- Symptomatic bradycardia (first choice)
- May be beneficial in AV nodal block
- Not indicated in type II second-degree AV block or third-degree AV block
- Not indicated routinely for PEA or asystole
- Bradycardia with or without acute coronary syndrome: 0.5 mg IV every 3 to 5 minutes
- Do not exceed a total of 3 mg or 0.04 mg/kg dosage
- If clinically unstable, dose every 3 minutes.
- May use higher doses if clinical conditions are severe.
- Organophosphate poisoning: 2 to 4 mg doses may be needed.
- May not be effective in type II AV block and new third-degree AV block; may cause paradoxical slowing. Have catecholamines at hand.
- Hypothermic bradycardia.
- Myocardial ischemia and hypoxia – causes increased oxygen demand
- Doses of less than 0.5 mg may result in a paradoxically slower heart rate.
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