Atropine_dosing_cholinesterase_inhibitor_toxicity v.0
Doses atropine for cholinesterase inhibitor toxicity (prescribed drugs, nerve gas, insecticides).
Doses atropine for cholinesterase inhibitor toxicity (prescribed drugs, nerve gas, insecticides). This dosing guide was created to facilitate early and safe atropinization of the patient exhibiting signs of acute cholinergic toxicity.
Use in patients with cholinergic toxicity to determine atropine bolus dose and continuous infusion rate. This dosing tool is intended to assist with calculation, not to provide comprehensive or definitive drug information. Always double-check dosing of any drug and consult a pharmacist when necessary. Use for patients with cholinergic toxicity (causative agents are typically organophosphate compounds or carbamate, found in pesticides, or agents used in chemical warfare and terrorist attacks). Many symptoms of cholinergic toxicity are recalled with the “SLUDGE and killer B’s” mnemonic: Salivation. Lacrimation. Urination. Defecation. Gastric Emesis. Bradycardia. Assess for atropinization every 5 minutes: Clear lung exam on auscultation is the most important factor. Additional factors: heart rate >80, systolic blood pressure >80. If atropinization has not been achieved, double previous dose and reassess in another 5 minutes. Repeat doubling every 5 minutes until atropinization achieved. Once atropinization achieved, begin continuous infusion at an hourly rate of 10% of the sum of all doses necessary to achieve initial atropinization. Titrate as necessary.
Not for use in treating isolated bradycardia. Not for use in AtroPen Atropine Auto-Injector dosing.
1. Howland, MA Antidotes in Depth: Atropine. In: Hoffman R, Howland MA, Lewin N et al. Goldfrank's Toxicologic Emergencies, Tenth Edition. McGraw-Hill Education / Medical; 2014.
EVALUATION.atropine_dosing_cholinesterase_inhibitor_toxicity.v0
