Atropine

Generic Name

Atropine

Brand Names

Atropen, Isopto Atropine

Drug Class

Anticholinergic / Muscarinic Antagonist

Mechanism

Competitively blocks acetylcholine at postganglionic muscarinic receptors, increasing heart rate, reducing secretions, and causing bronchodilation and mydriasis.

Pharmacokinetics

Rapidly absorbed. Crosses the blood-brain barrier. Excreted in urine.

Indications

Symptomatic bradycardia, organophosphate/carbamate poisoning, preoperative reduction of secretions, cycloplegia/mydriasis.

Contraindications

Narrow-angle glaucoma, tachycardia, thyrotoxicosis, obstructive GI disease, myasthenia gravis.

Dosing

Bradycardia (ACLS): 1 mg IV every 3-5 mins (max 3 mg). Organophosphate poisoning requires much higher doses.

Adverse Effects

Dry mouth, blurred vision, photophobia, tachycardia, urinary retention, constipation, confusion, hyperthermia.

Monitoring

Heart rate, blood pressure, mental status, urine output.

Clinical Pearls

Classic anticholinergic toxidrome mnemonic: Mad as a hatter, blind as a bat, red as a beet, hot as a hare, dry as a bone.

Clinical Notes

References

DailyMed. National Library of Medicine.
FDA Prescribing Information.

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