Department of Medicine, MTI, Khyber Teaching Hospital

Adult IV Medication Monograph

Atropine sulphate 1mg/1ml

Emergency medication
Drug Class Anticholinergic
Available dosage form Injection form – 1mg/1ml

Usual Dosing 1. Perioperative use.

2. During CPR for asystole: 3mg IV stat
3. Symptomatic sinus bradycardia induced by drugs or toxic
substances such as pilocarpine, organophosphate pesticides,
amanita muscaria mushrooms: 2mg IV or IM.
4. Symptomatic arrhythmic Bradycardia: 300 micrograms IV
initially, increasing to 1mg if necessary.
5. In combination with neostigmine during reversal of effect of
non-depolarising muscle relaxants: 0.6 –1.2 mg given IV in
conjunction with neostigmine methyl- sulfate
Dilution & Preparation Nil

Administration IV, IM, SQ

Dosage adjustment Nil
Incompatibility Atropine sulfate injection is reported to be physically incompatible
with, alkalis, noradrenaline bitartrate, metaraminol bitartrate and
sodium bicarbonate.

Monitoring Nil

Contraindications & Contraindications:

1. Hypersensitivity to Atropine Sulfate .
Precautions
2. Closed-angle glaucoma
3. prostatic enlargement,
4. myasthenia gravis (unless given in conjunction with
anticholinesterase),
5. paralytic ileus
6. pyloric stenosis
7. severe ulcerative colitis.

Precautions:
1. It should be given with caution to patients with diarrhoea,
urinary retention or fever.
2. Care is required in patients with acute myocardial infarction.
3. Caution is also required when using the drug in patients
tachycardia.
4. Caution is required when atropine is administered systemically
to chronic obstructive pulmonary disease, as a reduction in
bronchial secretions may lead to the formation of bronchial
plugs.
 Department of Medicine, MTI, Khyber Teaching Hospital
Adult IV Medication Monograph

Clinical considerations 1. Perioperative use.

2. During CPR for asystole:
3. Symptomatic sinus bradycardia induced by drugs or toxic
substances such as pilocarpine, organophosphate pesticides,
amanita muscaria mushrooms.
4. Bradycardia of acute myocardial infarction.
5. In combination with neostigmine during reversal of effect of
non-depolarising muscle relaxants.

Adverse Effects These effects are dose-related and usually reversible when therapy is
discontinued
1. Anaphylaxis.
2. Dizziness, confusional states, especially in the elderly. At
higher doses hallucinations, restlessness, delirium
3. Dilatation of the pupils with loss of accommodation and
photophobia, raised intraocular pressure.
4. Transient bradycardia followed by tachycardia, palpitations,
arrhythmias.
5. Flushing.
6. Reduced bronchial secretion may result in the formation of
thick bronchial plugs which are difficult to eject from the
respiratory tract (see section 4.4).
7. Dry mouth with difficulty in swallowing, nausea, vomiting,
constipation. Inhibition of gastric secretion, retrosternal pain
due to gastric reflux.
8. Dry skin, urticaria, rashes, skin exfoliation.
9. Difficulty with micturition.
10. Thirst, fever.

Diazepam may be administered to control excitement and convulsions

but the risk of central nervous system depression should be considered.
Hypoxia and acidosis should be corrected.
Pregnancy and lactation Should only be used if considered essential.