Emergency Pharmacology: The Lifesaving Drugs

Atropine Sulfate

Classification: anticholinergic drug (parasympatholytic). acetylcholinergic antagonist, atropine increases firing of thesinoatrial node(SA)

conduction through theatrioventricular node(AV) of theheart, opposes the actions of thevagus nerve, blocksacetylcholinereceptorsites,

Decreasesbronchial secretions.

Injectionsof atropine are used in the treatment ofbradycardia.Therefore, its primary function in this circumstance is to increase the heart rate. Atropine was previously included in international resuscitation guidelines for use in cardiac arrestDosage is 0.5 to 1mg IV push, may repeat every 3 to 5 minutes up to a total dose of 3mg (maximum 0.04mg/kg)Atropine is also useful in treatingsecond-degree heart block Mobitz Type 1 (Wenckebach block), and alsothird-degree heart blockwith a highPurkinjeorAV-nodalescape rhythm. It is usually not effective insecond-degree heart block Mobitz type 2, and in third-degree heart block with a low Purkinje or ventricular escape rhythm.

Atropine's actions on the parasympathetic nervous system inhibit salivary and mucus glands. The drug may also inhibit sweating via the sympathetic nervous system.

PROBLEMS

Adverse reactions to atropine include ventricularfibrillation supraventricular or ventriculartachycardia dizziness nausea blurred vision

loss of balance

dilated pupils

photophobia dry mouth

potentially extremeconfusion dissociativehallucinations

andexcitationespecially amongst the elderly. These latter effects are because atropine is able to cross thebloodbrain barrier. Because of thehallucinogenicproperties, some have used the drugrecreationally, though this is potentially dangerous and often unpleasant.In overdoses, atropine ispoisonous..Although atropine treatsbradycardia(slow heart rate) in emergency settings, it can cause paradoxical heart rate slowing when given at very low doses (i.e.