atropine

Disclaimer to the Online Edition

This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

atropine

Indication

  • An anticholinergic agent used to treat sinus bradycardia caused by excessive vagal stimulation
  • To inhibit salivation and reduce excessive secretion within the respiratory tract
  • To prevent reflex bradycardia from vagal stimulation during intubation

Dosage Guidelines

For bradycardia:

  • 0.01-0.03 mg/kg (10 to 30 mcg/kg)/dose IV/IM/SUBCUT/ETT
  • May repeat every 10-15 minutes, maximum total dose of 0.04 mg/kg (40 mcg/kg)

For elective intubation:

  • 0.02 mg/kg (20 mcg/kg) IV

Administration

  • IV direct over 30 seconds to 1 minute by MD/NP or under direct supervision by MD/NP
  • IM
  • SUBCUTANEOUS
  • ETT by MD/NP or under direct supervision by MD/NP

Adverse Effects

  • Tachycardia, dilated pupils, dry mucous membranes, flushed skin with rash, and abdominal distention with absent bowel activity

Comments

  • Consult the Neonatal Premedication for Endotracheal Intubation Standardized Dosing Chart for weight-banded dose and volume found on the LHSC NICU Intranet Site

Supplied As

  • 0.4 mg/mL (400 mcg/mL), ampoule

References

Lexi Sick Kids, Lexi Peds, Neofax