Atropine Sulfate

Question 1

Drug code for atropine sulfate?

Answer 1

ATR

Question 2

Presentation of Atropine Sulfate?

Answer 2

Pre-filled syringe containing 1 milligram Atropine Sulfate in 10 ml (100 microgram Atropine Sulfate per 1ml)
Pre-filled syringe containing 1 milligram Atropine Sulfate in 5ml (200 microgram Atropine Sulfate per 1ml)
pre-filled syringe containing 3 milligrams Atropine Sulfate in 10 ml (300 microgram Atropine Sulfate per 1ml)
An ampoule containing 600 micrograms in 1ml

Question 3

Indications for use of Atropine Sulfate?

Answer 3

Symptomatic bradycardia in the presence of any of these adverse signs

• absolute bradycardia (pulse <40 bpm)
• systolic blood pressure below expected range for age
• paroxysmal ventricular arrhythmias requiring suppression
• inadequate perfusion causing confusion
• bradycardia following return of spontaneous circulation (ROSC)

Question 4

What is the most common cause of bradycardia in children, how might there treatment differ because of this?

Answer 4

Hypoxia
interventions to support ABC and oxygen therapy should therefore be used opposed to drug therapy
Atropine Sulfate should therefore only be administered in cases of bradycardia caused by canal stimulation e.g. suction

Question 5

Contra-indications of Atropine Sulfate?

Answer 5

Should not be given to treat bradycardia in suspected hypothermia

Question 6

Actions of Atropine Sulfate?

Answer 6

Reverses the effect of vagal overdrive
Increases heart rate by blocking vagal activity in sinus bradycardia
Second or third degree heart block
Enhances AV conduction

Question 7

What is vagal overdrive?

Answer 7

occurs when the vagus nerve goes into overdrive in response to a stimulus such as the sight of blood, emotional distress, exposure to heat, standing for a long period of time, or even straining to pass a bowel movement.

Question 8

When does vagal overdrive often occur?

Answer 8

the sight of blood
emotional distress
exposure to heat
standing for a long period of time
straining to pass a bowel movement.

Question 9

Side effects of Atropine Sulfate?

Answer 9

Dry mouth, visual blurring and pupil dilation
Confusion and occasional hallucinations
Tachycardia
Do not use small (<100 micrograms) doses as they may cause paradoxical bradycardia

Question 10

What can happen after using Atropine Sulfate to treat myocardial infarction, why is this bad?

Answer 10

May induce tachycardia
This will increase myocardial oxygen demand and worsen ischaemia
Therefore bradycardia in a patient with an MI should only be treated. if the low heart rate is causing problems with perfusion

Question 11

What is ischaemia?

Answer 11

a restriction in blood supply to tissues, causing a shortage of oxygen that is needed for cellular metabolism

Question 12

Route of administration for Atropine Sulfate?

Answer 12

Intravenous/intraosseous administered as a rapid bolus

Question 13

Dose interval for Atropine Sulfate?

Answer 13

3-5 minutes

Question 14

Maximum dose of Atropine Sulfate?

Answer 14

3 milligrams