• Class – Anticholinergic 
• MOA – Competes reversibly with ACH at the site of the muscarinic receptor. 
• Indication – Symptomatic Bradycardia, asystole or PEA, Nerve agent exposure or organophosphate poisoning.
• Contraindications – Acute MI, Myasthenia Gravis, GI obstruction, closed angle glaucoma, known sensitivity to atropine, belladonna alkaloids, or sulfites. Atropine may not be effective on second degree type 2 and 3rd degree heart blocks.
• Side effects – decreased secretions resulting in dry mouth and hot skin, intense facial flushing, blurred vision or dilation of the pupils with photophobia, tachycardia and restlessness. Atropine may cause paradoxical bradycardia if the dose administered is too low or if it is administered too slowly. 
• Dosing 

Symptomatic Bradycardia 

Adult: 0.5mg IV/IO every 3-5 minutes to a maximum dose of 3mg

Pediatric: 0.02mg/kg  IV/IO up to a total dose of 2mg  

Nerve Agent or Organophosphate Poisoning 

Adult: 1-6mg IV/IM repeat every 5 minutes until symptoms dissipate 

Pediatric: 0.05mg/kg IV/IM every 10 – 30 minutes until symptoms dissipate