ATROPINE SULFATE

CLASS:

• Parasympatholytic

• Anticholinergic (vagolytic)

• Antimuscarinic

ACTIONS:

• An acetylcholine (Ach) antagonist that inhibits the action of ACh by competing with ACh for binding sites on muscarinic receptors, which are located on exocrine glands, cardiac and smooth muscle ganglia

• Blocks effects of parasympathetic innervation to the heart which enhances both sinus node automaticity and AV conduction

• Relaxes smooth muscle in bronchial tree = bronchodilation

• Inhibits glandular secretion in respiratory tract

• Inhibits secretions from sweat and salivary glands

• Decreases gastrointestinal motility

INDICATIONS:

• Symptomatic bradyarrhythmias

• Symptomatic conduction defects, ie. Stokes-Adams syndrome

• Organophosphate (cholinergic) poisoning

• Status asthmaticus (aerosol nebulizer route)

CONTRAINDICATION:

• Tachycardia

• Acute narrow-angle glaucoma

• Acute MI

• Myasthenia gravis

• Obstructive disease of the GI tract

• Hypersensitivity

STANDARD PREPS:

• 1 mg / 10 cc preloaded syringe

• 1mg / 1 cc vial

DOSAGES/ROUTES:

• 0.5 to 1.0mg up to a total of 3mg

• POISONING LARGE doses IV

• RESP. DIFF. 1.0mg via nebulizer with beta-2 agonist for adults

PEDS DOSE:

• 0.02 mg / kg (minimum 0.1 mg)

SIDE EFFECTS:

• Acute psychosis, vasodilation, dehydration, elevated surface temp, mydriasis.

• Tachycardia or palpitations.

• Mad as a hatter, red as a beet, dry as a bone, hot as a hare, blind as a bat

PRECAUTIONS:

• Atropine has been reported to be harmful in some patients with AV block at the HIS-Purkinje level (type II AV block and third-degree AV block with a new wide-QRS complex).

• May increase myocardial O2 demand in MI patients and aggravate CP

• Too low a dose may cause paradoxical bradycardia

• Exacerbation of glaucoma

• Can cause acute urinary retention in males with enlarged prostate

• Physostigmine reverses the effects of atropine and is used to treat atropine overdose

• Worsens symptoms of myasthenia gravis