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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.
Bradyarrythmias with signs of shock can be treated with epinephrine and atropine in order to increase heart rate. If medications aren't helping, providers can consider cardiac pacing. epinephrine: 0.01 mg/kg every 3–5 minutes; atropine: 0.02 mg/kg, can repeat one time, max dose 0.5 mg, min dose of 0.1 mg [2] [4]
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.
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).
Atropine can be given when children produce a vagal response, evidenced by bradycardia, in response to intubation. Some physicians even give out vecuronium, which is a neuromuscular blocker to prevent muscle fasciculations in patients over 4 years old.
In the 1850s, atropine was used as antispasmodic in asthma treatment and as morphine antidote for its mydriatic effect. [4] Bezold and Bloebaum showed that atropine blocked the effects of vagal stimulation on the heart in 1867. Subsequently in 1872, Heidenhain found its ability to prevent salivary secretion. [6]
Atropine is often used as a first line treatment of a third-degree heart block in the presence of a narrow QRS which indicates a nodal block, but, may have little to no effect in an infra-nodal block. [11] Atropine works by reducing vagal stimulation through the AV node but will not be effective in those who have had a previous heart transplant ...