Atropine Sulfate

Aliases: None  

Indications: Symptomatic Bradycardia (if TCP is not immediately available); Organophosphate poisoning  

Contraindications: A-Fib or A-Flutter 

Concentrations: 

Injection: 0.1 mg/mL

Dosing

Adult:

Indication	Dose	Route	Note
Symptomatic Bradycardia	1 mg	IV Push	May repeat every 3 minutes. Max 3 mg.
Organophosphate Poisoning	2-6 mg	IV Push/IM	Repeat every 3 minutes until symptoms resolve

Pediatric:

Indication	Dose	Route	Note
Symptomatic Bradycardia	0.02 mg/kg (Between 0.1 -0.5 mg)	IV Push	May repeat every 3 minutes. Max 3 mg.
Organophosphate Poisoning	0.02 mg/kg (Between 0.1 -0.5 mg)	IV Push/IM	Repeat every 3 minutes until symptoms resolve

Precautions: Slow administration of Atropine can cause paradoxical bradycardia 

Adverse/Side Effects: Pupil dilation, tachycardia, V-Tach, V-Fib, HA, dry mouth  

Class: Parasympatholytic & Anticholinergic  

Mechanism of Action: Competitive antagonist that selectively blocks all muscarinic responses to acetylcholine. Blocks vagal impulses, thereby increasing SA node discharge, thereby enhancing AV conduction and cardiac output. Potent anti-secretory effects caused by the blocking of acetylcholine at the muscarinic site. Atropine is also useful in the treatment of the symptoms associated with nerve agent poisoning.   

Onset of Action	Peak Effect	Duration of Action
Immediate	0.7 – 4 minutes	Variable