Atropine Sulphate (Apr 2012)

Question 1

TYPE:

Answer 1

Parasympathetic blocking agent [S4]

Question 2

PRESENTATION:

Answer 2

1 mg in 10 mls – IMS Mini-jet

Question 3

ACTIONS:

Answer 3

Large number of actions.
Those important in the pre-hospital setting:
1. Blocks the action of the vagus nerve on the heart
2. Increases the rate of the sinus node
3. Increases speed of conduction through the AV node
4. Reduces the amount of secretions from some glands (e.g. tear & salivary glands).
Onset IV: 2 minutes
Max effect: 5 minutes

Question 4

USES:

Answer 4

1. Bradyarrhythmias with poor perfusion
2. Organophosphate poisoning/spider bite (to increase heart rate irrespective of BP and/or assist airway maintenance by reducing excessive salivation)
3. To prevent bradycardia with Suxamethonium use

Question 5

ADVERSE EFFECTS:

Answer 5

Tachycardia; palpitations; blurred vision; dry mouth; confusion, urinary retention; increased body temperature (by decreasing perspiration).

Question 6

CONTRA-INDICATIONS:

Answer 6

Known hypersensitivity

Question 7

PRECAUTIONS:

Answer 7

Care needed in patients with Glaucoma

Aim not to increase heart rate above 100/minute

Question 8

DOSE: Bradyarrhythmias:

Answer 8

Adult: IV/IO - 0.01 mg/kg – fast push
Repeat x 1 as necessary
Paediatric: Not used

Question 9

DOSE: Organophosphate poisoning/cholinergic symptoms of spider bite:

Answer 9

Adult/Paediatric: 0.01 mg/kg IV – fast push
Double each repeat dose as required. No upper limit on doses.
Continue use even if BP is not low.
May be used IM in these circumstances if IV access is not available or if there are multiple patients affected.

Question 10

DOSE: To treat bradycardia with Suxamethonium use:

Answer 10

Adult/Paediatric: 0.01 mg/kg IV – fast push