Atropine
Symptomatic bradycardia, Organophosphate poisoning, RSI premedication (pediatric)
Indications
- Symptomatic bradycardia
- Organophosphate poisoning
- RSI premedication (pediatric)
Adult dosing
- bradycardia: dose: 0.5; unit: mg; route: IV; interval: q3-5min, max 3mg; fixed: true; organophosphate: dose: 2; unit: mg; route: IV; interval: q5min until secretions dry; fixed: true
Pediatric dosing
- bradycardia: dose: 0.02; unit: mg/kg; maxDose: 0.5; maxDoseAbsolute: true; route: IV/IO; weightBased: true; pedNote: Minimum dose 0.1mg; max 3mg total; rsi pretreatment: dose: 0.02; unit: mg/kg; maxDose: 0.5; maxDoseAbsolute: true; route: IV; weightBased: true; pedNote: RSI pretreatment for children <1 year
Contraindications
- Glaucoma (relative)
- Obstructive uropathy
Clinical pearls
- Minimum dose 0.5mg in adults — lower doses may cause paradoxical bradycardia
- Max total dose 3mg in bradycardia (full vagolytic dose)
- In organophosphate poisoning, no maximum dose — titrate to drying of secretions
Source and review
- ACLS Guidelines 2020, AHA. Last reviewed: 2024-10-15