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Atropine

Atropine

CLASS

Anticholinergic, Vagolytic
Belladonna alkaloid, Cycloplegic mydriatic

Atropine Sulfate as Cardiac Agent

DOSAGE

    Adult:
    Bradycardias: 0.5-1 mg IV, or 1-2 mg ET, may repeat every 3-5 minutes until improved or total of 0.04 mg/kg or 3 mg is reached.

    Pediatric: 0.02 mg/kg IV or ET (minimum dose is 0.1 mg and maximum single dose is 0.5 mg child, 1 mg adolescent).

ACTIONS

    Atropine is a potent anti-cholinergic (parasympathetic blocker, parasympatholytic) that reduces vagal tone and thus increases automatically the SA node and increases A-V conduction.

INDICATIONS

    -Sinus Bradycardia accompanied by hemodynamic compromise, (e.g. hypotension; confusion; frequent PVC's; pales, cold, clammy skin). In infants (
      -Pretreatment in pediatric intubations to prevent bradycardia

    CONTRAINDICATIONS

      None in emergency situations.

    WARNINGS

      Too small of a dose (

      SIDE EFFECTS

        CNS: Restlessness, agitation, confusion, psychotic reaction, pupil dilation, blurred vision, and headache.

        Cardio:Increase heart rate, may worsen ischemia or increase area of infarction, ventricular fibrillation, ventricular tachycardia, angina, flushing of skin.

        GI:Dry mouth, difficulty swallowing.

        Other:Urinary retention. Worsened pre-existing glaucoma.

      Atropine Sulfate as Antidote for Poisonings

      DOSAGE

        Adult: 0.03 mg/kg (2 mg) IV / IM, repeat q 5-10 minutes until atropinization occurs.

        Pediatric: 0.05 mg/kg (max. 3 mg) IV, repeat q 5-10 minutes until atropinization occurs.

      ACTIONS

        Atropine is a potent parasympatholytic that binds to acetylcholine receptors thus diminishing the actions of acetylcholine.

      INDICATIONS

        Anticholinesterase syndrome poisoning such as; Organophosphate (e.g. parathion, Malathion, rid-a-bug) and carbamate (Baygon, Sevin and many common roach & ant sprays). Signs of organophosphate poisoning are: Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis, pinpoint pupils, bradycardia, and excessive sweating.

      CONTRAINDICATIONS

        None when used in the management of severe organophosphate poisoning.

      WARNINGS

        It is important that the patient be adequately oxygenated and ventilated prior to using atropine as Atropine may precipitate ventricular fibrillation in a poorly oxygenated patient. Even after Atropine is administered, the patient may require intubation and aggressive ventilatory support.

      ADVERSE REACTIONS AND SIDE EFFECTS

        Victims of organophosphate poisoning can tolerate large doses (1000 mg) of Atropine. Signs of atropinization are the end point of treatment: flushing, pupil dilation, dry mouth, and tachycardia.

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