About:

¤Used in cardiac arrest setting or with symptomatic bradycardia.

¤Derived from an alkaloid extracted from deadly nightshade.

¤Was used to make women more attractive by dilating their pupils.

¤Deadly nightshade - Atropa belladonna.

Mode of action:

¤Competitive Muscarinic Ach blocker.

¤Blocks the action of acetyl choline.

Indications:

¤Symptomatic bradycardia.

¤Cardiac arrest setting.

¤Poisoning from organophosphates and nerve agents which increase Ach.

Interactions:

¤N/A

Contraindications:

¤Cardiac transplant - oversensitive use with great caution.

Side effects:

¤Reduced secretions, Delirium, Pupils dilate, Increased heart rate.

¤Relax smooth bowel, Urinary retention, Bronchodilation.

¤High dose - tachyarrhythmias e.g. VF,VT, SVT.

Atropine Dose:

¤Cardiac arrest up to 3 mg IV.

¤Bradycardia 500 mcg iv bolus repeated up to 3 mg IV.

¤Consider pacing if bradycardia induced hypotension persists.

Reference:Shanbhag Pharmacology 3rd edition