Atropine Sulfate

GENERIC NAME

Atropine Sulfate

TRADE NAME

None

DESCRIPTION

Atropine is used to increase slow heart rates and to treat organophosphate and nerve agent poisoning.

HOW SUPPLIED

• Prefilled syringe: 1.0 mg / 10 mL
• DuoDote: One auto-injector containing both 600 mg Pralidoxime chloride and 2.1 mg Atropine
• Mark I Kit: One auto-injector containing 600 mg Pralidoxime chloride and one auto-injector containing 2 mg Atropine

INDICATIONS

• Hemodynamically significant bradycardia
• Organophosphate poisoning
• WMD Nerve Agent poisoning

CONTRAINDICATIONS

• Hypersensitivity or allergy to Atropine

MECHANISM OF ACTION

Atropine sulfate increases heart rate by blocking the parasympathetic nervous system and its inhibitory effects on heart rate. It is used when a slow heart rate is accompanied by hypotension, shortness of breath, chest pain, altered mental status, congestive heart failure, or shock. It also reverses the effects of parasympathetic overstimulation seen in organophosphate poisoning.

SIDE EFFECTS

• Blurred vision
• Dilated pupils
• Dry mouth
• Palpitations
• Tachycardia
• Drowsiness
• Confusion
• Paradoxical bradycardia if less than 0.5 mg is given to adults

AUTHORIZATION

EMT: Standing order when DuoDote or Mark I Kit is necessary for WMD Nerve Agents; all other usages not authorized

AEMT: Standing order when DuoDote or Mark I Kit is necessary for WMD Nerve Agents; all other usages not authorized

Paramedic: Standing Order

DOSAGE

• Bradycardia:
  • Adult: 0.5 mg IV/IO every 3–5 minutes, with a maximum total dose of 3 mg
  • Infant & Child: 0.02 mg/kg IV/IO every 3–5 minutes, with a maximum total dose of 3 mg (single dose minimum 0.1 mg; maximum 0.5 mg)
• Overdose / Poisoning (Organophosphate Poisoning) / WMD:
  • Adult: 2–4 mg IV/IO every 5 minutes until secretions dry (No total maximum dose)
  • Pediatric: 0.05 mg/kg IV/IO every 5 minutes until secretions dry (single dose minimum 0.1 mg; maximum 0.5 mg; No total maximum dose)