Atropine
 
Presentation
• 0.6 mg in 1ml amp
• 1.2 mg in 1ml amp
Pharmacology
• An anticholinergic agent
Actions
• Inhibits the actions of acetylcholine on post-ganglionic cholinergic nerves at the neuro-effector site, e.g. as a vagal blocker and allows sympathetic effect to:
  - increase pulse rate by increasing S.A. Node firing rate
  - increase the conduction velocity through the A.V. Node
• Antidote to reverse the effects of cholinesterase inhibitors, e.g. organophosphate insecticides, at the post-ganglionic neuro-effector sites of cholinergic nerves, i.e. reduces the excessive salivary, sweat, gastrointestinal, and bronchial secretions, and relaxes smooth muscles.
Metabolism
• By the liver and
• Excreted mainly by the kidneys
Primary Emergency Indications
• Bradycardia with poor perfusion Adult
• Organophosphate poisoning with excessive cholinergic effects Adult Paed
Contraindications
Nil of significance in the above indications
Precautions
• Atrial flutter
• Atrial fibrillation
• Do not increase heart rate above 100/min except in children under 6 years
• Glaucoma
Route of Administration
• Intravenous
• Endotracheal
Side Effects
• Tachycardia
• Palpitations
• Dry mouth
• Dilated pupils
• Visual blurring
• Retention of urine
• Confusion, restlessness (in large doses)
• Hot, dry skin (in large doses)
Special Notes
 
Therapeutic Effect
IV/ETT   
Onset:
<2min
Peak:
<5min
Duration:
2-6hr
Reference Dilutions
- Atropine - Paediatric IV
 
- Atropine - Adult via ETT
- Atropine - Paediatric via ETT