Atropine Sulfate (CARDIAC DRUG) Flashcards
What is the pharmacodynamics
what are the pharmacokinetics for atropine
administered: parental
distributed: plasma proteins
Metabolism: liver
Excretion: urine
what are the pharmacodynamics for atropine
this is anti-cholinergic (blocks the action of a neurotransmitter called acetylcholine which plays a role in the brain)
Increases heart rate by blocking vagal activity in sinus bradycardia, second or third degree heart block
enhanced a-v conduction
reverses effects of vagal overdrive
What are the indications for atropine
symptomatic bradycardia (hr below 60 with bad symptoms)
also includes bradycardia with adverse signs:
absolute bradycardia (hr below 40)
systolic bp below age-related bp
paroxysmal ventricular arrhythmias requiring suppression
inadequate perfusion causing confusion
bradycardia following ROSC
what are the contra indications for atropine
NOT given to treat bradycardia in suspected hypothermic pt
NOT given if pt has cardiac transplant (due to heart not responding to vagal block by atropine and paradoxical high degree AV block. sinus arrest may occur
what are the adverse effects caused by atropine
dry mouth, visual blurring and pupil dilation
confusion/hallucinations
tachycardia
why should small doses f atropine not be given
can cause paradoxical bradycardia (meaning the opposite effect to what atropine should do)
how is atropine presented on the road (HINT- can be presented in 4 different ways)
pre filled syringe with 1 milligram(mg) atropine sulfate in 10 millilitres (ml) (also known as 100 microgram (mcg) atropine sulfate per 1 millilitre (ml))
OR
pre-filled syringe with 1 milligram (mg) atropine sulfate in 5 milliliters (ml) (also known as 200 microgram (mcg) atropine sulfate per 1 millilitre (ml))
OR
pre-filled syringe containing 3 milligrams (mg) atropine sulfate in 10 milliliters (ml) (also known as 300 micrograms (mcg) atropine sulfate per 1 milliliters(ml))
OR
ampoule with 600 microgram (mcg) in 1 mililitre(ml)
what is the route of administration for atropine
IV or IO with rapid bolus
what is the max dose for atropine in adults
3 milligrams (mg)
what is the initial dosage for atropine in an adult pt
500 or 600 micrograms (mcg)
why should atropine only be given to treat low hr WITH issues with perfusion
because atropine may cause tachycardia after an MI which will increase myocardial oxygen demand and worsen ischaemia.
what is the rule for giving atropine to children (why not drug therapy first)
when should atropine be given for children
bradycardia in children is most commonly caused by HYPOXIA meaning ABC care is needed not drug therapy
therefore only administer atropine in children if bradycardia is caused by vagal stimulation like suction
