Increases HR (primary), increases cardiac output, dries secretions
This is the most potent of the anticholinergic drugs to increase HR. The primary reservation is that it crosses the blood-brain barrier and can cause sedation, delirium, and at high doses, anticholinergic syndrome.
Atropine may increase intraocular pressure (IOP) by more than 6 mm Hg in 8% of adults. This does not appear to be the case in pediatric patients 3 years old and younger.
Atropine is a bronchodilator (often given to asthmatic patients for this reason).
Atropine has NO effect on nicotinic receptors responsible for weakness/paralysis.
Drug interactions:Ephedrine, Glycopyrrolate, Opioids: May enhance the effects of these drugsNitroglycerine: Decreases the absorption of this drugMetoclopramide & other prokinetics: Atropine may diminish the effects of these drugGlucagon: may enhance the adverse/toxic effects of glucagon
OB: Crosses the placenta. Trace amounts can be found in breast milk.
none per the manufacturer. However, there are some precautions to take:
1. Myasthenia Gravis: If the patient has this condition, Atropine should be avoided as it could cause a cholinergic crisis
2. Renal / Hepatic Impairment: this would give pronounced/prolonged effects of atropine.
3. Cardiac patients: be particularly careful of anything that would place greater demand on the heart. This would be particularly true in patients with Aortic Stenosis
Bradycardia popular dose: 10-20 ug/kg (0.01 – 0.02 mg/kg).
Oculocardiac reflex dose: 15 – 20 ug/kg.
ACLS bradyarrhythmias/pauses dose: 1.0 mg IV (can be repeated up to 0.04 mg/kg)
Anticholinergic (Antimuscarinic)
< 1 min
1 - 3 min
15-30 min
Blocks acetylcholine at parasympathetic sites in smooth muscle, secretory
Renal
References: Barash. Clinical anesthesia. 7th edition. 2013.
UpToDate. Retrieved from www.uptodate.com. 2018.
Urman. Pocket Anesthesia. 2009
Wu. Does atropine use increase intraocular pressure in myopic children? 2012.
