MASSACHUSETTS GENERAL HOSPITAL

Department of Pharmacy

Department of Nursing

Generic Name

Atropine Sulfate

Trade Name

Designated Clinical Area

Adult General Care

Action

Anticholinergic agent; gastrointestinal antispasmodic

Indications

To treat early cholinergic syndrome and diarrhea associated with irinotecan administration.

Symptomatic Bradycardia

Administration Guidelines

Usual Dosage Range and Route

Dosing for cholinergic syndrome/diarrhea associated with irinotecan: Usual initial dose is 0.4 mg IVP then 0.25mg-1mg IVP daily as needed for early cholinergic symptoms.

May administer in all adult clinical areas where chemotherapy is administered by an Oncology certified RN or RN working collaboratively with an Oncology certified RN.

Symptomatic Bradycardia: 0.5- 1 mg IVP

Critical Elements/Special Considerations

• Geriatric patients may be more sensitive to adverse effects

• Administer undiluted by rapid IV injection; slow injection may result in paradoxical bradycardia

Precautions and Side Effects

• Caution should be used in patients with significant cardiac and/or pulmonary disease. Serious adverse effects associated with the dose and frequency used to treat chemo-related cholinergic syndrome/diarrhea are uncommon

• Flushing

• Hypotension

• Tachycardia

• Dizziness

• Drowsiness

• Headache

• Dry mouth

• Urinary hesitancy, retention

• Blurred vision

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