Class: Anticholinergic (antimuscarinic)

Action: Blocks muscarinic responses to acetylcholine (ACH); by blocking vagal (parasympathetic) impulses to the heart, it increases SA node discharge.

Indications: Symptomatic bradycardia, nerve agent exposure, organophosphate poisoning, beta blocker complications

Adverse Effects: Decreased secretions resulting in dry mouth and hot skin temperature, intense facial flushing, blurred vision or dilation of the pupils with subsequent photophobia, tachycardia, restlessness, paradoxical bradycardia of dose is too low or administered too slow.

Contraindications: Acute MI, myasthenia gravis, GI obstruction, glaucoma (closed angle), sensitivity to atropine, belladonna alkaloids or sulfites.

Special Considerations: Pregnancy Class C

Dosages:

Adults:

Symptomatic Bradycardia:

• 0.5 - 1mg IV/IO every 3-5 mins to (MAX of 3mg)

Organophosphates (Pesticides):

• 2 mg rapid IV every 5 mins until symptoms controlled

Pediatrics:

Symptomatic Bradycardia:

• 0.02mg/kg for Bradycardia to MAX of 1mg