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atropine

atropine
  • Restricted Medications IV
Brand names: Atropine Sulfate
Form Strength
SOLUTION, INJECTABLE 0.1 mg/mL; 0.4 mg/mL
Display Antimuscarinics/Antispasmodics, Anticholinergic Agents Class: 120808, 481208
Medication comments:
atropine should generally not be interrupted during procedures unless there is a specific physician order.
Per policy, these medications require cardiac and/or special monitoring.
(KEY: "Y" = may be given as described on chart. "N" = may NOT be given except in Rapid Response/Code Blue situations or as otherwise described in Exceptions section of Policy.
generic (Brand) / Notes CCU, OR, PACU, CCL, ED PCU 2N (Tele) 1N (Tele), 3N (Tele) Med/Surg (1N w/o Tele, 3N w/o Tele, 4N, 5N) BirthPlace SNF ICS OPS
atropine
IV Key: designated staff		 Y Y Y N Y
1N only for side effects of chemo		 N N Y
only for side effects of chemo		 N
2023 American Geriatrics Society Beers Criteria® for potentially inappropriate medication use in older adults.
Medication: atropine
excludes ophthalmic
 
Criteria 1: Potentially inappropriate medication use in older adults. (Table 2)
Drug(s) GI antispasmodics with strong anticholinergic activity
Rationale Highly anticholinergic, uncertain effectiveness.
Recommendation Avoid
 Quality of evidence: Moderate, Strength of Recommendation: Strong
 
Criteria 2: Potentially inappropriate medication use in older adults due to drug–disease or drug–syndrome interactions that may exacerbate the disease or syndrome. (Table 3)
Drug(s) ⇆ disease or syndrome anticholinergics ⇄ Delirium
Rationale Avoid in older adults with or at high risk of delirium because of the potential of inducing or worsening delirium.
Recommendation Avoid
 Quality of evidence: Moderate, Strength of Recommendation: Strong
 
Drug(s) ⇆ disease or syndrome anticholinergics ⇄ Dementia or cognitive impairment
Rationale Avoid because of adverse CNS effects. If used, periodic deprescribing attempts should be considered to assess ongoing need and/or the lowest effective dose.
Recommendation Avoid
 Quality of evidence: Moderate, Strength of Recommendation: Strong
 
Drug(s) ⇆ disease or syndrome anticholinergics ⇄ History of falls or fractures
Rationale May cause ataxia, impaired psychomotor function, syncope, or additional falls. If one of the drugs must be used, consider reducing the use of other CNS-active medications that increase the risk of falls and fractures. (i.e., anticholinergics, selected antidepressants, antiepileptics, antipsychotics, sedative/hypnotics including benzodiazepines and, Nonbenzodiazepine benzodiazepine receptor agonist hypnotics, opioids) and implement other strategies to reduce fall risk.
Recommendation Avoid unless safer alternatives are not available.
 Quality of evidence: High, Strength of Recommendation: Strong
 
Drug(s) ⇆ disease or syndrome strongly anticholinergic drugs, except antimuscarinics for urinary incontinence ⇄ Lower urinary tract symptoms, benign prostatic hyperplasia
Rationale May decrease urinary flow and cause urinary retention
Recommendation Avoid in men
 Quality of evidence: Moderate, Strength of Recommendation: Strong
 
Criteria 4: Potentially clinically important drug-drug interactions that should be avoided in older adults. (Table 5)
Interacting drug(s) or class(es) anticholinergics ⇄ anticholinergics
Risk Rationale Use of more than one medication with anticholinergic properties increases the risk of cognitive decline, delirium, and falls or fractures.
Recommendation Avoid; minimize the number of anticholinergic drugs Click for list.
 Quality of evidence: Moderate, Strength of Recommendation: Strong
Last updated: Sep. 18, 2025
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