My Nurses Notes: ATROPINE INJECTION

ATROPINE INJECTION

Helps keep your heart rate stable after a heart attack or during surgery. Lowers the amount of body fluids inside your mouth and throat before a surgery. This keeps you from possibly choking on your saliva while you are unconscious. Also treats many other conditions such as problems with heart rhythm or bladder control, stomach or intestinal disorders, or certain types of poisoning.

1ml = 1mg sc/iv

Indication of Atropine Injection BP:

This drug may be used to reduce salivary and bronchial secretions prior to anaesthesia before surgery.

It may also be used in the prevention of abnormal heart rhythms and low blood pressure caused by acetylcholine associated events.

Atropine Injection BP can also be used in the management of acute myocardial infarction (heart attack).

The drug can also be used in the management of cholinergic poisoning by organophosphates or anticholinesterases with muscarinic effects.

^ top

Action of Atropine Injection BP:

Atropine is a medicine known as an anticholinergic agent that acts centrally (on the brain) and peripherally. It inhibits the actions of a chemical in the body called acetylcholine, thereby causing relaxation of sm,ooth muscles and nerves.

^ top

Dose advice of Atropine Injection BP:

Preanaesthesia:

Adults may be given atropine 300-600 microgram intramuscularly or subcutaneously, 30-60 minutes prior to anaesthetic induction. Alternatively 300-600 microgram may be given intravenously immediately prior to anaesthetic induction.
Children are given subcutaneous injections 30-60 minutes prior to anaesthetic induction as accordingly: infants<3kg 100 microgram, children 7-9kg 200 microgram, 12-16kg 300 microgram, 20-27kg 400 microgram, 32kg 500 microgram, 41kg 600 microgram.

Cardiopulmonary resuscitation:

Adult dosage is usually atropine 0.4-1mg intravenously, repeated at 5 minute intervals until the preferred heart rate is achieved. The total dose should not be more than 2mg.
In paediatric cases, the usual dose is 0.02mg/kg (maximum single dose <0.5mg) intravenously, repeated at 5 minute intervals until the preferred heart rate is achieved. The total dose should not be more than 1mg.

Reversing competitive neuromuscular block:

Adult doses are atropine 600 microgram-1.2mg as a slow intravenous injection for every 0.5-2.5mg of anticholinesterase agent (e.g. neostigmine, physostigmine).
Paediatric dosage is 0.02mg/kg for every 0.04mg/kg of anticholinesterase agent.

Organophosphate poisoning:

For adults 1-2mg atropine may be give intravenously. Additional 2mg doses may be given every 5-60 minutes until symptoms subside. For severe cases, 2-6mg atropine can be administered intravenously with additional 2-6mg doses given every 5-60 minutes until symptoms subside.
For children, 0.05mg/kg intravenously or intramuscularly can be administered and repeated every 10-30 minutes until symptoms subside.

^ top

Schedule of Atropine Injection BP:

S2 for 0.6mg/mL or less for organophosphate poisoning

^ top

Common side effects of Atropine Injection BP:

Most side effects of atropine are related to its antimuscarinic actions and are most likely due to excessive dose intake. Some commonly experienced side effects may include:

increased heart rate

palpitations

thirst

dryness of mouth

constipation

urinary difficulty

pupil dilatation

flushing and dryness of the skin

^ top