Understanding Anesthesiology - The Global Regional Anesthesia ...

Atropine
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
Elimination
Hepatic, renal
Effects
Most effects result from the anticholinergic action of atropine.
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.
Related Glossary Terms
Acetylcholine, Anticholinergic, Anticholinesterase, Antisialagogue, Autonomic nervous system,
Glycopyrrolate, Muscarinic, Vagus nerve
Index
Find Term
Chapter 3 - General Anesthesia
Chapter 5 - Pediatric Anesthesia
Chapter 6 - Drug Finder
Chapter 6 - Anticholinesterase and Anticholinergics