Adenosine (Adenocard®)
Cardiac Medications Atropine
Atropine Sulfate
Type:
Cardiac antidysrhythmic
Mechanism of Action (What the drug does in the body):
Atropine inhibits the effect of acetylcholine (neurotransmitter) in the parasympathetic nervous system (feed-or-breed system). It is given during symptomatic bradycardia to block the effect of the vagus nerve. If you block the effect of the vagus nerve, than the sympathetic nervous system will dominate (i.e. increased heart rate, increased conduction velocity, etc.). When administered for organophosphate or nerve gas poisoning, it helps to reverse the S.L.U.D.G.E. effect.
Half-Life (How long the drug is in the therapeutic range):
2-6 hours
Indications (When to give the drug):
Symptomatic bradycardia (rate-dependant PVC’s, diaphoresis, altered LOC, hypotension)
Asystole
Cardiac Medications Atropine
Organophosphate poisoning
Nerve gas poisoning
Contraindications (When not to give the drug):
Tachycardia (except when associated with organophosphate or nerve gas poisoning) Narrow-angle glaucoma
Hypersensitivity
Side Effects (Undesirable things that happen in addition to the therapeutic benefit):
Flushing Dizziness
Tachydysrhythmias Nausea
Headache Increased myocardial oxygen demand
Palpitations
Supplied:
1 mg / 10 ml prefilled syringe
8 mg / 20 ml vial
Precautions:
, Do not administer a dosage less than 0.5 mg to adults and 0.1 mg for pediatrics—may
result in a paradoxical (reverse) effect ndrd, Is not considered effective for 2 degree type II or 3 degree AV blocks, and if used,
may reduce conduction thereby slowing the heart rate. Some protocols still allow
atropine to be administered for these AV blocks with discretion exercised by the
medical director.
Dosage and Route:
Adults: Symptomatic bradycardia – 0.5 – 1.0 mg IVP every 3-5 minutes as needed.
Maximum 0.04 mg/kg. (usually around 3-4 mg).
Asystole – 1.0 mg IVP or 2-3 mg diluted in 10 ml of saline administered via ET
Tube. Maximum 0.03-0.04 mg/kg.
Organophosphate/Nerve Gas poisoning – 2-5 mg IVP every 5-15 minutes to dry
Secretions. No maximum – doses as high as 1 gram have been given for severe cases
Peds: Symptomatic bradycardia: 0.02 mg/kg (max. of 0.5 mg dosage for child and 1.0 mg
for adolescent in a single bolus). May repeat once only.
Organophosphate/Nerve Gas poisoning – 0.05 mg IVP every 5-15 minutes to dry
Secretions
Asystole – efficacy is not established (no strong evidence to say it works)
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