Intravenous atropine sulfate

THA overdosage can result in a cholinergic crisis with severe nausea, vomiting, salivation, sweating, bradycardia, hypotension, convulsions, etc. Progressive muscle weakness may result in death from asphyxiation. Treatment with anticholinergics (such as intravenous atropine sulfate) and general supportive treatment are recommended. 

In one (107), coma-producing doses of atropine sulfate were Injected Intravenously, [3H]atroplne being mixed with unlabeled atropine to permit a dose of 100 uCl of 3h to be Included In the total dose of atropine sulfate. One psychopath, one epileptic, and 13 schizophrenics were studied. Graphs of data from three patients were presented In the paper. One man received a total dose of 70 mg of atropine sulfate (1.06 mg/kg), another man received 150 mg (2.8 mg/kg), and the third patient, a woman, received 270 mg (4.5 mg/kg). All Injections were said to have been Intravenous, but the curve for the concentration of the Isotope In the blood of the woman Is like chat from a subcutaneous Injection. 

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. 

Heilman a. (137) studied the reliability of the response of the fetal heart to administration of atropine to a pregnant woman, the fetal heartbeat being recorded and analyzed by a computer as an indicator of transplacental transfer. Intravenous Injection of atropine sulfate at 22 ug/kg during a 2-mln period to 28 normal pregnant women resulted first In slowing of fecal... 

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. 

Ketchum et al. (24,165,166) reported the results of Intramuscular injection of atropine sulfate at 32-175 jig/kg, of Intravenous Injection of scopolamine hydrobromide at 5-24 Pg/kg, of Intramuscular Injection of scopolamine hydrobromide at 5-24 itg/kg, of Intramuscular Injection of scopolamine metl lbromlde at 5-30 ug/kg, and of attempts to find... 

Although the ratios between the ED qs of atropine and of the other anticholinergic compounds for the production of the different effects varied somewhat, intravenously injected scopolamine hydrobromide was about 8.7 times as active as atropine sulfate and, when Injected Intramuscularly, about 7.5 times as effective as atropine sulfate. Scopolamine methylbromlde was about A times as active as atropine sulfate, except chat no dose of the former substance produced as much as a 9CX decrease In performance In the Number Facility Test, so comparative potencies had to be assigned on the basis of less than maximal actions by atropine and scopolamine. Therefore, scopolamine methylbromlde was only about 532 as potent as the l dro bromide. 

Intramuscular injections of scopolamine hydrobromide at 26 pg/kg and of atropine sulfate at 175 ug/kg Induced approximately equal decrements In performance In the Number Facility Test, except that the maximal effect after scopolamine was attained in about half the time required to reach that after atropine. Intravenously Injected scopolamine hydrobromide produced Its maximal effect even more rapidly than that Injected Intramuscularly. Scopolamine mett lbromlde was slower In exerting Its maximal tachycardlsd. effect than scopolamine faydrobromlde, but no Information about the rapidity of Its action on performance In the Number Facility Test was provided In any of the three reports (24,165,166). The Increase In heart rate Induced by scopolamine methylbromlde was greater than those Induced by the same amounts of scopolamine hydrobromide or atropine sulfate. 

In a classic study, more than a generation ago, of patients given atropine sulfate intravenously as premedication in a total dose of 1 mg, dysrhythmias occurred in over one-third of the subjects, and in over half of those younger than 20 years. 

If exposure is through ingestion, the victim should seek medical help immediately. Emesis should not be induced. Initial management involves establishment of adequate ventilation and maintenance of adequate respiratory function. Activated charcoal therapy may be used to retard absorption from the gastrointestinal tract. Atropine sulfate alone, or in combination with pralidoxime chloride, can be administered as an antidote. Atropine is initially administered intravenously at a dosage of 1-2 mg kg every 5-10 min until... 

Atropine sulfate, in conjunction with pralidoxime (2-PAM), can be administered as an antidote. Atropine should be administered by intravenous injection. Intramuscular injection can be used if IV injection is not possible. Atropine dosage Adults 0.4-2.0 mg... 

The immediate treatment for nerve agent intoxication is intravenous injection of 2 mg atropine sulfate (intramuscular injection should be considered if the patient is hypoxic and ventilation cannot be initiated, as there is a risk of ventricular fibrillation). This should be followed by additional injections of atropine at 10-15 min intervals, continuing until bradycardia has been reversed (e.g., until the heart rate is at 90 beats per minute). If breathing has stopped, a mechanical respirator should be used to ventilate the patient. Mouth-to-mouth resuscitation should not be attempted. If possible, oxygen or oxygen-enriched air should be used for ventilation. If possible, cardiac activity should be monitored. 

First aid for ingestion victims would be to induce vomiting, keeping in mind the possibility of aspiration of solvents. Gastric decontamination should be performed within 30 min of ingestion, to be the most effective. Initial management of acute toxicity is the establishment and maintenance of adequate airway and ventilation. Atropine sulfate in conjunction with pralidoxime chloride can be administered as an antidote. Atropine by intravenous injection is the primary antidote in severe cases. Test injections of atropine (Img in adults and 0.15 mg kg in... 

Adults After cyanosis is overcome, atropine sulfate should be used, 2 mg i.v. Doses should be repeated at 5-10 min intervals until signs of atropin-ization appear. This should be maintained for 24 h or longer if necessary. 2-PAM (pralidoxime chloride) should be given. Adult dose 1 g, slowly, intravenously. Contraindicated are morphine, aminophylline, theophylline, phenothiazine tranquilizers, and barbiturates. 

Children Atropine sulfate in proportion to body weight 0.05 mg kg 2-PAM, 0.25 g, should be given slowly, intravenously. 

Neostigmine methylsulfate (2.5 mg) and atropine sulfate (1.2 mg) are given intravenously as an antidote to d-tubocurarine overdosage. The patient should be weU ventilated... 

Muscarinic agonists are administered subcutaneously to achieve an acute response and orally to treat more chronic conditions. Should serious toxic reactions to these drugs arise, atropine sulfate (0.5—1 mg in adults) should be given subcutaneously or intravenously. Epinephrine (0.3—1 mg, subcutaneously or intramuscularly) also is of value in overcoming severe cardiovascular or bron-choconstrictor responses. 

Atropine sulfate 2 mg (0,02-0.1 mg/kg in a child) intravenously should be given as soon as possible to patients who have increased secretions or brunchorrhea. Repeated injections of atropine, every few minutes if necessary, may be required during the first few hours of therapy the dose should be titrated to control peripheral mascarinic signs, notably bronchorrhea and bronchospasm. In very severe cases, 100 mg or more per day may be required to control symptoms. 

The client complaining of weakness, dizziness, and lightheadedness is exhibiting die following telemetry strip. The nurse administered the antidysrhythmic medication atropine sulfate intravenously. Which data best indicates die medication was effective ... 

The treatment of poisoning is based essentially upon the blocking of excessive nervous activity, due to the direct effects of the poison and to apprehension, fear, physical activity, and external stimuli. Quiet, reassurance, and gentle handling of the casualty are therefore essential. Atropine sulfate (1.0 mg) should be given by intravenous or intramuscular injection very promptly. This effectively blocks the excessive activity of smooth muscle and glands, and also controls convulsions.117... 

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