Atropine (Atropair, Atropen, Isopto Atropine, Sal-Tropine)

Category:

  • Nervous system

Description:

  • Anticholinergic, antispasmotic, antiasthmatic, bronchodilator, mydriatic

Indications:

  • Bradycardia, bradydysrhythmia, anticholinesterase insecticide poisoning

  • Blockade of cardiac vagal refleses, antisialagogue, rigidity/tremor of parkinsonism

  • Antispasmotic with GU and biliary surgery, bronchodilator

  • Mydriasis/cycloplegia for iritis, cycloplegic refraction

Contraindications:

  • Hypersensitivity to belladonna alkaloids, angle-closure glaucoma, GI obstruction

  • Myasthenia gravis, ulcerative colitis, prostatic hypertrophy, tachydysrhythmias, asthma, acute hemorrhage, myocardial ischemia

Precautions:

  • Pregnancy category C

  • Renal disease, lactation, CHF, hyperthyroidism, COPD, hepatic disease, child <6 years

  • Hypertension, elderly, intraabdominal infections, Down syndrome, spastic paralysis

  • Gastric ulcer

Adverse Reactions (Side Effects):

  • CNS: anxiety, coma, confusion, dizziness, flushing, headache, involuntary movement, psychosis, weakness

  • CV: angina, ectopic ventricular beats, hypertension, hypotension, PVCs, paradoxical bradycardia, tachycardia

  • EENT: blurred vision, eye pain, glaucoma, nasal congestion, photophobia, pupil dilation

  • GI: abdominal distension, abdominal pain, altered taste, anorexia, constipation, dry mouth, nausea, paralytic ileus, vomiting

  • GU: dysuria, hesitancy, impotence, retention

  • SKIN: contact dermatitis, dry skin, flushing, rash, urticaria

  • MISC: decreased sweating, suppression of lactation

Dosage:

Administered topically, intramuscularly, intravenously, subcutaneously

  • Adult:

    • Bradycardia/bradydysrhythmias: 

      • IV bolus 0.5-1mg given every 3-5 minutes

      • not to exceed 2mg

    • Insecticide poisoning: 

      • IM/IV 2mg every hour until muscarinic symptoms disappear

      • may need 6mg every hour

    • Pre-surgery: 

      • SC/IM/IV 0.4-0.6mg before anesthesia

    • Iritis/cycloplegic refraction: 

      • Instill solution 1-2 drops of 1% solution 1-3 times daily for iritis or 1 hour before refracting

  • Child:             

    • Bradycardia/bradydysrhythmias: 

      • IV bolus 0.01-0.03 mg/kg up to 0.4 mg or 0.3 mg per meter square

      • may repeat every 4-6 hours

    • Insecticide poisoning: 

      • IM/IV 2mg hourly until muscarinic symptoms disappear

      • may need 6mg hourly

    • Pre-surgery: 

      • SC 0.1-0.4mg 30 minutes before surgery

  •             Iritis/cycloplegic refraction: Instill 1-2 drops of a 0.5% solution 1-3 times daily for iritis or twice daily 1-3 days before exam; instill ointment 1-2 times daily 2-3 days before exam

Back to Medical Corps Pharmacy Page