¤Used in cardiac arrest setting or with symptomatic bradycardia.
¤Derived from an alkaloid extracted from deadly nightshade.
¤Was used to make women more attractive by dilating their pupils.
¤Deadly nightshade - Atropa belladonna.
Mode of action:
¤Competitive Muscarinic Ach blocker.
¤Blocks the action of acetyl choline.
¤Cardiac arrest setting.
¤Poisoning from organophosphates and nerve agents which increase Ach.
¤Cardiac transplant - oversensitive use with great caution.
¤Reduced secretions, Delirium, Pupils dilate, Increased heart rate.
¤Relax smooth bowel, Urinary retention, Bronchodilation.
¤High dose - tachyarrhythmias e.g. VF,VT, SVT.
¤Cardiac arrest up to 3 mg IV.
¤Bradycardia 500 mcg iv bolus repeated up to 3 mg IV.
¤Consider pacing if bradycardia induced hypotension persists.
Reference:Shanbhag Pharmacology 3rd edition