Understanding Anesthesiology - The Global Regional Anesthesia ...

ATROPINE SULFATE
Class
Anticholinergic. Clinical use in anesthesia includes the
treatment of bryadycardia and asystole; as a antisialagogue
for awake intubation; or for counteracting the
muscarinic effects of the anticholinesterases used for the
reversal of neuromuscular blockade.
Mechanism of Action
An acetylcholine receptor blocker active at the muscarinic
(not nicotinic) acetylcholine receptors. Therefore,
atropine has an anti-parasympathetic effect.
Dose
Premedication 0.4-0.6 mg IV/IM in adults, 10-20 ug/kg
IV/IM in children. Reversal 0.015 mg/kg IV with neostigmine
0.05 mg/kg IV.
Onset
Immediate
Duration
1-2 hours
CNS
Confusion, hallucinations, mydriasis, blurred vision, increased
intraocular pressure
CVS
Tachycardia (high doses), bradycardia (low doses)
GI
Gastroesophageal reflux
GU
Urinary hesitancy, retention
Misc.
Has additive anticholinergic effects with antihistamines,
phenothiazines, tricyclic antidepressants, mono-amine
oxidase inhibitors and benzodiazepines. Potentiates sympathomimetics.
May produce central anticholinergic syndrome.
Contraindications
Contraindicated in patients with narrow-angle glaucoma,
gastrointestinal or genitourinary obstruction.
Elimination
Hepatic, renal
Effects
Most effects result from the anticholinergic action of atropine.
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