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Functional Class
Parasympatholytic
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Mechanism of Action
- -Blocks Muscarinic Acetylcholine receptors inhibiting parasympathetic stimulation
- -Blocks vagal impulses to the heart and accelerates SA node discharge, enhances conduction through AV node and increases cardiac output.
- -Potent bronchodilator if bronchoconstriction is caused by increases parasympathetic tone
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Indications
- -Symptomatic Bradycardia
- -Asystole
- -Bradycardic PEA
- -Organophosphate/nerve agent poisoning
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Precautions
- -2nd degree Mobitz II and 3rd degree AV blocks. Can worsen bradycardia. Consider TCP first
- -Acute Myocardial Ischemia or AMI. Glaucoma
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Side Effects
- Blurred vision
- Dilated Pupils
- Dry mouth
- Tachy
- Drowsiness
- Convulsions
- HTN or Hypotension
- Palpitations
- Paradoxical bradycardia (if given to slowly)
- AV dissociation
- Urinary retention
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Interactions
- Antihistamines
- Tricyclic antidepressants
- Procainamide
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Dosage
- AsystoleADULT
- 1 mg IVP q 3-5 mins max total 0.04 mg/kg
- 2-2.5 mg ET q 3-5 mins
- PEDI
- .02 mg/kg IVP or IO (min single .1 mg max single 1 mg) q 5 mins max total .04 mg/kg
- Symptomatic BradycardiaADULT
- 0.5 mg IVO q 3-5 mins max total .04 mg/kg
- PEDI
- .02 mg/kg IVP or IO (min single .1 mg max single 1 mg) q 5 mins max total .04 mg/kg
- Organophosphate PoisoningADULT
- 2 mg IVP q 5 mins prn
- PEDI
- .05-.1 mg/kg IV/IM (min single .1 mg max and max single 5 mg) q 2-5 mins prn
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Pharmacokinetics
- Absorption= 2-4 mins IV
- Half-life=2-3 hours
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