse muscle weakness associated with OPP - the medication 2-PAM (Protopam) will reverse
• Assess effectiveness in pts with bradycardia by monitoring the ECG, pulse, & BP
• Assess effectiveness in pts with OPP by watching for drying of skin & mucous membranes
• Not effective for infranodal (Mobitz Type II) AV blocks & new 3rd degree AV blocks with wide QRS Complexes (May cause paradoxical slowing, be prepared to pace)

Question 11

Atropine - Pediatric Note

Answer 11

Refer to Pediatric Drug Guide