Atropine

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General

  • Type: Anticholinergic
  • Routes of Administration: IV/IM/IO/SC, endotracheal, nebulized, PO, topical/ophthalmic
  • Common Trade Names: Atropine, Atreza, SalTropine, AtroPen, IsoptoAtropine

Adult Dosing

Symptomatic bradyarrhythmia or AV block

  • 0.5 mg IV rapid push q3-5m (max = 0.04 milligram/kg)

Cardiac arrest (bradyasystolic)

  • 1mg IV/IM/subQ/endotracheally q3-5m

Organophosphate toxicity

  • 1-3mg IV/IM/SC/endotracheally q10-30m, max 3 doses

IBS, PUD

  • 0.4-0.6 mg PO or IV/IM/SC q4-6h

Cycloplegia/mydriasis induction

  • 1-2 drops of 1% solution 1-3 times daily

Pediatric dosing

Symptomatic bradyarrhythmia or AV block

  • 0.01-0.03 mg/kg IV/IO q1-2h

Cardiac arrest (bradyasystolic)

  • 0.01-0.03 mg/kg IV/IM/subQ/endotracheally

Organophosphate toxicity

  • 0.01-0.03 mg/kg IV/IM/subQ/endotracheally

IBS, PUD

  • 0.01 mg/kg (max 0.4 mg or 0.3 mg/m2) PO/SC q4-6h

Cycloplegia/mydriasis induction

  • 1-2 drops of 1% solution 1-3 times daily

Special Populations

  • Pregnancy Rating: C
  • Lactation: Infant risk cannot be ruled out
  • Renal Dosing: no adjustment
  • Hepatic Dosing: no adjustment
  • Ineffective in cardiac transplant patients

Contraindications

  • Allergy to class/drug
  • Primary glaucoma or predisposition to narrow anterior chamber angle glaucoma

Adverse Reactions

Serious

Common

  • Constipation, xerostomia
  • Blurred vision, decreased lacrimation, eye pain, photophobia, superficial keratitis

Pharmacology

  • Half-life: 2.5 hrs
  • Metabolism: hepatic
  • Excretion: renal
  • Onset of action (IV) = 2-4min
  • Duration of action (IV) = 5hr

Mechanism of Action

  • Parasympatholytic
    • Increases sinus/AV conduction

See Also