Possible Interaction: Atropine and Epinephrine

“ Atropine enhanced HR-increasing effects of all three beta-AR agonists and exercise; increases were larger for beta2-AR (terbutaline, adrenaline ) mediated effects than for beta1-AR (exercise) mediated effects.”

“In man, atropine slowed clearance, while the adrenergic stimulating drugs, isoproterenol and epinephrine , both accelerated it by greater than or equal to 4 times, as did isoproterenol when given subsequent to atropine.”

“The odds ratio (OR) for the survival to hospital admission after the administration of atropine with epinephrine was 1.33 (95% CI 1.09-1.62; p<0.01), while that after the administration of epinephrine was 0.64 (95% CI: 0.55-0.74, p<0.01).”

“A multivariate logistic model of variables available at the time of arrest, which controlled for gender, age, race, and asystole or ventricular fibrillation/ventricular tachycardia anytime during the arrest, found the administration of atropine and epinephrine to be associated with mortality.”

“In 19 of 20 patients who received atropine (10 g/kg), there was an increase in the HR of 10 bpm after the intravascular administration of epinephrine whereas only 16 of 21 patients who had not received atropine had an increase in the HR of 10 bpm or more.”

“Two minutes after the onset of asystole, cardiac rhythm was detected following the administration of epinephrine and atropine.”

“Again, asystole occurred after defibrillation, and only sporadic QRS complexes appeared after repeated epinephrine and atropine administration.”

“The ventricular rate can occasionally be increased by the administration of large doses of atropine and by epinephrine and isoproterenol.”

“Intravenous injection of epinephrine or norepinephrine sometimes produced atrial fibrillation after the sinus node arteries were ligated (but not before), and this could be prevented with atropine.”

“ Atropine administration antagonized the electroencephalographic activation produced by epinephrine , methamphetamine and d -amphetamine in rabbits transected at the ponto-mesencephalic junction.”