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For symptomatic bradycardia, the usual dosage is 0.5 to 1 mg IV push; this may be repeated every 3 to 5 minutes, up to a total dose of 3 mg (maximum 0.04 mg/kg). [23] Atropine is also useful in treating second-degree heart block Mobitz type 1 (Wenckebach block), and also third-degree heart block with a high Purkinje or AV-nodal escape rhythm.
The typical dose is 1.5 mg/kg IV given three minutes prior to intubation. [34] Atropine may also be used as a premedication agent in pediatrics to prevent bradycardia caused by hypoxia, laryngoscopy, and succinylcholine. Atropine is a parasympathetic blocker. The common premedication dose for atropine is 0.01–0.02 mg/kg.
As a condition of approval, the FDA lists on the device label the precise instructions that are to be given to military personnel on dosage and administration. [ 1 ] [ 2 ] While each branch of the DoD typically provides their own tailored training, an example of the MK I NAAK and ATNAA are referenced in the United States Air Force Self Aid ...
The practice began declining during the 1970s as more reliable delivery methods (i.e., intravenous, endotracheal, and intraosseous) came into use. Around that time, studies revealed that intravenous injections were equally effective and were less prone to risks and complications.
Acetylcholine hyperpolarizes the sinoatrial node; this is overcome by MRAs, and thus they increase the heart rate. If atropine is given by intramuscular or subcutaneous injection, it causes initial bradycardia. This is because when administered intramuscularly or subcutaneously atropine acts on presynaptic M1 receptors (autoreceptors).
The Mark I NAAK (left) and its training kit (right) In the United States military, the Mark I NAAK, or MARK I Kit, ("Nerve Agent Antidote Kit") is a dual-chamber autoinjector: Two anti-nerve agent drugs—atropine sulfate and pralidoxime chloride—each in injectable form, constitute the kit.
The use of atropine, lidocaine, and amiodarone have not been shown to improve survival from cardiac arrest. [116] [117] [81] Atropine is used for symptomatic bradycardia. It is given at a does of 1 mg (iv), and additional 1 mg (iv) doses can be given every 3–5 minutes for a total of 3 mg.
A military autoinjector in use. An autoinjector (or auto-injector) is a medical device for injection of a premeasured dose of a particular drug.Most autoinjectors are one-use, disposable, spring-loaded syringes (prefilled syringes).