Atropine Infusion for Cholinesterase Inhibitor Toxicity calculator

Clinical inputs

• Age group in the poisoning tables
• Body weight (kg)Accepted range: 2 to 250
• Loading dose that produced the response (mg)Accepted range: 0.5 to 1000

Primary source

Atropine Sulfate Injection prescribing information, FDA application 209260, label 209260s000, Table 1 and Table 2. Adult organophosphorus, carbamate, or muscarinic mushroom poisoning: initial single dose 1 to 6 mg, repeated every 3 to 5 minutes. The dose may be doubled with each administration until response, defined as reduced bronchospasm, improved oxygenation, and drying of pulmonary secretions. Maintenance: 10% to 20% of the loading dose required for response as a continuous infusion per hour. Maximum total dose: no maximum total dose. Pediatric poisoning row: initial 0.02 to 0.06 mg/kg, repeated every 5 minutes, with the same doubling rule and the same 10% to 20% hourly infusion. Maximum total dose: no maximum total dose. The table prints a range. Both ends are shown in mg/h. The result number is the 20% end, so it is not the 10% end alone. A result line also states the 20% end in mg/h, and another line states the 10% end in mg/h. The adult poisoning row does not use weight. The pediatric row uses weight only for the initial range and does not print a kilogram cap. The 250 kg and 1000 mg entry limits are not label ceilings. Section 2.4, ischemic heart disease, is a different row and is not applied here. The dose has to be verified against the local protocol. (2018)