Medication 7-121 - Atropine (Sal-Tropine)

CMH EMS & MIH Protocols

Scope of Practice:

• Registered Nurse
• Paramedic
• Community Paramedic

Route(s):

• ET, IO, IV,

Pharmacodynamics (class and mechanism of action):

• Anticholinergic / Parasympatholytic (Competes with acetylcholine at the site of muscarinic receptor. Increases heart rate).

Pharmacokinetics:

• Half-life: 2 hours.
• Onset time: Immediate.
• Peak action time: 2-4 minutes.
• Duration of action: 4 hours.

• Peak	24	48	72	96	120	144	168	192	216	240	264	minutes
  Duration	24	48	72	96	120	144	168	192	216	240	264	minutes

Dosing:

• Refer to specific protocol(s) below for dose(s).

Indications:

• Protocol 2-044 - Airway: RSI.
• Protocol 2-154 - Bradycardia.
• Protocol 2-198 - Cardiac Arrest.
• Protocol 2-374 - Exposure: Nerve Agents.
• Protocol 2-484 - Head Trauma.
• Protocol 2-748 - Pulselss Electrical Activity.

Contraindications:

• None when used in emergency situations.

Pregnancy Risk Factor:

• Category C
• Risk not ruled out: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. FDA requires a relatively large amount of high-quality data on a pharmaceutical for it to be defined as Pregnancy Category A. As a result of this, many drugs that would be considered Pregnancy Category A in other countries are allocated to Category C by the FDA.

Potential Incompatibilities:

• Medication 7-417 - Heparin.

Precautions and Adverse Effects:

• Use cautiously in the presence of myocardial ischemia and hypoxia because it increases oxygen demand on the heart and can worsen ischemia.
• May prolong QT interval. 12-lead is indicated after administration.
• May cause Hypertension and/or Bradycardia if dose is too low or administered too slowly.
• May cause palpitations, Tachycardia, headache, dizziness, anxiety, dry mouth, pupillary dilation, blurred vision, urinary retention (especially older males), hot skin temperature, intense facial flushing, and/or restlessness.

Antidote:

• Physostigmine (Antilirium).

Controlled Substance Information:

• Not a scheduled drug
• The DEA and FDA have not identified this drug with a schedule classification.
• DEA number: NA.
• Narcotic: No.
• Street names: NA.

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CMH Mobile Integrated Healthcare Mission: "Provide exceptional, compassionate, and patient-centered care by a mobile collaborative team to improve patient experience, improve quality outcomes, and reduce healthcare costs."

Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.