Description and indication for use:
Atropine is an anti-cholinergic agent
having effects on smooth muscle, cardiac muscle and various glandular
cells. It causes increased heart rate,
reduced gastrointestinal motility and tone, urinary retention, cycloplegia and
reduced salivation and sweating. It is
used to treat bradycardia and for cardiopulmonary resuscitation. It may also be used in conjunction with
neostigmine for reversal of muscle relaxation due to pancuronium.
May be used prior to intubation to reduce
incidence of bradycardia and therefore maintain cerebral perfusion during
procedure.
Dose
IV and IM:
20 micrograms/kg/dose (may be repeated in
5-10 minutes).
ETT: (when IV route not available)
2 - 3 times IV dose followed by 1 mL of sodium
chloride 0.9%.
Reconstitution/Dilution
Ampoule = 0.6 mg in 1 mL (600 micrograms/mL).
IV 1:
For Intubation pre-med dose please see neat
dosing guidelines in Medicines for Intubation and Resuscitation Quick Reference
Guide page 121 [Appendix C].
IV 2:
Withdraw 0.2 mL of 600micrograms/mL
solution and add to 1 mL of sodium chloride 0.9% in a second 2 mL syringe = 120
micrograms/1.2 mL = 100 mcg/mL.
Discard excess volume to obtain required
dose or withdraw dose using another 1 mL syringe.
Route and method of administration
IV:
Give over 1 minute.
Peak increase in heart rate occurs 2-4
minutes.
Special precautions
Compatibilities
Glucose 5%.
Glucose 10%.
Sodium chloride 0.9%.
TPN
Incompatibilities
Do
not mix with sodium bicarbonate
Atropine sulphate must not be mixed with
the following drugs:
adrenaline,
ampicillin, heparin sodium, thiopentone sodium.
Contraindications
Hypersensitivity to atropine.
Thyrotoxicosis, tachycardia secondary to
cardiac insufficiency.
Cardiospasm .
Caution in patients with Down’s Syndrome.
Paralytic ileus/Gastrointestinal
obstruction.
Pyrexia.
Nursing responsibilities
Monitor vital signs with cardiorespiratory
monitor.
Monitor urinary output.
Strict mouth care.