Home Drug Guide Atropine

Drug Guide

Generic Name

Atropine

Brand Names Atropen, Atropine autoinjector

Classification

Therapeutic: Anticholinergic agent

Pharmacological: Muscarinic receptor antagonist

FDA Approved Indications

  • Bradycardia (to increase heart rate)
  • Organophosphate poisoning reversal
  • Preoperative reduction of salivary and respiratory secretions

Mechanism of Action

Atropine blocks muscarinic acetylcholine receptors, inhibiting parasympathetic nerve impulses, thereby increasing heart rate and reducing secretions.

Dosage and Administration

Adult: 0.5 mg IV every 3-5 minutes as needed; maximum dose 3 mg.

Pediatric: 0.02 mg/kg IV; typically administered every 3-5 minutes as needed, not exceeding 0.5 mg per dose or 3 mg total.

Geriatric: Same as adult, but monitor closely for anticholinergic side effects; adjust dose as necessary.

Renal Impairment: Use with caution; no specific dose adjustment established.

Hepatic Impairment: Use with caution; no specific dose adjustment established.

Pharmacokinetics

Absorption: Well absorbed via IV, IM, SC, and topical routes.

Distribution: Widely distributed including CNS, crosses the blood-brain barrier.

Metabolism: Primarily hepatic.

Excretion: Renally excreted as unchanged drug and metabolites.

Half Life: About 2-4 hours.

Contraindications

  • Obstructive disease of the gastrointestinal or urinary tracts
  • Myasthenia gravis (except in cholinergic crisis)
  • Tachyarrhythmias (except during bradycardia)
  • Allergy to atropine or belladonna alkaloids

Precautions

  • Use with caution in patients with glaucoma, cardiovascular disease, hypertension, or in the elderly. Caution in pregnancy and lactation; use only if clearly needed. Monitor for signs of anticholinergic toxicity.

Adverse Reactions - Common

  • Dry mouth (Common)
  • Blurred vision (Common)
  • Photophobia (Common)
  • Urinary retention (Uncommon)
  • Constipation (Uncommon)

Adverse Reactions - Serious

  • Tachycardia or arrhythmias (Uncommon)
  • Anaphylactic reactions (Rare)
  • Central nervous system disturbances (e.g., hallucinations, delirium) (Uncommon)

Drug-Drug Interactions

  • Other anticholinergic drugs, antihistamines, tricyclic antidepressants, phenothiazines, quinidine

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor heart rate, blood pressure, signs of anticholinergic toxicity (dry mouth, blurred vision, urinary retention). Watch for changes in mental status.

Diagnoses:

  • Risk for decreased cardiac output due to tachyarrhythmia
  • Risk for urinary retention
  • Risk for CNS disturbances

Implementation: Administer IV doses slowly; monitor patient response.

Evaluation: Assess effectiveness by restoring or maintaining adequate heart rate; monitor for adverse effects.

Patient/Family Teaching

  • Report any signs of dry mouth, blurred vision, dizziness, or difficulty urinating.
  • Use caution when operating machinery or driving.
  • Follow instructions carefully regarding dosage and timing.

Special Considerations

Black Box Warnings:

  • None.

Genetic Factors: Pharmacogenomic variations are not well characterized for atropine.

Lab Test Interference: May affect certain laboratory tests (e.g., urinary catecholamines) due to anticholinergic effects.

Overdose Management

Signs/Symptoms: Dry mouth, fever, blurred vision, hallucinations, seizures, coma, tachycardia, urinary retention, hot, dry skin.

Treatment: Supportive care; administer activated charcoal if ingestion was recent; physostigmine may be used under specialist guidance for severe toxicity.

Storage and Handling

Storage: Store at room temperature (20-25°C), protect from light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.