Drug Cards

Atropine Sulfate

Class:
Anticholinergic agent.
Mechanism of Action:
  • Increases conduction through the AV Node. + Chronotrope
  • Increases heart rate in life-theatening bradydysrithmias
  • Parasympatholytic: inhibits action of acetylcholine at postganglionic parasympathetic neuroeffector sites.
Indications:
  • Hemodynamically significant bradycardia.
  • Drug of choice for organophosphate poisoning.
Contraindications:
  • Tachycardia.
  • Hypersensitivity.
  • Unstable cardiovascular status in acute hemmorrhage and myocardial ischemia.
Adverse reactions:
  • Headache, dizziness, palpations, nausea and vomiting.
  • Tachycardia, dysrhythmias, anticholinergic effects (blurred vision, dry mouth, urinary retention).
  • Paradoxical bradycardia when pushed slowly or at low doses.
  • Flushed, hot dry skin.
Drug Interactions:
Effects enhanced by antihistamines, antipsychotics, benzodiazepines and antidepressants.
Adult Dosage and Administration
  • Bradydisrithmias: 1mg IV every 3-5 minutes as needed to a maximum total dose of 3mg
  • Organophosphate poisoning: higher and escalated dose often required. Therapeutic index reached when secretions dry up.
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Pediatric Dosage and Administration:
  • Bradydisrhythmias: 0.02 mg/kg IV / ET / IO (minimum single dose 0.1mg, maximum single dose 1.0mg).
Duration of action:
  • Onset: Immediate.
  • Peak Effect: Rapid to 1-2 minutes.
  • Duration: 2-6 hours.
Special Considerations:
Pregnancy safety: Category C
Moderate doses dilate pupiles.