Treatments for bradydysrhythmias are indicated when there is a structural disease of the infra-nodal system or if the heart rate is less than 50 beats/min with unstable vital signs. Pupils and heart rate are poor indications of appropriate dosing in these patients.Ītropine is the first-line therapy (Class IIa) for symptomatic bradycardia in the absence of reversible causes. Titrate to effect by monitoring the patient’s ability to clear excess secretions. Ingestions especially require higher doses (up to 20 mg). Large doses and repeat doses may be required. Intravenous (IV) atropine indications include patients with hypersalivation, bronchial secretions, or bradycardia. If there are local symptoms to the eyes or respiratory tract, atropine is not indicated. ![]() Atropine is only useful to counter muscarinic effects (pralidoxime and benzodiazepines act on the others). It is not formally recommended for routine use in controlled airways, though it can be used off-label for minimizing secretions in the intubated patient.Īcetylcholine works on three different receptors that merit attention in nerve agent poisonings. While atropine can be used independently for anti-salivation effects, it most commonly is secondary to anticholinergic or antimuscarinic poisoning, as discussed below. ![]() It was originally synthesized from the plant Atropa belladonna which is where the drug derives its name. ![]() Atropine or atropine sulfate carries FDA indications for anti-sialagogue/anti-vagal effect, organophosphate/muscarinic poisoning, and bradycardia.
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