ATROPINE 

• Used in the treatment of symptomatic sinus bradycardia (not recommended for bradycardias below AV  node such as Type II 2^o, or complete AV block)
• Antidote for sinus bradycardia induced by drugs or toxic substances or neurological disorders (which may be induced by suctioning)
• Reduces salivation and excessive secretions of the respiratory tract
• Antidote for organophosphate or carbamate poisoning

For Treatment of Bradycardia

IV Direct

• 0.5-1mg q3-5min until desired rate achieved

IM/SC

• 0.4-0.6mg q4-6h prn 

Intratracheal 

• 2-3 mg prefilled syringe

When used as a cholinergic antidote may require larger and more frequent doses.  See PDAM for other indications

• Slow IV administration may result in paradoxical bradycardia and is not recommended
• may be given via endotracheal tube if IV administration not possible

• Tachycardia 
• Myasthenia Gravis
• Acute angle-closure glaucoma
• Ileus
• Urinary obstruction
• Hypersensitivity to atropine or its components

• Tachycardia, palpitations
• Dilated pupils; blurred vision
• Fatigue, delirium, headache, restlessness, ataxia
• Dry mouth
• Dry eyes
• Dry, hot skin
• Flushed dry skin
• Ileus, decreased GI Motility
• Urinary retention and hesitancy

• atropine + phenothiazines = increased anticholinergic effect
• atropine + quinidine = increased anticholinergic effect
• atropine + procainamide = increased anticholinergic effect

• Continuous heart rate and rhythm
• Blood pressure

• May be administered IV direct by an approved nurse in the CCTC.
• May be administered as 0.5mg IV direct or intraosseus by medical directive by a certified nurse or RRT in Adult Critical Care for symptomatic bradycardia <60 beats/min and SBP < 90, and at least one sign or symptom (i.e. decreased level of consciousness, signs of shock or myocardial ischemia/pain).
  
  A certified nurse or RRT may administer additional doses of 1 mg every 3 minutes to a maximum total dose of 3 mg.