Group 4 - Atropine Sulfate Flashcards
Atropine Sulfate
Drug Class?
Atropine Sulfate Drug Class:
- Anticholinergic Agent
- Antidote
- Antispasmodic Agent
- Antimuscarinic
Atropine Sulfate
Mechanism of Action?
Atropine Sulfate Mechanism of Action:
- CV: increased heart rate, increased conduction velocity, increased force of contraction, increased cardiac output
- Resp: Decreased mucus production, increased bronchial smooth muscle relaxation (bronchodilation)
- GI: Decreased GI secretion and motility
- GU: Decreased urinary bladder tone
- Misc: Mydriasis (pupillary dilation); decreased sweat production
Atropine Sulfate
Indications?
Atropine Sulfate Indications:
- Symptomatic bradycardia
- Acetylcholinesterase inhibitor poisoning (organophosphate, carbamate cholinergic poisoning)
Atropine Sulfate
Contraindications?
Atropine Sulfate Contraindications:
- Hypersensitivity to atropine
- Acute narrow angle glaucoma (relative)
- Asthma
- 2nd degree Type II and 3rd degree AV Blocks
- Myasthenia gravis
- Obstructive GI disease, renal disease, hepatic disease
Atropine Sulfate
Adverse Reactions?
Atropine Sulfate Adverse Reactions:
- Major: tachydysrhythmias, blurred vision, ventricular irritability
- Minor: nausea, vomiting, decreased sweating/increased body temperature
Atropine Sulfate
Adult Dose?
Atropine Sulfate Adult Dose:
- Symptomatic Bradycardia:
- (Old Guideline) IV/IO: 0.5 mg every 3 - 5 minutes. Max total dose of 3 mg
- (2020 AHA) IV/IO: 1 mg every 3 - 5 min Max dose 3 mg
- Organophosphate or carbamate poisoning:
- IV/IO: 1 - 5 mg. Dose should be doubled every 5 minutes until signs of muscarinic excess abate
- IV Infusion: 0.5 - 1 mg/hr
Atropine Sulfate
Pediatric Dose?
Atropine Sulfate Pediatric Dose:
- Symptomatic Bradycardia:
- IV/IO: 0.02 mg/kg (minimum of 0.1 mg) every 5 minutes. Max total dose of 1 mg in children, 2 mg in adolescents.
- Organophosphate or carbamate poisoning:
- IV/IO: 0.03 - 0.05 mg/kg every 10 to 20 minutes until cholinergic symptoms minimize.
Atropine Sulfate
Onset of Action?
Atropine Sulfate Onset of Action:
- 1 minute
Atropine Sulfate
Peak Effects?
Atropine Sulfate Peak Effects:
- IV: 2 - 5 minutes
- IM: 30 minutes
Atropine Sulfate
Duration of Action?
Atropine Sulfate Duration of Action:
- Half-life 2 - 3 hours
Atropine Sulfate
AZ Drug Box Minimum Supply?
Atropine Sulfate
AZ Drug Box Minimum Supply:
- 3 (1 mg/10 ml) prefilled syringes
- Optional: 1 (8 mg/20 ml) multidose vial
Atropine Sulfate
Special Notes?
Atropine Sulfate Special Notes:
- Administering too small doses or too slowly may result in paradoxical bradycardia.
- Signs and symptoms of cholinergic/organophosphate poisoning: excess salivation, lacrimation, urination, defecation, bradycardia, coma.
- Patients that describe their glaucoma as painful probably have acute narrow angle glaucoma.
