Atropine & Dopamine

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  1. Generic name for Atropine?
    Atropine Sulfate
  2. Brand name for Atropine?
    Atropine
  3. Class for Atropine?
    • Parasympatholytic
    • Anticholinergic
  4. Mechanism of Action for Atropine?
    • Competitive antagonist to ACh at muscarinic receptor site
    •      Blocks parasypathetic response & allows sysmpathetic response to take over
    •          Heart
    •                Atrial effects
    •                     Positive chronotrope
    •                     Postive dromotrope                    
    •                     Positive inotrope
    •                          Slight effect
    •           Lungs
    •                Decreased mucous production
    •                Increased bronchial smooth muscle relaxation
    •           GI
    •                Decreased secretions
    •                Decreased motility
    •           Urinary
    •                Decreased bladder tone
    •           Other  
    •                Pupil dilation
    •                Decreased sweat production
  5. Indications and field use for Atropine?
    • Symptomatic Bradycardia
    •      Atrial mechanisms only
    •           Why?
    •                  Blocks parasympathetic response increasing heart rate
    • Acetylcholinesterase inhibitor poisoning
    •      Organophosphate poisoning
    •      Nerve agent poisoning
    • Cholinergic posoning
    •      Why?
    •           Blocks the muscarinic receptors reducing the effects of ACh
  6. Dosage for Atropine?
    All Dosages are IV Push or ETT - FAST

    Adult

    • Symptomatic Bradycardia
    •      Atrial mechanisms only
    •           Atropine 0.5mg IV Push - q 5 min - max 0.04mg/kg

    • Acetylcholinestrase inhibitor poisoning
    • Cholinergic poisoning
    •      Atropine 2.0 - 5.0 mg IV Push - q 5 min - until symptoms resolved 
  7. Contraindications for Atropine?
    • Allergy
    • Wide complex 2nd Degree type II heart block
    • 3rd degree heart block
    • Acute narrow angle glaucoma
    •      Painful glaucoma probably narrow type
  8. Drug interactions for Atropine?
    Sodium bicarbonate
  9. Side effects for Atropine?
    • Dysrhythmias
    • Angina / AMI
    • Hyperthermia
    • Agitation / Delirium
    • Acute narrow angle glaucoma
  10. Onset of action for Atropine?
    1 minute
  11. AZ Drug box supply for Atropine?
    • 4 x Atropine 1mg in 10cc prefilled syringe
    • 1 x Atropine 8mg in 20cc multidose vial
  12. Generic name for Dopamine?
    Dopamine
  13. Brand name for Dopamine?
    Intropin
  14. Class for Dopamine?
    • Dopamine agonist
    • Sympathomimetic
  15. Mechanism of Action for Dopamine?
    MOA depends upon dosage

    • Dopamine dose 1-2mcg/kg/min
    •      Activates dopamine receptors causing cerebral, renal, mesenteric vasodilation
    •           May increase urine output
    •           May drop BP

    • Beta-1 Dose 2-10mcg/kg/min
    •      Activates Beta-1 receptors stimulates heart increasing cardiac output & BP
    •           Postive inotrope
    •           Positive chronotrope
    •           Postivite dropmotrope

    • Alpha-1 dose 10-20mcg/kg/min
    •      Activates Alpha-1 receptors causing renal, mesenteric, & peripheral vasoconstriction
    •           Increases PVR increases BP
    •           Increased Preload
    •           >20mcg/kg/min similar to norepi with massive vasoconstriction
  16. Indications and field use for Dopamine?
    • Hypotension without fluid loss
    •      Symptomatic bradycardia with hypotension
    •      Cardiogenic shock
    •      Septic shock
    •      Neurogenic shock
  17. Dosage for Dopamine?
    All doses via IV infusion

    • Add 400mcg to 250cc NS bag giving 1600mcg/cc
    •      Symptomatic bradycardia with hypostension &/or non-hypovolemic shock
    •           Dopamine 5mcg/kg/min initial infusion, increase if no repsonse
  18. Contraindication for Dopamine?
    • Hypovolemic shock
    • Pheochromocytoma (tumor of the adrenal gland)
    • MAOI's
  19. Drug interactions for Dopamine?
    • Incompatible with alkaline drugs/solutions
    • MAOI use will cause hypertensive crisis
  20. Side effects for Dopamine?
    • Dysrhthmias
    • Hypertension
    • Hypotension at dopamine dosage
    • Chest pain
    • Nausea/vomiting
    • Renal failure at higher dosage
    • Tissue necrosis if extravasation (notify hospital)
  21. Onset of action for Dopamine?
    Immediate
  22. AZ Drug Box Supply for Dopamine?
    • 2 x Dopamine 400mg in 5cc vial
    • 2 x Dopamine 400mg in 250cc D5W premixed IV solution

    • Note: Never run "wide open", always calculate dosage and drip rate
    • Effects stop when infusion stops

Card Set Information

Author:
cjl410
ID:
171282
Filename:
Atropine & Dopamine
Updated:
2012-09-16 23:15:38
Tags:
Phoenix College Paramedic 2012 2013 Drug Profiles Atropine Dopamine
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Description:
PCC Drug Profiles Atropine & Dopamine
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