From the Guidelines
Atropine should be administered at a dose of 0.02 mg/kg IV/IO to control excessive secretions, with a minimum single dose of 0.1 mg and a maximum single dose of 0.5 mg for a child and 1.0 mg for an adolescent or adult, as needed, every 5 minutes, to a maximum total dose of 1 mg for a child and 2 mg for an adolescent or adult 1. The dose of atropine for excessive secretions can be administered via different routes, including IV/IO, IM, or ET, with specific dosages and considerations for each route.
- For IV/IO administration, the dose is 0.02 mg/kg, with a minimum single dose of 0.1 mg and a maximum single dose of 0.5 mg for a child and 1.0 mg for an adolescent or adult 1.
- For IM administration, the dose is 0.02–0.04 mg/kg 1.
- For ET administration, the dose is 0.03–0.06 mg/kg for children and adolescents, with a saline flush of 1–5 mL based on patient size 1. It is essential to consider the patient's age, weight, and medical condition when administering atropine, as well as potential side effects, such as dry mouth, blurred vision, urinary retention, tachycardia, and confusion, particularly in elderly patients. Atropine works by blocking muscarinic acetylcholine receptors, thereby reducing secretions from salivary, bronchial, and sweat glands. Alternative anticholinergics, such as glycopyrrolate, may be considered, especially in patients with glaucoma, prostatic hypertrophy, or cardiac conditions 1.
From the FDA Drug Label
Adult dosage Antisialagogue or for antivagal effects: Initial single dose of 0. 5 to 1 mg. The recommended dose of atropine for excessive secretions is an initial single dose of 0.5 to 1 mg administered intravenously 2.
From the Research
Atropine Dose for Excessive Secretions
- The dose of atropine for excessive secretions is not explicitly stated in the provided studies, but its effects on various end-organs with cholinergic innervation are discussed 3.
- Atropine has been used in various studies to inhibit physiological growth hormone secretion 4, and its pharmacokinetic properties have been characterized 5.
- The combination of atropine and glycopyrrolate has been compared with atropine alone for the reversal of muscle relaxant, and the results show that atropine 0.6 mg and glycopyrrolate 0.2 mg can be an alternative to antagonize muscarinic effects of neostigmine 6.
- Glycopyrrolate appears to be five to six times more potent than atropine in its antisialogogue effect, and it exhibits a selective, though prolonged, effect on salivary secretion and sweat gland activity 3.
- Atropine has been administered orally in doses of 0.6 mg or 1.8 mg to investigate its effects on the nocturnal secretion of growth hormone 4.
- The pharmacokinetics of atropine, scopolamine, and glycopyrrolate, and their relation to clinical response, are not fully understood, and further studies are needed 5.