Atropine

Question 1

Atropine:
Classification -
1. (List of 2)

Answer 1

Classification -
1. Parasympathetic blocker, anticholinergic.
(Others not listed in PCPs: antiparasympathetic, parasympatholytic, muscarinic)

Question 2

Atropine: 
Action - 
1. Cardiac 
     a. \_\_\_ 
     b. \_\_\_

Answer 2

Action -
1. Cardiac
a. Increases firing rate of sinoatrial (SA) node by
blocking action of vagus nerve, which results in
an increased pulse rate.
b. Increases conduciton velocity through the
atrioventricular (AV) node.

Question 3

Atropine:
Onset of Action -
1. IV: ___
2. IM: ___

Answer 3

Onset of Action -

1. IV: immediate.
2. IM: 1 minute.

Question 4

Atropine:
Duration of Action -
1. ___

Answer 4

Duration of Action -

1. 4 hours.

Question 5

Atropine: 
Indication - 
1. \_\_\_ 
2. \_\_\_ 
3. \_\_\_ 
4. \_\_\_

Answer 5

Indication -

1. Symptomatic bradycardic rhythms associated with hypotension, decreased mentation, ventricular irritability (PVCs), chest pain.
2. May be beneficial in AV nodal block, but not likely to be effective for type 2 second-degree or third-degree AV block, PEA or asystole.
3. Organophosphate anticholinesterase poisoning.
4. Nerve Agent poisoning.

Question 6

Atropine: 
Contraindication - 
1. \_\_\_ 
2. \_\_\_ 
3. \_\_\_ 
4. \_\_\_

Answer 6

Contraindication -

1. Atrial fibrillation or flutter.
2. Tachycardia.
3. Bradycardia secondary to increased ICP (i.e. stroke, head trauma).
4. Unstable cardiovascular status in acute hemorrhage.

Question 7

Atropine: 
Use with Caution - 
1. \_\_\_ 
2. \_\_\_ 
3. \_\_\_

Answer 7

Use with Caution -

1. Do not mix with sodium bicarbonate.
2. Be certain patient with bradycardia is not hypoxic or head injured in origin.
3. Ineffective for bradycardia treatment in transplanted heart.

Question 8

Atropine:
Dosage and Administration -
1. Bradycardia:
a. Adult:
i. IV: ___
a) Minimum single dose: ___
b) Maximum total dose: ___
c) Use ___ interval and ___ doses in severe
clinical conditions.

Answer 8

Dosage and Aministration -
1. Bradycardia:
a. Adult:
i. IV: 0.5 mg every 3-5 minutes as needed.
a) Minimum single dose: 0.5 mg.
b) Maximum total dose 0.04 mg/kg (total 3
mg).
c) Use shorter dosing interval (3 minutes) and
higher doses in severe clinical conditions.

Question 9

Atropine
Adverse Reaction -
1. Cardiac: (List of 3)
2. Non-Cardiac: (List of 6)

Answer 9

Adverse Reaction -

1. Cardiac: Tachycardia, Palpitations, Ventricular fibrillation.
2. Non-Cardiac: Dryness of mouth (common), Pain in eyes or blurred vision (precipitates glaucoma), Restlessness, Irritability, Change in mental state, Injection site pain.

Question 10

Atropine: 
Action - 
1. Non-Cardiac 
     a. \_\_\_ 
     b. \_\_\_ 
     c. \_\_\_ 
     d. \_\_\_

Answer 10

Action -

1. Non-Cardiac
   a. Decrease of all body secretions.
   b. Dilation of pupils and paralysis of the ciliary
   muscle.
   c. Decrease in bladder tone resulting in urinary
   retention.
   d. Central nervous system stimulation.

Question 11

Atropine: 
Dosage and Administration - 
1. Bradycardia: 
     a. Adult:
          i. ET: \_\_\_

Answer 11

Dosage and Administration -

1. Bradycardia:
   a. Adult:
   i. ET: 1 mg diluted in 10 mL NS.

Question 12

Atropine:
Dosage and Administration -
1. Bradycardia:
a. Pediatric:
i. IV: ___.
a) Minimum single dose: ___.
b) Maximum child single dose: ___,
maximum child total dose ___.
c) Maximum adolescent single dose: ___,
max adolescent total dose ___.
d) May double for ___.

Answer 12

Dosage and Administration -
1. Bradycardia:
a. Pediatric:
i. IV: 0.02 mg/kg.
a) Minimum single dose: 0.1 mg.
b) Maximum child single dose: 0.5 mg,
maximum child total dose 1 mg.
c) Maximum adolescent single dose: 1 mg,
max adolescent total dose 2 mg.
d) May double for second IV dose.

Question 13

Atropine:
Dosage and Administration -
1. Anticholinesterase/organophosphate/nerve agent poisoning:
a. Adult: ___
b. If using the DuoDote/Mark I antidote kit: ___

Answer 13

Dosage and Administration -
1. Anticholinesterase/organophosphate/nerve agent poisoning:
a. Adult: 1 mg IV every 1 minute until symptoms
(bradycardia, bronchial secretions, etc.) clear, up
to 10 mg.
b. If using the DuoDote/Mark I antidote kit: give one
atropine injector (2 mg) into the thigh followed
with 2-PAM chloride injection. May give up to
three sets.

Question 14

Atropine: 
Dosage and Administration - 
1. Bradycardia: 
     a. Pediatric: 
          I. ET: \_\_\_

Answer 14

Dosage and Administration -

1. Bradycardia:
   a. Pediatric:
   i. ET: 0.05 mg/kg diluted in 5 mL NS.

Question 15

Atropine:
Dosage and Administration -
1. Anticholinesterase/organophosphate/nerve agent poisoning:
a. Pediatric: ___

Answer 15

Dosage and Administration -

1. Anticholinesterase/organophosphate/nerve agent poisoning:
   a. Pediatric: Age < 12 years old start with 0.5 mg IV/IO and repeat every 1 minute until symptoms clear, up to 10 mg. Age >= 12 years old, follow adult dosing.