Atropine

 

  • Indications:

 

    • Sinus bradycardia when accompanied by PVCs or hypotension
    • 2nd or 3rd degree block
    • Asystole
    • Organophosphate poisoning
    • Pulseless Electrical Activity (PEA)
    • Pediatric:
      • Symptomatic bradycardia secondary to AV block or vagal activity 2nd line after Epinephrine for bradycardia due to poor perfusion or hypotension.

 

  • Administration:

 

    • IV, IO, ET IM (May double IV dosage with ET administration.)

 

  • Contraindications:

 

    • Tachycardia
    • glaucoma
    • A-Fib
    • A-Flutter with rapid ventricular response

 

  • Side Effects:

 

    • tachycardia
    • dry mouth
    • thirst
    • flushing of skin
    • blurred vision
    • headache
    • pupillary dilation
    • urine retention

 

  • Adult Dosage:

 

    • Bradycardia

 

      • 0.5 mg IV administration; repeat Q 3-5 minutes to a total dose of 3 mg

 

    • Organophosphate Poisoning:

 

      • To block parasympathetic response:

 

        • 1 - 2 mg; IV dose repeated Q 5 minutes until a decrease in secretions are observed or to total dose of 6 mg. May be administered per standing orders

 

  • Pediatric:

 

    • Bradycardia

 

      • 0.02 mg/kg (0.2 ml/kg) IV administration Minimum 0.1 mg, Maximum single dose 0.5 mg child; 1.0 mg adolescent.
      • May be repeated once

 

    • Organophosphate Poisoning:

 

      • To block parasympathetic response:

 

        • Children: 0.05 to 0.1 mg/kg Loading dose. Adolescents: 2 mg Repeat every 10 – 15 minutes until rales and bronchial secretions resolved. May be administered per standing orders

 

  • THERAPEUTIC EFFECTS

 

    • Blocks acetylcholine receptor sites
    • Increase SA & AV node conduction
    • May suppress PVCs secondary to bradycardia

 

  • RELATIVE CONTRAINDICATIONS:

 

    • Tachycardia
    • Glaucoma
    • Atrial fibrillation/atrial flutter with rapid ventricular response