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Atropine

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Atropine

Indications
Dosage
How Supplied

INDICATIONS

Atropine Sulfate Injections, USP, is indicated when excessive (or sometime normal) muscarinic effects are judged to be life threatening or are producing symptoms sever enough to call of temporary, reversible muscarinic blockade. Examples, not an exhaustive list, of such possible uses are:

1. As an antisialogogue when reduction of secretions of the respiratory tract are thought to be needed; its routine use as a preanesthetic agent is discouraged
2. To blunt the increased vagal tone (decreased pulse and blood pressure) produced by intra-abdominal tract or ocular muscle traction, its routine use to prevent such events is discouraged
3. To temporarily increase heart rate or decrease AV-block until definitive intervention can take place, when bradycardia or AV-block are judged to be hemodynamically significant and thought to be due to excess vagal tone
4. As an antidote for inadvertent overdose of cholinergic drugs or for cholinesterase poisoning such as from organophosphorus insecticides
5. As an antidote for the "rapid type of mushroom poisoning due to the presence of the alkaloid muscarine, in certain species of fungus such as Amanita muscaria, and 6. To alleviate the muscarinic side effects of anticholinesterase drugs used for reversal of neuromuscular blockade

DOSAGE AND ADMINISTRATION

Atropine Sulfate Injection, USP in Ansyr Syringe is intended fo rintravenous use, but may be administered subcutaneously or intramuscularly. Its use usually requires titration, using heart rate, PR interval, blook pressure and/or patient's symptoms as a guide for having reached an appropriate dose.

Adults
Initial single doses in adults vary from around 0.5 mg to 1 mg (5 - 10 mL of the 0.1 mg/mL solution) for antisialagogue and other antivagal effects, to 2 to 3 mg (20 - 30 mL of the 0.1 mg/mL solution) as an antidote for organophosporous or muscarinic mushroom poisoning. When used as an antidote, the 2 to 3 mg dose should be repeated no less often that every 20 to 30 minutes until signs of poisoning are sufficiently lessened or signs of atropine poisoning (See ADVERSE REACTIONS and OVERDOSAGE) occur.

When the recurrent use of atropine is essential in patients with coronary atery disease, the total dose should be restricted to 2 to 3 (maximum 0.03 to 0.04 mg/kg) to avoid the detrimental effects of atropine-induced tachycardia on myocardial oxygen demand. For patients with bradyasystolic cardiac arrest, a 1 mg dose of atropine is administered inbravenously and is repeated every 3-5 minutes if asystole persists. Three milligrams (0.04 mg/kg) given I.V. is a fully vagolytic dose in most patients. The administration of less than 0.5 mg can produce a paradoxical bradycardia because of the central or peripheral parasympathomimatic effects of low dose in adults.

Endotracheal administration of atropine can be used in patients without I.V. access. The recommended adult dose of atropine for endotracheal administration is 1 to 2 mg diluted to a total not to exceed 10 ml of sterile water or normal saline.

Titration intervals of one or two hours are recommended tin circumstances that are not life-threatening.

Pediatrics
Dosing information in pediatric populations ahs not been well studied. Usage history of initial dose has been in the range of 0.01to 0.03 mg/kg body weight.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. See PRECAUTIONS.

HOW SUPPLIED

Atropine Sulfate Injection, USP is supplied in single-dose containers as follows:

List No.

Container

Size

Conc.

Total Content (Atropine)

9629

Ansyr® Plastic Syringe

5mL

0.1 mg/mL (Adult)

0.5 mg

1630

Ansyr® Plastic Syringe

10mL

0.1 mg/mL (Adult)

1 mg

9630

Ansyr® Plastic Syringe

5mL

0.05 mg/mL (Pediatric)

0.25 mg


Store at controlled room temperature 15° to 30°C (59° to 86°F).

Caution: Federal (USA) law prohibits dispensing without prescription.

Last reviewed on RxList: 10/4/2010
This monograph has been modified to include the generic and brand name in many instances.

Indications
Dosage
How Supplied
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