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atropine (injection)

Pronunciation

Generic Name: atropine (injection) (AT roe peen)
Brand Name: Sal-Tropine, AtroPen, Atreza

What is atropine?

Atropine produces many effects in the body such as reducing muscle spasms and fluid secretions.

Atropine is used to help reduce saliva, mucus, or other secretions in your airway during a surgery. Atropine is also used to treat spasms in the stomach, intestines, bladder, or other organs.

Atropine is sometimes used as an antidote to treat certain types of poisoning.

Atropine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about atropine?

Before you receive atropine, tell your doctor about all your medical conditions or allergies, and all the medicines you are using. Also make sure your doctor knows if you are pregnant or breast-feeding.

What should I discuss with my healthcare provider before receiving atropine?

To make sure atropine is safe for you, tell your doctor if you have:

  • asthma or other breathing disorder;

  • glaucoma;

  • enlarged prostate;

  • urination problems,

  • a heart rhythm disorder;

  • liver or kidney disease;

  • myasthenia gravis; or

  • blockage in your digestive tract (stomach or intestines).

It is not known whether this medicine will harm an unborn baby. However, some forms of this medicine contain a preservative that may be harmful to a newborn. Tell your doctor if you are pregnant.

It is not known whether atropine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

In an emergency situation it may not be possible to tell your caregivers about your health conditions. Make sure any doctor caring for you afterward knows you have received this medicine.

How is atropine given?

Atropine is injected into a muscle, under the skin, or into a vein through an IV. A healthcare provider will give you this injection.

What happens if I miss a dose?

Because you will receive atropine in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Overdose symptoms may include confusion, fever, or fast heartbeats.

What should I avoid while taking atropine?

This medicine may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Atropine can decrease sweating and you may be more prone to heat stroke.

Atropine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have:

  • a light-headed feeling, like you might pass out;

  • pounding heartbeats or fluttering in your chest;

  • restlessness;

  • speech problems, trouble swallowing;

  • confusion, hallucinations;

  • weakness, loss of balance;

  • hot, dry skin; or

  • a severe skin rash.

Common side effects may include:

  • dry mouth, nose, or throat;

  • dry eyes, blurred vision;

  • dizziness; or

  • headache, drowsiness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Atropine dosing information

Usual Adult Dose for Bradyarrhythmia:

0.4 to 1 mg, IV, every 1 to 2 hours as needed
-Larger doses, up to a maximum of 2 mg, may be required

Use: To overcome severe bradycardia and syncope due to a hyperactive carotid sinus reflex

Usual Adult Dose for Anesthesia:

0.4 mg to 0.6 mg, IV, intramuscularly, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episode in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-To lessen the degree of atrioventricular heart block when increased vagal tone is a major factor in the conduction defect, as in some cases due to digitalis

Usual Adult Dose for Anticholinesterase Poisoning:

0.4 mg to 0.6 mg, IV, intramuscularly, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episode in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-To lessen the degree of atrioventricular heart block when increased vagal tone is a major factor in the conduction defect, as in some cases due to digitalis

Usual Adult Dose for Rhinorrhea:

0.4 mg to 0.6 mg, IV, intramuscularly, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episode in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-To lessen the degree of atrioventricular heart block when increased vagal tone is a major factor in the conduction defect, as in some cases due to digitalis

Usual Adult Dose for AV Heart Block:

0.4 mg to 0.6 mg, IV, intramuscularly, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episode in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-To lessen the degree of atrioventricular heart block when increased vagal tone is a major factor in the conduction defect, as in some cases due to digitalis

Usual Adult Dose for Head Injury:

0.4 mg to 0.6 mg, IV, intramuscularly, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episode in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-To lessen the degree of atrioventricular heart block when increased vagal tone is a major factor in the conduction defect, as in some cases due to digitalis

Usual Adult Dose for Peptic Ulcer:

0.4 mg to 0.6 mg, IV, intramuscularly, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episode in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-To lessen the degree of atrioventricular heart block when increased vagal tone is a major factor in the conduction defect, as in some cases due to digitalis

Usual Adult Dose for Organophosphate Poisoning:

0.8 mg, IM
-If no apparent effect within 30 minutes OR definite poisoning symptoms occur (nausea, vomiting, diarrhea, pupillary constriction, pulmonary edema, fasciculations of eyelids and tongue, jerky ocular movements and excessive sweating, salivation and bronchial secretion): Give 2 mg, IM, every hour, until signs of atropinization are seen
-The 2 mg dose may need to be given 2 or 3 times (4 to 6 mg total) in severe cases

Auto-injector:
2 or more mild symptoms of exposure: One 2 mg dose
Severe symptoms: One 2 mg dose, followed by two additional 2 mg injections given in rapid succession 10 minutes after the first dose
or
Severe symptoms or unconscious: Three 2 mg doses into the mid-lateral thigh in rapid succession

Mild symptoms:
-Blurred vision, miosis
-Excessive unexplained teary eyes
-Excessive unexplained runny nose
-Increased salivation such as sudden unexplained excessive drooling
-Chest tightness or difficulty breathing
-Tremors throughout the body or muscular twitching
-Nausea and/or vomiting
-Unexplained wheezing or coughing
-Acute onset of stomach cramps
-Tachycardia or bradycardia

Severe symptoms:
-Strange or confused behavior
-Severe difficulty breathing or severe secretions from the lungs/airway
-Severe muscular twitching and general weakness
-Involuntary urination and defecation
-Convulsions
-Unconsciousness


Comments:
-These doses may be considerably exceeded in certain cases.
-Protective garments, including masks, designed specifically for protection against exposure to chemical nerve agents and insecticide poisoning should be worn as primary protection.
-Patients should not rely solely on the availability of antidotes for protection against chemical nerve agent and insecticide poisoning.
-Immediate evacuation from the contaminated environment is essential.
-Decontaminate the poisoned individual as soon as possible.
-The auto-injector should be used by persons with adequate training in recognizing and treating nerve agent or insecticide intoxication.
-Pralidoxime chloride may serve as an important adjunct to atropine therapy.
-The auto-injector is intended as initial treatment of muscarinic symptoms of nerve agent or insecticide poisoning; definitive medical care should be sought immediately.
-Administer as soon as symptoms of poisoning occur (usually tearing, excessive oral secretions, wheezing, muscle fasciculations, etc.).
-In severe poisonings, an anticonvulsant may be concurrently administered if seizure is suspected in the unconscious individual as the classic tonic-clonic jerking may not be apparent due to the effects of the poison.
-It is recommended that 3 auto-injectors be available for each person at risk of nerve agent or organophosphate insecticide poisoning: 1 for mild symptoms, plus 2 more for severe symptoms. Do not administer more than 3 injections unless under supervision of trained medical providers.
-Administering atropine in the absence of actual nerve agent or insecticide poisoning may cause an overdose of atropine which could result in temporary incapacitation (inability to walk properly, see or think clearly for several or more hours); patients with cardiac disease risk severe adverse events, including death.

Uses: Treatment of poisoning by susceptible organophosphorous nerve agents having cholinesterase activity as well as organophosphorous or carbamate insecticides.

Usual Adult Dose for Nerve Agent Poisoning:

0.8 mg, IM
-If no apparent effect within 30 minutes OR definite poisoning symptoms occur (nausea, vomiting, diarrhea, pupillary constriction, pulmonary edema, fasciculations of eyelids and tongue, jerky ocular movements and excessive sweating, salivation and bronchial secretion): Give 2 mg, IM, every hour, until signs of atropinization are seen
-The 2 mg dose may need to be given 2 or 3 times (4 to 6 mg total) in severe cases

Auto-injector:
2 or more mild symptoms of exposure: One 2 mg dose
Severe symptoms: One 2 mg dose, followed by two additional 2 mg injections given in rapid succession 10 minutes after the first dose
or
Severe symptoms or unconscious: Three 2 mg doses into the mid-lateral thigh in rapid succession

Mild symptoms:
-Blurred vision, miosis
-Excessive unexplained teary eyes
-Excessive unexplained runny nose
-Increased salivation such as sudden unexplained excessive drooling
-Chest tightness or difficulty breathing
-Tremors throughout the body or muscular twitching
-Nausea and/or vomiting
-Unexplained wheezing or coughing
-Acute onset of stomach cramps
-Tachycardia or bradycardia

Severe symptoms:
-Strange or confused behavior
-Severe difficulty breathing or severe secretions from the lungs/airway
-Severe muscular twitching and general weakness
-Involuntary urination and defecation
-Convulsions
-Unconsciousness


Comments:
-These doses may be considerably exceeded in certain cases.
-Protective garments, including masks, designed specifically for protection against exposure to chemical nerve agents and insecticide poisoning should be worn as primary protection.
-Patients should not rely solely on the availability of antidotes for protection against chemical nerve agent and insecticide poisoning.
-Immediate evacuation from the contaminated environment is essential.
-Decontaminate the poisoned individual as soon as possible.
-The auto-injector should be used by persons with adequate training in recognizing and treating nerve agent or insecticide intoxication.
-Pralidoxime chloride may serve as an important adjunct to atropine therapy.
-The auto-injector is intended as initial treatment of muscarinic symptoms of nerve agent or insecticide poisoning; definitive medical care should be sought immediately.
-Administer as soon as symptoms of poisoning occur (usually tearing, excessive oral secretions, wheezing, muscle fasciculations, etc.).
-In severe poisonings, an anticonvulsant may be concurrently administered if seizure is suspected in the unconscious individual as the classic tonic-clonic jerking may not be apparent due to the effects of the poison.
-It is recommended that 3 auto-injectors be available for each person at risk of nerve agent or organophosphate insecticide poisoning: 1 for mild symptoms, plus 2 more for severe symptoms. Do not administer more than 3 injections unless under supervision of trained medical providers.
-Administering atropine in the absence of actual nerve agent or insecticide poisoning may cause an overdose of atropine which could result in temporary incapacitation (inability to walk properly, see or think clearly for several or more hours); patients with cardiac disease risk severe adverse events, including death.

Uses: Treatment of poisoning by susceptible organophosphorous nerve agents having cholinesterase activity as well as organophosphorous or carbamate insecticides.

Usual Adult Dose for Radiographic Exam:

1 mg, IM

Use: Relaxation of the upper gastrointestinal tract and colon during radiography

Usual Pediatric Dose for Anesthesia:

7 to 16 pounds: 0.1 mg, IV, IM, or subcutaneously

17 to 24 pounds: 0.15 mg, IV, IM, or subcutaneously

24 to 40 pounds: 0.2 mg, IV, IM, or subcutaneously

40 to 65 pounds: 0.3 mg, IV, IM, or subcutaneously

65 to 90 pounds: 0.4 mg, IV, IM, or subcutaneously

Over 90 pounds: 0.4 to 0.6 mg, IV, IM, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic, and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episodes in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action

Usual Pediatric Dose for Anticholinesterase Poisoning:

7 to 16 pounds: 0.1 mg, IV, IM, or subcutaneously

17 to 24 pounds: 0.15 mg, IV, IM, or subcutaneously

24 to 40 pounds: 0.2 mg, IV, IM, or subcutaneously

40 to 65 pounds: 0.3 mg, IV, IM, or subcutaneously

65 to 90 pounds: 0.4 mg, IV, IM, or subcutaneously

Over 90 pounds: 0.4 to 0.6 mg, IV, IM, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic, and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episodes in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action

Usual Pediatric Dose for Bradyarrhythmia:

7 to 16 pounds: 0.1 mg, IV, IM, or subcutaneously

17 to 24 pounds: 0.15 mg, IV, IM, or subcutaneously

24 to 40 pounds: 0.2 mg, IV, IM, or subcutaneously

40 to 65 pounds: 0.3 mg, IV, IM, or subcutaneously

65 to 90 pounds: 0.4 mg, IV, IM, or subcutaneously

Over 90 pounds: 0.4 to 0.6 mg, IV, IM, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic, and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episodes in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action

Usual Pediatric Dose for Rhinorrhea:

7 to 16 pounds: 0.1 mg, IV, IM, or subcutaneously

17 to 24 pounds: 0.15 mg, IV, IM, or subcutaneously

24 to 40 pounds: 0.2 mg, IV, IM, or subcutaneously

40 to 65 pounds: 0.3 mg, IV, IM, or subcutaneously

65 to 90 pounds: 0.4 mg, IV, IM, or subcutaneously

Over 90 pounds: 0.4 to 0.6 mg, IV, IM, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic, and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episodes in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action

Usual Pediatric Dose for AV Heart Block:

7 to 16 pounds: 0.1 mg, IV, IM, or subcutaneously

17 to 24 pounds: 0.15 mg, IV, IM, or subcutaneously

24 to 40 pounds: 0.2 mg, IV, IM, or subcutaneously

40 to 65 pounds: 0.3 mg, IV, IM, or subcutaneously

65 to 90 pounds: 0.4 mg, IV, IM, or subcutaneously

Over 90 pounds: 0.4 to 0.6 mg, IV, IM, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic, and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episodes in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action

Usual Pediatric Dose for Head Injury:

7 to 16 pounds: 0.1 mg, IV, IM, or subcutaneously

17 to 24 pounds: 0.15 mg, IV, IM, or subcutaneously

24 to 40 pounds: 0.2 mg, IV, IM, or subcutaneously

40 to 65 pounds: 0.3 mg, IV, IM, or subcutaneously

65 to 90 pounds: 0.4 mg, IV, IM, or subcutaneously

Over 90 pounds: 0.4 to 0.6 mg, IV, IM, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic, and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episodes in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action

Usual Pediatric Dose for Peptic Ulcer:

7 to 16 pounds: 0.1 mg, IV, IM, or subcutaneously

17 to 24 pounds: 0.15 mg, IV, IM, or subcutaneously

24 to 40 pounds: 0.2 mg, IV, IM, or subcutaneously

40 to 65 pounds: 0.3 mg, IV, IM, or subcutaneously

65 to 90 pounds: 0.4 mg, IV, IM, or subcutaneously

Over 90 pounds: 0.4 to 0.6 mg, IV, IM, or subcutaneously

Comments:
-Doses may be considerably exceeded in certain cases.

Uses:
-Relieve pylorospasm, hypertonicity of the small intestine, and hypermotility of the colon
-Relieve hypertonicity of the uterine muscle
-Relax the spasm of biliary and ureter colic, and bronchial spasm
-Diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders
-Control the crying and laughing episodes in patients with brain lesions
-Closed head injuries which cause acetylcholine to be released or present in the cerebrospinal fluid, causing abnormal EEG patterns, stupor, and neurological signs
-Management of peptic ulcer
-In anesthesia to control excessive salivation and bronchial secretions
-Control rhinorrhea of acute rhinitis or hay fever
-Antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata mushrooms, and anticholinesterase insecticide poisoning
-Treatment of parkinsonism; rigidity and tremor relieved by the apparently selective depressant action

Usual Pediatric Dose for Organophosphate Poisoning:

Auto-injector:
Children weighing over 90 pounds: 2 mg dose
40 to 90 pounds: 1 mg dose
15 to 40 pounds: 0.5 mg dose
Less than 15 pounds: 0.25 mg dose (bunch up thigh to provide a thicker area for injection)

2 or more mild symptoms of exposure: One dose (see weight guide above)
Severe symptoms: One dose, followed by two additional doses given in rapid succession 10 minutes after the first dose
or
Severe symptoms or unconscious: Three doses into the mid-lateral thigh in rapid succession

Mild symptoms:
-Blurred vision, miosis
-Excessive unexplained teary eyes
-Excessive unexplained runny nose
-Increased salivation such as sudden unexplained excessive drooling
-Chest tightness or difficulty breathing
-Tremors throughout the body or muscular twitching
-Nausea and/or vomiting
-Unexplained wheezing or coughing
-Acute onset of stomach cramps
-Tachycardia or bradycardia

Severe symptoms:
-Strange or confused behavior
-Severe difficulty breathing or severe secretions from the lungs/airway
-Severe muscular twitching and general weakness
-Involuntary urination and defecation
-Convulsions
-Unconsciousness

Comments:
-These doses may be considerably exceeded in certain cases.
-Protective garments, including masks, designed specifically for protection against exposure to chemical nerve agents and insecticide poisoning should be worn as primary protection.
-Patients should not rely solely on the availability of antidotes for protection against chemical nerve agent and insecticide poisoning.
-Immediate evacuation from the contaminated environment is essential.
-Decontaminate the poisoned individual as soon as possible.
-The auto-injector should be used by persons with adequate training in recognizing and treating nerve agent or insecticide intoxication.
-Pralidoxime chloride may serve as an important adjunct to atropine therapy.
-The auto-injector is intended as initial treatment of muscarinic symptoms of nerve agent or insecticide poisoning; definitive medical care should be sought immediately.
-Administer as soon as symptoms of poisoning occur (usually tearing, excessive oral secretions, wheezing, muscle fasciculations, etc.).
-In severe poisonings, an anticonvulsant may be concurrently administered if seizure is suspected in the unconscious individual as the classic tonic-clonic jerking may not be apparent due to the effects of the poison.
-It is recommended that 3 auto-injectors be available for each person at risk of nerve agent or organophosphate insecticide poisoning: 1 for mild symptoms, plus 2 more for severe symptoms. Do not administer more than 3 injections unless under supervision of trained medical providers.
-Administering atropine in the absence of actual nerve agent or insecticide poisoning may cause an overdose of atropine which could result in temporary incapacitation (inability to walk properly, see or think clearly for several or more hours); patients with cardiac disease risk severe adverse events, including death.

Use: Treatment of poisoning by susceptible organophosphorous nerve agents having cholinesterase activity as well as organophosphorous or carbamate insecticides.

Usual Pediatric Dose for Nerve Agent Poisoning:

Auto-injector:
Children weighing over 90 pounds: 2 mg dose
40 to 90 pounds: 1 mg dose
15 to 40 pounds: 0.5 mg dose
Less than 15 pounds: 0.25 mg dose (bunch up thigh to provide a thicker area for injection)

2 or more mild symptoms of exposure: One dose (see weight guide above)
Severe symptoms: One dose, followed by two additional doses given in rapid succession 10 minutes after the first dose
or
Severe symptoms or unconscious: Three doses into the mid-lateral thigh in rapid succession

Mild symptoms:
-Blurred vision, miosis
-Excessive unexplained teary eyes
-Excessive unexplained runny nose
-Increased salivation such as sudden unexplained excessive drooling
-Chest tightness or difficulty breathing
-Tremors throughout the body or muscular twitching
-Nausea and/or vomiting
-Unexplained wheezing or coughing
-Acute onset of stomach cramps
-Tachycardia or bradycardia

Severe symptoms:
-Strange or confused behavior
-Severe difficulty breathing or severe secretions from the lungs/airway
-Severe muscular twitching and general weakness
-Involuntary urination and defecation
-Convulsions
-Unconsciousness

Comments:
-These doses may be considerably exceeded in certain cases.
-Protective garments, including masks, designed specifically for protection against exposure to chemical nerve agents and insecticide poisoning should be worn as primary protection.
-Patients should not rely solely on the availability of antidotes for protection against chemical nerve agent and insecticide poisoning.
-Immediate evacuation from the contaminated environment is essential.
-Decontaminate the poisoned individual as soon as possible.
-The auto-injector should be used by persons with adequate training in recognizing and treating nerve agent or insecticide intoxication.
-Pralidoxime chloride may serve as an important adjunct to atropine therapy.
-The auto-injector is intended as initial treatment of muscarinic symptoms of nerve agent or insecticide poisoning; definitive medical care should be sought immediately.
-Administer as soon as symptoms of poisoning occur (usually tearing, excessive oral secretions, wheezing, muscle fasciculations, etc.).
-In severe poisonings, an anticonvulsant may be concurrently administered if seizure is suspected in the unconscious individual as the classic tonic-clonic jerking may not be apparent due to the effects of the poison.
-It is recommended that 3 auto-injectors be available for each person at risk of nerve agent or organophosphate insecticide poisoning: 1 for mild symptoms, plus 2 more for severe symptoms. Do not administer more than 3 injections unless under supervision of trained medical providers.
-Administering atropine in the absence of actual nerve agent or insecticide poisoning may cause an overdose of atropine which could result in temporary incapacitation (inability to walk properly, see or think clearly for several or more hours); patients with cardiac disease risk severe adverse events, including death.

Use: Treatment of poisoning by susceptible organophosphorous nerve agents having cholinesterase activity as well as organophosphorous or carbamate insecticides.

What other drugs will affect atropine?

Tell your doctor about all other medicines you take. Atropine can slow your digestion, and it may take longer for your body to absorb any medicines you take by mouth.

Other drugs may interact with atropine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about atropine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.02.

Last reviewed: July 20, 2016
Date modified: November 30, 2016

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