Atropine sulfate

dr.joan

5. Atropine sulfate:
Trade name: atropine
Class: Cholinergic blocking agent
Pregnancy: (Category C)

Action: It is a parasympatholytic agent which cause relaxation of smooth muscles & inhibition of secretary glands
Uses:
· Adjunct in peptic ulcer treatment.
· Irritable bowel syndrome.
· Treatment of spastic disorders of biliary tract.
· During anesthesia to control salivation & bronchial secretions.
· Parkinsonism.
· Anti-arrhythmic (prophylaxis).
· Prophylaxis and treatment of toxicity due to cholinesterase inhibitor including organophosphate pesticides.
· Ophthalmologic treatment of uveitis.
Dose
Bradydysrhythmia :Adult 0.5-1 mg IV may repeated at 5 min intervals until desired rate achieved " max 0.03- 0.04 mg / kg " Pediatric 0.02 mg/kg " min dose 0.1 mg , max single dose 0.5 mg for a child and 1 mg for an adolescent.
Asystole & PEA: Adult 1 mg IV may repeated every 3-5 min "max 0.03- 0.04 mg / kg, complete vagal block"
Pediatric unknown efficacy.
Endotracheal route: 30 mic/kg diluted in 5 ml NS
Anticholinesterase poisoning: Adult 1-2 mg push every 5-15 minutes to dry secretions, no max dose
Pediatric 0.05 mg/kg/dose every 5-15 min
NB
Possible paradoxical bradycardia when pushed slowly or when used at doses less than 0.5 mg
Contraindications:
§ Glaucoma, tachycardia, myocardial ischemia.
§ Prostate hypertrophy, myasthenia gravis, paralytic ileus.
§ Mental impairment, lactation, hepatic disease.
Side effects:
§ Nausea, vomiting, dry mouth, constipation, heartburn,
§ dizziness, drowsiness, headache, insomnia, blurring of vision,
§ Photophobia, flashing, euphoria, hallucination flushing of the skin.
Nursing considerations:
§ Check dosage & measure the drug exactly.
§ Assess for history of asthma, glaucoma, ulcer... etc.
§ Determine the age of the client.
§ Frequent mouth care.
§ Assess client for change in pulse rate.
§ In case of blurring of vision, assist on ambulating & give safety measures.