Cgabryszek: Created page with "'''Class''' Parasympatholytic (anticholinergic) '''Pharmacology and Actions''' # Increases heart rate (by blocking vagal influences). # Increases conduction through AV node. # Reduces motility and tone of GI tract. # Reduces action and tone of urinary bladder (may cause urinary retention). # Dilates pupils '''Note:''' This drug blocks cholinergic (vagal) influences already present. If there is little cholinergic stimulation present, effects will be minimal. '''Indic..."

2022-04-04T03:21:48Z

Created page with "'''Class''' Parasympatholytic (anticholinergic) '''Pharmacology and Actions''' # Increases heart rate (by blocking vagal influences). # Increases conduction through AV node. # Reduces motility and tone of GI tract. # Reduces action and tone of urinary bladder (may cause urinary retention). # Dilates pupils '''Note:''' This drug blocks cholinergic (vagal) influences already present. If there is little cholinergic stimulation present, effects will be minimal. '''Indic..."

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'''Class'''

Parasympatholytic (anticholinergic)

'''Pharmacology and Actions'''

# Increases heart rate (by blocking vagal influences).
# Increases conduction through AV node.
# Reduces motility and tone of GI tract.
# Reduces action and tone of urinary bladder (may cause urinary retention).
# Dilates pupils

'''Note:''' This drug blocks cholinergic (vagal) influences already present. If there is little cholinergic stimulation present, effects will be minimal.

'''Indications'''

# To counteract excessive vagal influences responsible for some bradyarrhythmias.
# To increase heart rate in hemodynamically significant bradycardia.
# To improve conduction in AV heart block at the nodal level. Will not be effective when intranodal (Mobitz type II) block is suspected.
# As an antidote for some insecticide exposures (organophosphate poisoning) and nerve gases with symptoms of excess cholinergic stimulation: salivation, constricted pupils, bradycardia, tearing, diaphoresis, vomiting, and diarrhea.

'''Precautions'''

# Bradycardias in the setting of an acute MI are common and may be beneficial. Do not treat them unless there are signs of poor perfusion (low B/P, mental confusion). If in doubt, consult with the base physician.
# People do well with chronic 2<sup>d</sup> and 3`<sup>d</sup> degree block. Symptoms occur mainly with acute change. Treat the patient, not the arrhythmia.
# Pediatric bradycardias are most commonly secondary to hypoxia. Correct the ventilation first, and only treat the rate directly if that fails. Epinephrine is almost always the first-line medication for bradycardia in pediatric patients.

'''Administration'''

# Hemodynamically unstable bradycardia:
## Adult: 1 mg IV/IO, repeated if needed at 3-5 minute intervals to a dose of 3mg. (Stop at ventricular rate which provides adequate medication and B/P).
## Pediatric: 0.02 mg/kg IV/IO, minimum 0.1 mg.
# May be given through the ET tube at 2 times the IV dose. Maximum ET dose is 6 mg.
# For symptomatic insecticide/organophosphate poisoning exposures: Usually begin with 2 mg IV/IO and titrate (2 mg q 5 min) until secretions are dried. Total required dose may be massive.

'''Side Effects and Special Notes'''

# Remember in cardiac arrest situations that atropine dilates the pupils.

ATROPINE - Revision history