Atropine
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
- 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