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  • First drug for symptomatic sinus bradycardia with or without ACS.

  • It May be beneficial in presence of AV nodal block; not likely to be effective for second-degree Block type 2 or third-degree AV block or a block in non-nodal tissue

  • Routine use during PEA or systole is unlikely to have a therapeutic benefit and is not part of the AHA recommendations anymore.

For Organophosphate poisoning, an extremely large dose may be needed.

🫀Mechanism of Action:

Increase Parasympatholytic (Vagolytic Action) Increase HR, Increase Sinus Nod Discharge and Increased AV Conduction

ACLS Dosage:

  • 1mg IV every 3-5 minutes as needed. Kindly note that the dose of Atropine has been increased from 0.5mg to 1mg in the 2020 AHA guidelines.

  • Do not exceed 0.04mg/kg or a total dose of 3mg.

  • ☠️ For Organophosphate Poisoning the dose is 2-4mg or higher

PALS Dosage:

  • The IV/IO dose is 0.02 mg/kg for a maximum single dose: 0.5 mg May repeat dose once in 3-5 minutes

  • Maximum total dose for a child: 1 mg; for an adolescent: 3 mg

Side Effects:

  • Due to the increase in myocardial oxygen demand, Use with caution in presence of myocardial ischemia and hypoxia.

  • Unlikely to be effective for hypothermic bradycardia

  • May not be effective for infranodal, Type 2 AV block and new third-degree block with wide QRS complexes. In these patients, it may cause paradoxical slowing. So be prepared to pace or give catecholamines.

Disclaimer: This video is for educational purposes only and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.



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