Atropine

From WikEM
Jump to: navigation, search

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

Contraindications

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

Adverse Reactions

Serious

  • Cardiac dysrhythmia, tachyarrhythmia
  • If given slowly or in amounts <0.5mg, may cause paradoxical bradycardia
  • Increased O2 consumption
  • Hypotension
  • Coma
  • Respiratory depression
  • Glaucoma

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