ge 10 years, improvement of amblyopia was maintained in both groups, although approximately half experienced mild residual amblyopia (i.e., visual acuity less than 20/25).
For management of early-onset irinotecan-induced diarrhea†.
Intravenous Dosage
Adults
Unless clinically contraindicated, a dose of 0.25 to 1 mg IV should be considered for patients experiencing early-onset (e.g., occurring within 24 hours following irinotecan administration) diarrhea, diaphoresis, or abdominal cramps.
For the prevention of bradycardia and reduction of oral secretions during rapid-sequence intubation†.
Intravenous Dosage
Infants, Children, and Adolescents
0.02 mg/kg/dose IV (with no minimum dose) given 1 to 2 minutes prior to intubation. Max: 0.5 mg/dose. Available evidence does not support routine use of atropine as a premedicant for emergency intubation in critically ill children; however, it may be considered when there is a high risk of bradycardia.
Neonates
0.02 mg/kg/dose IV.
†Indicates off-label use
MAXIMUM DOSAGE
The maximum dosage of atropine is variable depending on the indication for use, route of administration, and the individual patient response.
DOSING CONSIDERATIONS
Hepatic Impairment
Specific guidelines for dosage adjustments in hepatic impairment are not available.
Renal Impairment
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
ADMINISTRATION
Oral Administration
Administer 30 minutes before meals.
Injectable Administration
Administer intramuscularly, intravenously, subcutaneously, or intraosseously. The auto-injector Atropen, for use only in nerve agent and insecticide poisoning, is exclusively for intramuscular (IM) use.
Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit.
Intravenous Administration
Direct intravenous (IV) injection:
May be given undiluted or diluted in 10 mL of sterile water for injection.
Inject via Y-site or through a 3-way stopcock at a rate of 0.6 mg over 1 minute. Doses less than 0.4 mg or IV administration over more than 1 minute may cause paradoxical slowing of the heart rate which usually resolves within approximately 2 minutes.
During adult cardiopulmonary resuscitation (CPR): Resuscitation drugs may be administered intravenously by bolus injection into a peripheral vein, followed by an injection of 20 mL IV fluid. Elevate the extremity for 10 to 20 seconds to facilitate drug delivery to the central circulation. Although peak drug concentrations are lower when drugs are administered via peripheral vs. central sites, the establishment of peripheral access does not require interruption of CPR. Drugs generally reach the central circulation within 1 to 2 minutes when administered peripherally but require less time when given via central venous access.
Intramuscular Administration
Atropen intramuscular (IM) auto-injection:
Only to be administered by persons with adequate training in the recognition and treatment of nerve agent or insecticide intoxication.
Snap the grooved end of the plastic sleeve down and over the yellow safety cap. Remove the Atropen from the plastic sleeve.
Firmly grasp the Atropen with the green tip pointed downward. Pull off the yellow safety cap with the other hand.
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