CodeBlue
Drug Reference

Rhythm

Atropine

Antimuscarinic (parasympatholytic)

BradycardiaAdult1 mg IV every 3–5 min, max 3 mgPeds0.02 mg/kg, may repeat once; max single dose 0.5 mg
OrganophosphatesAdult1–6 mg IV, double every 5 min until secretions dryPeds0.05–0.1 mg/kg

Indications

  • Symptomatic bradycardia
  • Organophosphate / nerve agent poisoning

Contraindications & cautions

  • Not indicated in asystole/PEA
  • Likely ineffective in heart transplant and infranodal block

Key pearls

  • Doses < 0.5 mg (adult) were historically linked to paradoxical bradycardia
  • Do not delay pacing in Mobitz II or 3rd degree block

Used in

Adult Bradycardia Pediatric Bradycardia β-Blocker / CCB Overdose