Plasma Atropine Concentrations Determined by Radioimmunoassay After Single-Dose I.V. And I.M. Administration

Abstract

The plasma concentrations of atropine following i.v. or i.m. administration to surgical patients were determined by radioimmunoassay. When atropine sulphate 1 mg was given i.v. there was a rapid initial removal of the drug from the circulation in the first 10 min; thereafter the plasma concentration decreased more slowly. Atropine i.m. was rapidly absorbed with peak concentrations occurring at 30 min following injection. The plasma atropine concentration then decreased slowly, probably because of uptake of atropine by muscarinic cholinergic receptors. The chronotropic effect of atropine appeared to correspond to the concentration in plasma following i.m. administration. We conclude that i.m. atropine, as a premedication, should be given not later than 30 min before induction of anaesthesia.

Civilian Adult Self Injections of Atropine – Trimedoxime (TMB4) Auto-Injectors

“…Atropinization score was assessed by the Wilcoxon score (rank sum) test. The dose groups were divided into 3 subgroups according to time of presentation after injection: ≤30 minutes (corresponding to Tmax of atropine blood level and peak tachycardic effect of atropine auto-injector), >30 minutes-4 hours (Tmax to one elimination T ½ of atropine), and >4 hours (>1T ½) (7)(8)(9)(10)(11). The association between score and time to medical care was assessed by Wilcoxon score (rank sum).…”

The use of atropine in a nerve agent response with specific reference to children: are current guidelines too cautious?

“…With little paediatric data much of the information has been extrapolated from adult studies. Peak serum concentrations in adults occur in 15–30 minutes after the intramuscular injection of 0.02 mg/kg atropine 25 26 27 28 29. Although this time frame appeared to correspond with a peak in heart rate, the primary goal of therapy is to prevent death from respiratory failure due to bronchorrhoea.…”

Development and clinical study of submicronic-atropine sulphate respiratory fluid as a novel organophosphorous poisoning antidote

“…However, the peak plasma concentration (6-8 ng/mL) after giving a standard dose of 2 mg AS intramuscular injection does not occur until 30 min have elapsed, limiting its use as a therapeutic option, more so in case of mass casualty (Kehe et al, 1992;Ali et al, 2009). In a hospital setting, assuming the patient can be transported there, the intravenous bolus route is the fastest way to introduce and maintain a state of atropinization, with the peak pharmacological concentration occurring within 5-10 min (Berghem et al, 1980;Ali-Melkkilä et al, 1993;Ali et al, 2009). However, in the field conditions or in a pre-hospital setting where giving an intravenous injection may not be always possible, efforts are required to develop and evaluate alternative but effective routes so as to obtain therapeutic range and peak concentration of the drug in blood earlier than 30 min and as close to intravenous range as possible (Albuquerque et al, 2006).…”