Indications:
First drug for symptomatic sinus bradycardia with or without ACS.
It May be beneficial in presence of AV nodal block; not likely to be effective for second-degree Block type 2 or third-degree AV block or a block in non-nodal tissue
Routine use during PEA or systole is unlikely to have a therapeutic benefit and is not part of the AHA recommendations anymore.
For Organophosphate poisoning, an extremely large dose may be needed.
🫀Mechanism of Action:
Increase Parasympatholytic (Vagolytic Action) Increase HR, Increase Sinus Nod Discharge and Increased AV Conduction
ACLS Dosage:
1mg IV every 3-5 minutes as needed. Kindly note that the dose of Atropine has been increased from 0.5mg to 1mg in the 2020 AHA guidelines.
Do not exceed 0.04mg/kg or a total dose of 3mg.
☠️ For Organophosphate Poisoning the dose is 2-4mg or higher
PALS Dosage:
The IV/IO dose is 0.02 mg/kg for a maximum single dose: 0.5 mg May repeat dose once in 3-5 minutes
Maximum total dose for a child: 1 mg; for an adolescent: 3 mg
Side Effects:
Due to the increase in myocardial oxygen demand, Use with caution in presence of myocardial ischemia and hypoxia.
Unlikely to be effective for hypothermic bradycardia
May not be effective for infranodal, Type 2 AV block and new third-degree block with wide QRS complexes. In these patients, it may cause paradoxical slowing. So be prepared to pace or give catecholamines.
Disclaimer: This video is for educational purposes only and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.
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