Atropine

Indications:

• Symptomatic bradycardia
• Organophosphate pesticide poisoning
• Chemical exposure due to nerve agent
• Pharmacologically-Assisted Intubation

Contraindications:

Hypothermic bradycardia

Precautions:

• If given too slowly, can cause transient bradycardia
• Administer into medication port closest to IV/IO site
• Notify BioTel before giving to patients with glaucoma

Side Effects:

• Tachycardia
• Dilated pupils (may make pupil assessment unreliable)
• Anticholinergic effects: dry mouth, blurred vision, decreased sweating, confusion

Adult Dose:

Symptomatic Bradycardia – BIOTEL AUTHORIZATION ONLY

• 0.5 mg – 1.0 mg push – BioTel must approve all dosing

Organophosphate poisoning:  BIOTEL AUTHORIZATION ONLY

• 2 mg push every 5 – 15 minutes until excessive secretions are diminished

Nerve agent exposure:  BIOTEL AUTHORIZATION ONLY

• 2 mg – 20 mg IM, IV, IO

Pediatric Dose:

Standing order:
CONSIDER for symptomatic bradycardia unresponsive to oxygenation and ventilation, when a vagally-mediated cause is suspected:

• 0.02 mg/kg (0.2 mL/kg) (minimum single dose 0.1 mg), IV or IO. 
• May repeat once, up to a maximum, total, cumulative dose of 1 mg.

BIOTEL AUTHORIZATION ONLY
Organophosphate poisoning: 

• 0.05 mg/kg push every 20 minutes until excessive secretions are diminished

Premedication in Pharmacologically-Assisted Intubation (PAI)

• 0.01 to 0.02 mg/kg IV/IO push (0.1 to 0.2 mL/kg), two minutes prior to intubation; maximum single dose 1 mg

Route:

• IV or IO, rapid push
• Deep IM (via auto-injector) for nerve agent exposure (or PAI)

Drug Action:

• Reverses suspected vagal tone in some types of bradycardia
• Blocks acetylcholine in organophosphate poisoning (pesticide or nerve agent)

Class: Anticholinergic/Parasympatholytic agent

Onset: Rapid

Duration: 2 - 6 hours