Atropine dosing

Children weighing less than 15 lbs (generally younger than 6 months of age) should ordinarily not be treated with the AtroPen auto-injector. Atropine doses for these children should be individualized at doses of 0.05 mg/kg. 

Sinus rhythm with a rate of less than 60/min is defined as sinus bradycardia. This bradycardia is usually a physiological response. Pathological and/or symptomatic sinus bradycardia may suggest sinus node dysfunction (see sick sinus syndrome). Vagally induced sinus bradycardia may be responsive to atropine, but only needs to be treated if symptomatic. Atropine doses of less than 0.5 mg may cause a paradoxical increase in vagal bradycardia. 

In the second paper (76), the investigators compared the effects on brain acetylcholine concentration in the rat caused by a series of doses of atropine sulfate with those caused by two doses of i osclne hydrobromide and one dose of methylatroplnlum nitrate at 30 min after intraperitoneal injections of the drugs The three lowest doses of atropine sulfate (1, 5, and 25 mg/kg) produced dose-related mean decreases in acetylcholine concentration, but the highest dose (50 mg/kg) produced a smaller mean decrease chan the two next lower doses A dose of methylatroplnlum nitrate equimolar with a dose of atropine sulfate of 2 5 mg/kg resulted in a slightly smaller decrease in the mean acetylcholine concentration chan the atropine dose of 1 0 mg/kg. A dose of hyosclne hydrobromide equimolar with atropine sulfate at 2 5 mg/kg resulted in a lowering of the mean acetylcholine concentration nearly midway between those resulting from doses of 5 and 25 mg/kg of atropine sulfate ... 

Modrow, H.E. and McDonough, J.H. 1986. Changes in atropine dose effect curve after subacute administration. Pharmacol. Biochem. Behav., 24 845-848. 

Taysse, L., Calvet, J.H., Buee, J., Christin, D., Delamanche, S. and Breton, P. 2003. Comparative efficacy of diazepam and avizafone against sarin-induced neuropathology and respiratory failure in guinea pigs influence of atropine dose. Toxicology, 188 197-209. 

Interaction Synergy with prahdoxime Reduces atropine dose requirement... 

NERVE AGENT Route of admin. OXIME Dose (umol/kq) Route of admin. Atropine dose Route of admin. Species Protective ratio Reference... 

Once atropinization had been accomplished in Dr Foroutan s Chemical Emergency Unit, casualties were evacuated to a recovery unit 100 km behind the front lines. There, he recommended that the atropine dose be reduced to a few milligrams per day, and that atropine 1 to 2 mg every 4 to 6 h be given for up to two days after the resolution of all clinical symptoms, with the dose only to be increased if bradycardia developed. 

Guidelines for the treatment of pediatric casualties in a potential homeland defense type of situation have been recently published (Rotenberg andNewmark, 2003). They recommend atropine doses scaled to the weight of the child, with 0.05 mg kg-1 per dose being the rough unit dose 2 mg for 40 kg+ 1 mg for 20 kg+ 0.5 for 10 kg+. They recommend that these doses be given every 5-10 min to a moderate or severe pediatric casualty until atropinization is accomplished. 

B. Atropine doses of less than 0.5 mg (in adults) and those administered by very slow intravenous push may result in paradoxic slowing of heart rate. 

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