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Pronunciation

AT-ro-peen

Classifications

Therapeutic Classification: antiarrhythmics

Pharmacologic Classification: anticholinergics, antimuscarinics

Indications

BEERS REMS


Action

  • Inhibits the action of acetylcholine at postganglionic sites located in:
    • Smooth muscle,
    • Secretory glands,
    • CNS (antimuscarinic activity).
  • Low doses decrease:
    • Sweating,
    • Salivation,
    • Respiratory secretions.
  • Intermediate doses result in:
    • Mydriasis (pupillary dilation),
    • Cycloplegia (loss of visual accommodation),
    • Increased heart rate.
  • GI and GU tract motility are decreased at larger doses.
Therapeutic effects:
  • Increased heart rate.
  • Decreased GI and respiratory secretions.
  • Reversal of muscarinic effects.
  • May have a spasmolytic action on the biliary and genitourinary tracts.

Pharmacokinetics

Absorption: Well absorbed following SUBQ administration. IV administration results in complete bioavailability.

Distribution: Readily crosses the blood-brain barrier. Crosses the placenta and enters breast milk.

Metabolism/Excretion: Mostly metabolized by the liver; 30–50% excreted unchanged by the kidneys.

Half-Life: Children <2 yr: 4–10 hr; Children >2 yr: 1.5–3.5 hr; Adults: 4–5 hr.

Time/Action Profile

(inhibition of salivation)

ROUTEONSETPEAKDURATION
SUBQrapid15–50 min4–6 hr
IVimmediate2–4 min4–6 hr



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: tachycardia, arrhythmias, palpitations

Derm: sweating, flushing

EENT: blurred vision, cycloplegia, dry eyes, mydriasis, photophobia

GI: dry mouth, constipation, impaired GI motility

GU: urinary hesitancy, impotency, retention

Neuro: drowsiness, confusion

Resp: pulmonary edema, tachypnea

Interactions

Drug-drug:

Route/Dosage

Preanesthesia (To Decrease Salivation/Secretions)

Bradycardia

Reversal of Adverse Muscarinic Effects of Anticholinesterases

Organophosphate Poisoning

Bronchospasm

Availability

(Generic available)

Assessment

Implementation

Rate: Inject directly into the endotracheal tube followed by several positive pressure ventilations.

IV Administration:

Patient/Family Teaching

Evaluation/Desired Outcomes

Code

NDC Code