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12 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What is the best-known trade name for atropine?
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None.
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Atropine derives its name from Atropos, one of the three Fates who, according to Greek mythology, chose how a person was to die.
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What is the functional class of atropine?
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Parasympatholytic
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Atropine is one of only two prehospital parasympatholytics - the other is Atrovent (ipratropium bromide).
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What is the mechanism of action of atropine?
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Blocks muscarinic acetylcholine receptors thus inhibiting parasympathetic stimulation. By blocking vagal impulses to the heart it accelerates SA node discharge, enhances conduction through the AV junction, and increases cardiac output. It is also a potent bronchodilator when bronchoconstriction is caused by increased parasympathetic tone.
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One of the main actions of the parasympathetic nervous system is to stimulate the M2 muscarinic receptor in the heart, but atropine inhibits this action.
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What are the listed indications for atropine?
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- Symptomatic bradycardia
- Asystole (brady-asystolic arrest) - Organophosphate/nerve agent poisoning - Bradycardic PEA |
Atropine has many opthalmic uses including as a cyclopegic and mydriatic.
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What are the listed contraindications for atropine?
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None in the emergency setting.
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In non-emergency situations, atropine is contraindicated in patients pre-disposed to narrow angle glaucoma.
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What are the listed precautions for atropine?
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- May worsen bradycardia associated with 2nd Degree Mobitz II and 3rd Degree AV blocks thus consider TCP first.
- Use with caution in patients with signs and symptoms of acute myocardial ischemia, myocardial infarction & glaucoma. |
Atropine increases oxygen demand of the AV nodal tissue, thereby aggravating ischemia and any resulting heart block.
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What are the listed side effects for atropine?
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- Blurred vision
- Dilated pupils - Dry mouth - Tachycardia - Drowsiness - Convulsions - HTN or hypotension - Palpitations - Paradoxical bradycardia (if given too slowly) - AV dissociation - Urinary retention |
In medieval Europe women used the juice of the berries of Atropa belladonna (a source of atropine) to enlarge the pupils of their eyes for cosmetic reasons; "bella donna" is Italian for "beautiful lady".
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What are the listed interactions for atropine?
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Antihistamines, tricyclic antidepressants & procainamide can lead to the anticholinergic effects of atropine.
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Procainamide is a cardiac medication and used to treat supraventricular and ventricular arrhythmias.
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What is the dosage and route of atropine in asystole/bradycardic PEA?
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Adult:
- 1mg IVP q 3 - 5 minutes max total 0.04mg/kg - 2 - 2.5mg ET q 3 - 5 minutes Pedi: - 0.02mg/kg IVP or IO (min single dose is 0.1mg and max single dose is 1mg) q 5 minutes max total 0.04mg/kg |
There is no listed ET dosage for pediatric patients. The pediatric dose is the same as that for symptomatic bradycardia.
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What is the dosage and route of atropine in symptomatic bradycardia?
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Adult:
- 0.5mg IVP q 3 - 5 minutes max total 0.04mg/kg Pedi: - 0.02mg/kg IVP or IO (min single dose is 0.1mg and max single dose is 1mg) q 5 minutes max total 0.04mg/kg |
The pediatric dose is the same as that for asystole/bradycardic PEA.
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What is the dosage and route of atropine in organophosphate poisoning?
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Adult:
2 mg IVP q 5 minutes prn Pedi: 0.05 – 0.1mg/kg IV/IM (min dose of 0.1mg and max single dose 5mg), repeat q 2 – 5 minutes prn |
Atropine is included in the US military's Mark 1 NAAK ("Nerve Agent Antidote Kit") and ATNAA ("Antidote Treatment Nerve Agent Auto-Injector").
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What are the pharmacokinetics of atropine?
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Absorption: 2 - 4 minutes IV
Half-Life: 2 - 3 hours |
As a therapeutic mydriatic, atropine's effects can last for 1-2 weeks.
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