Atropine administration route

If an i.v. line cannot be placed, the intraosseous drug administration route can be used for pediatric patients during, for example, cardiopulmonary resuscitation (CPR) because drug delivery by this route is similar to that for i.v. administration.If drug or fluid deliver by this route is sluggish, a saline flush can be used to clear the needle. Intraosseous administration is used to deliver medications such as epinephrine, atropine, sodium bicarbonate, dopamine, diazepam, isoproterenol, phenytoin, phenobarbital, dexametha-sone, and various antibiotics. ... 

Recommended doses of atropine are 2 mg in patients with mild symptoms that are primarily ocular, but without respiratory symptoms or seizures 4 mg in patients with moderate symptoms, including respiratory symptoms such as dyspnea and 6 mg in patients with severe symptoms, including seizures and respiratory arrest. The standard administration route should be intramuscular. As menhoned previously, intravenous administration of atropine in the treatment of severe symptoms such as hypoxemia can induce ventricular fibrillation thus, intramuscular administration is advised. Oxime agents such as 2-pralidoxime methiodide (2-PAM), or 2-formyl-l-methylpyridinium iodide oxime should also be given. The recommended dose for 2-PAM in... 

In Tables 10 and 11, meta-analyses based on 576 cases gleaned by Goodman from a number of reports, there are only moderate variations in mortality among cases grouped by route of administration or by age. Using chi-square analysis, Goodman found no statistically significant age-related differences in susceptibility to the lethal effects of atropine. 

Drugs may be solid at room temperature (eg, aspirin, atropine), liquid (eg, nicotine, ethanol), or gaseous (eg, nitrous oxide). These factors often determine the best route of administration. The most common routes of administration are described in Chapter 3. The various classes of organic compounds—carbohydrates, proteins, lipids, and their constituents—are all represented in pharmacology. 

Dosages and routes of administration Diphenoxylate is used orally at initial doses of 10 mg, followed by 5 mg every 5 h. The standard formulation contains 1% atropine to inhibit parenteral misuse. 

After the Tokyo subway sarin attack, St Luke s Hospital, which treated 640 victims, used about 700 ampules of PAM and 2,800 ampules of atropine (Okumura et al, 1998). This calculates out to 550 mg of PAM and 2.2 mg of atropine for each victim. The route of administration was intravenous in all cases with a total dose of atropine in severe cases 1.5 mg to 9 mg (Okumura et al, 1996) doses which reflect the low concentration and passive means of sarin dispersal used in the Tokyo attack. 

Animal Route of administration 3-Quinuclidinyl benzilate (BZ) Atropine Scopolamine... 

Cullumblne e al. (115) studied the effects of atropine sulfate on healthy men. Twenty men each received 1 mg of atropine sulfate by subcutaneous and Intramuscular injection and 0.5 mg by intravenous Injection. Forty men received double doses by the same three routes of administration. The first sign of action by atropine In many subjects was a slight, temporary decrease In heart race, followed by a gradual Increase. Intravenous Injection produced effects more rapidly chan the other routes of administration. The Increase In heart rate Induced by 1 mg of atropine sulfate Injected Intravenously Was similar to, but of shorter duration than, that Induced by subcutaneous or Intramuscular Injection of 2 mg. Subcutaneous Injection of atropine sulfate Induced acceleration of the pulse more rapidly, but less lastingly, than the same dose Injected Intramuscularly. 

Gcob al. (147) compared the effects of atropine administered intravenously and Intramuscularly. Four subjects were used. Two received injections of 2 mg of atropine sulfate by the Intramuscular route only one of these subjects received only one Injection, and the other, two. A third subject received 1 mg of atropine sulfate intravenously on one occasion, 1 mg of atropine sulfate intramuscularly on another occasion, and 2 mg of atropine sulfate intramuscularly on four other occasions. The fourth subject received 1 mg of atropine sulfate Intravenously on two occasions and 2 mg of atropine sulfate Intramuscularly on three occasions Atropine sulfate by either route of administration induced an Increase In heart rate, an Increase In skin resistance, an Increase In pupil size, dryness of the skin, and an Increased sensation of dryness of the mouth. In general, the effects appeared earlier after Intravenous chan after intramuscular Injection. Prior administration of sufficient TEPP to Increase sweating and salivation and to Induce anorexia and mild nausea slightly delayed the onset of the effects of atropine and slightly reduced the extent of chose effects. 

Regarding the 16 compounds for which Incapacitating doses—usually calculated as the doses required to degrade the score In the Humber Facility Test to not more chan lOZ of the predose score—were given, three routes of administration were used Intramuscular Injection, Intravenous Injection, and Ingestion The most effective of the compounds Injected Intramuscularly was 3"qulnuclldlnyl benzllate, followed In order by EA 3443, EA 3580, 3-qulnuclidlnyl-L-(phenyl-cyclopentyl) >glycolace, L-2-alpha-troplnyl-L-(phenylcyclopencyl)-glycolate, L-l-alpha-croplnyl benzllate, scopolamine, 302,196, atropine, and Dlcran. 

The toxicokinetics of soman in anesthetized, atropinized, and artificially ventilated naive and HuBuChE-pretreated guinea pigs was studied. Animals were pretreated with HuBuChE by an i.m. administration at 24 h before administration of the nerve agent. The enzyme was administered i.m., since this route is much more appropriate than i.v. administration for application of a scavenger in a realistic scenario. The ratio of the dose of HuBuChE relative to the dose of the nerve agent was chosen on the basis of results reported by Ashani et al. or Allon et al. in order to obtain sufficient protection in a similar experiment. The dose of HuBuChE was a 0.7-fold fraction of the molar dose of soman, which corresponds with 0.7 X 55/182 = 211 nmol HuBuChE/kg. 

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