**6.4.8 Atropine**

318 Complementary Pediatrics

The serum potassium level, heart rate, respiration rate, blood gases of children should be

Treatment of neonatal apnea, including post-extubation, post-anesthesia, and prostaglandin E1-inducted. Bronchodilator. May improve respiratory function (Kavakl et al, 1998; Young

*Dose:* Loading dose: 8 mg/kg IV infusion over 30 minutes, or PO. Maintenance: 1.5 to 3 mg/kg per dose PO, or IV slow push Q8 to 12 hours. In preterms infants, changing from IV aminophylline to PO theophylline requires no dose adjustment (Young & Mangum, 2010). The dose of 20 mg/kg/day should not be exceeded in rectal application. IM administration of drug is not advised as it causes long-term pains in the injection area (Kavakl et al, 1998). When the drug is administered by IV route it reaches the highest level in blood within 30

The drug is metabolized in liver and discharged from body via urinary system. It reaches fetus through placenta in pregnancy period and is transmitted to child through natural

*Side Effects:* An allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); seizures; increased or irregular heartbeats; or severe nausea

*The things to be considered by nurse applying the drug:* The solution should be given in 20-30 minutes in IV administration. In infants younger than 6 months it should be slowly administered by infusion prepared in 5% dextrose. And it should not be mixed with other

In oral administration the drug should be administered with water half an hour or one hour before or 2 hours after meals as drug absorption is faster when child is hungry. Child should not break or chew the tablet; but swallow it as a whole. Tablet is not advised for children under the age of 12. Rectal route of administration is used for children who cannot take by oral route. If possible, drug use should be adjusted according to the excretion times of children as drug absorption is faster when rectum is empty. After the administration of drug child should be laid in supine position for 15-20 minutes. As the absorption via rectal route in children is way faster than adults the probability of toxicity is also higher. So nurse

Vital signs and inputs/outputs are observed and recorded at frequent intervals. Instant and

When side effect-related symptoms appear the drug should not be administered and doctor should be notified. In the event that the symptoms are light it can be administered with

Such commonly consumed beverages as coffee, tea, coke can increase the reactions. While a diet rich in protein increases the output of drug; a diet rich in carbohydrate decreases the output of it. These conditions result in changes in the drug level in blood. So it may be

closely monitored when the drug is administered (Kavakl et al, 1998).

minutes; by oral route it reaches within 1-2 hours.

nutrition in lactation period (Kavakl et al, 1998).

or vomiting (Kavakl et al, 1998; Young & Mangum, 2010).

should be warned not to exceed recommended dose.

clear tachycardia is one of the symptoms of toxicity.

**6.4.6 Aminophylline** 

& Mangum, 2010).

drugs.

higher doses.

required to readjust the dose.

Reversal of severe sinus Bradycardia, particularly when parasympathetic influences on the heart predominate. Also used to reduce the muscarinic effects if neostigmine when reversing neuromuscular blockade.

*Dose:* IV: 0.01 to 0.03 mg/kg per dose IV over 1 minute, or IM. Dose can be repeated Q10 to 15 minutes to achieve desired effect, with a maximum total dose of 0.04 mg/kg (Young & Mangum, 2010).

*Endotracheal:* The same dose can be administered from ET tube. Right after ET tube, 1 ml SF should be given and PPV should be applied for homogenous distribution.

*Oral:* 0.02 mg-0.09 mg/kg/dose every 4-6 hours (Kanmaz, 2010).

*Adverse Effects:* Cardiac arrhythmias can occurs, particularly during the first 2 minutes following IV administration; usually a simple A-V dissociation more often caused by smaller rather than larger doses. Fever, especially in brain-damaged infants. Abdominal distention with decreased bowel activity. Esophageal reflux. Mydriasis and cyclopedia (Young & Mangum, 2010).
