아트로핀 황산염

Atropine Sulfate

dl-hyoscyamine (racemic mixture of d-hyoscyamine and l-hyoscyamine)

항콜린제 / 항무스카린제IVIMSCPOIOIntratracheal (IT)Inhalation개고양이소형 포유류페렛새파충류말소돼지양염소

다른 이름: Atroject · Atropine SA · Atropine L.A. · AtroPen · Sal-Tropine · dl-hyoscyamine · atrop. sulph. · atropine sulphate · atropini sulfas

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

0.01-0.02 mg/kgIM, IV· once

체중— 🐕

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증	용량	경로	빈도	기간	지역
As a preanesthetic adjuvant (geriatric patients)	0.01-0.02 mg/kg	IM, IV	once	—	🌎 NA
As a preanesthetic adjuvant	0.074 mg/kg	IV, IM or SC	once	—	🌎 NA
As a preanesthetic adjuvant	0.02-0.04 mg/kg	SC, IM or IV	once	—	🌎 NA
During cardiopulmonary cerebral resuscitation (CPCR) efforts	0.04 mg/kg (IV or IO); 0.08-0.1 mg/kg (IT)	IV, IO, IT	every 3-5 minutes	maximum of 3 doses	🌎 NA
Adjunctive treatment of bradycardias, Incomplete AV block, etc.	0.02-0.04 mg/kg	IV or IM	as needed	—	🌎 NA
Atropine Response Test (Rishniw Preference)	0.04 mg/kg	IV	once	—	🌎 NA
Atropine Response Test (Kittleson Preference)	0.04 mg/kg	SQ	once	—	🌎 NA
Treatment of cholinergic toxicity	0.2-0.5 mg/kg	IV, IM, SC	as needed	—	🌎 NA
Treatment of bronchoconstriction	0.02-0.04 mg/kg	parenteral	as needed	duration of effect 1-1.5 hours	🌎 NA

As a preanesthetic adjuvant (geriatric patients): Do not use anticholinergics indiscriminately in geriatric patients.
During cardiopulmonary cerebral resuscitation (CPCR) efforts: For IT administration: dilute in 5-10 mL of sterile water before administering.
Atropine Response Test (Rishniw Preference): Wait 15 minutes, record ECG. Persistent sinus tachycardia at >140 bpm expected in vagally-mediated bradycardia.
Atropine Response Test (Kittleson Preference): Wait 30 minutes, record ECG. Persistent sinus tachycardia at >140 bpm expected in vagally-mediated bradycardia.
Treatment of cholinergic toxicity: 1/4 of the dose IV and the remainder IM or SC

고양이

적응증	용량	경로	빈도	기간	지역
As a preanesthetic adjuvant (geriatric patients)	0.01-0.02 mg/kg	IM, IV	once	—	🌎 NA
As a preanesthetic adjuvant	0.074 mg/kg	IV, IM or SC	once	—	🌎 NA
As a preanesthetic adjuvant	0.02-0.04 mg/kg	SC, IM or IV	once	—	🌎 NA
During cardiopulmonary cerebral resuscitation (CPCR) efforts	0.04 mg/kg (IV or IO); 0.08-0.1 mg/kg (IT)	IV, IO, IT	every 3-5 minutes	maximum of 3 doses	🌎 NA
Treatment of bradycardias	0.02-0.04 mg/kg	SC, IM or IV	q4-6h	—	🌎 NA
Treatment of cholinergic toxicity	0.2-2 mg/kg	IV, SC, IM	as needed	—	🌎 NA

As a preanesthetic adjuvant (geriatric patients): Do not use anticholinergics indiscriminately in geriatric patients.
During cardiopulmonary cerebral resuscitation (CPCR) efforts: For IT administration: dilute in 5-10 mL of sterile water before administering.
Treatment of cholinergic toxicity: give 1/4th of the dose IV and the remainder SC or IM

소형 포유류

적응증	용량	경로	빈도	기간	지역
To treat organophosphate toxicity (Rabbits/Rodents)	10 mg/kg	SC	q20 minutes	—	🌎 NA

페렛

적응증	용량	경로	빈도	기간	지역
As a premed	0.05 mg/kg	SC or IM	once	—	🌎 NA

새

적응증	용량	경로	빈도	기간	지역
Organophosphate poisoning	0.2 mg/kg	IM	every 3-4 hours as needed	—	🌎 NA
To assist in diagnosing organophosphate poisoning	0.02 mg/kg	IV	once	—	🌎 NA
As a preanesthetic	0.04-0.1 mg/kg	IM or SC	once	—	🌎 NA

Organophosphate poisoning: 1/4th the initial dose is administered. Use with pralidoxime (not in raptors) at 10-20 mg/kg IM q8-12h as needed.
To assist in diagnosing organophosphate poisoning: If bradycardia does not reverse, may consider organophosphate toxicity.

파충류

적응증	용량	경로	빈도	기간	지역
Organophosphate toxicity in most species	0.1-0.2 mg/kg	SC or IM	as needed	—	🌎 NA
Ptyalism in tortoises	0.05 mg/kg (50 micrograms/kg)	SC or IM	once daily	—	🌎 NA

말

적응증	용량	경로	빈도	기간	지역
Treatment of bradyarrhythmias due to increased parasympathetic tone	0.01-0.02 mg/kg	IV	as needed	—	🌎 NA
Treatment of bradyarrhythmias due to increased parasympathetic tone	0.045 mg/kg	parenterally	as needed	—	🌎 NA
As a bronchodilator	5 mg	IV	once	—	🌎 NA
As a bronchodilator (rescue medication for severe airway obstruction)	5-7 mg/kg	IV	single rescue dose	—	🌎 NA
Organophosphate poisoning	Approximately 1 mg/kg	IV, SC	may repeat every 1.5-2 hours as required subcutaneously	—	🌎 NA
Organophosphate poisoning	0.22 mg/kg	IV, SC, IM	as needed	—	🌎 NA

As a bronchodilator: for a 400-500 kg animal
As a bronchodilator (rescue medication for severe airway obstruction): for a 450 kg horse. Abbreviated duration (0.5-2 hours). Adverse effects limit use to a single rescue dose.
Organophosphate poisoning: given to effect, IV (use mydriasis and absence of salivation as therapy endpoints)
Organophosphate poisoning: 1/4th of the dose administered IV and the remainder SC or IM

소

적응증	용량	경로	빈도	기간	지역
As a preanesthetic	0.06-0.12 mg/kg	IM	once	—	🌎 NA
Adjunctive treatment of bovine hypersensitivity disease	1 gram per cow once daily followed by 0.5 gram/cow in 2-3 days	not specified	once daily then in 2-3 days	2-3 days	🌎 NA
Treatment of cholinergic toxicity (organophosphates)	0.5 mg/kg (average dose)	IV, SC, IM	may repeat q3-4h	1-2 days	🌎 NA

As a preanesthetic: Not used routinely as a preoperative agent in ruminants due to lack of extended efficacy and potential adverse reactions.
Treatment of cholinergic toxicity (organophosphates): give 1/4th of the dose IV and the remainder SC or IM

돼지

적응증	용량	경로	빈도	기간	지역
Organophosphate toxicity	Use equine dose	IV, SC, IM	as needed	—	🌎 NA
As an adjunctive preanesthetic agent	0.04 mg/kg	IM	once	—	🌎 NA

양

적응증	용량	경로	빈도	기간	지역
Treating organophosphate toxicity	Use the dose for cattle	IV, SC, IM	as needed	—	🌎 NA

염소

적응증	용량	경로	빈도	기간	지역
Treating organophosphate toxicity	Use the dose for cattle	IV, SC, IM	as needed	—	🌎 NA

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개요

아트로핀 황산염은 천연 벨라돈나 알칼로이드이며 수의학에서 광범위하게 사용되는 대표적인 항무스카린(항콜린) 제제입니다.

주요 임상 적용 분야는 다음과 같습니다:

응급 의학 및 심폐뇌소생술(CPCR): 혈역학적으로 유의미한 동성 서맥, 동방 정지 및 불완전 방실 차단 치료.
마취: 호흡기 및 타액 분비를 예방하거나 줄이고 미주신경 매개성 서맥을 완화하기 위한 마취 전 투약.
독성학: 콜린성 약물(유기인제, 카바메이트, 무스카린 버섯, 남조류 중독 등) 과다 복용 시 생명을 구하는 해독제.
호흡기: 기관지 수축 질환의 보조 치료.

임상 팁: 아트로핀은 매우 효과적이지만, 일상적인 마취 전 투약 프로토콜에서는 사용이 감소하고 있으며, 혈액뇌장벽을 잘 통과하지 않고 작용 시간이 더 긴 글리코피롤레이트(Glycopyrrolate)와 같은 대체제나 표적 사용이 선호되고 있습니다.

작용 기전

Atropine acts as a competitive, reversible antagonist at muscarinic acetylcholine receptors (mAChRs) (M1-M5 subtypes) located at postganglionic parasympathetic neuroeffector sites.

By blocking acetylcholine (ACh) binding, it inhibits parasympathetic tone:

Cardiovascular: Blocks vagal tone at the SA and AV nodes → increases heart rate (positive chronotropy) and improves AV conduction (positive dromotropy).
Secretions: Inhibits glandular M3 receptors → decreases salivary, bronchial, and gastric secretions.
Smooth Muscle: Relaxes smooth muscle in the GI, urinary, and biliary tracts → decreases motility and spasm.
Ocular: Blocks M3 receptors in the pupillary sphincter and ciliary muscle → causes pupillary dilation (mydriasis) and paralysis of accommodation (cycloplegia).

Mechanistic Note: At very low doses, atropine can cause a paradoxical, transient bradycardia due to the blockade of presynaptic M1 autoreceptors on vagal postganglionic fibers, which normally inhibit ACh release. High doses may also block nicotinic receptors at autonomic ganglia and the neuromuscular junction.

안전성·주의사항

금기사항

Narrow-angle glaucoma
Synechiae (adhesions) between the iris and lens
Hypersensitivity to anticholinergic drugs
Tachycardias secondary to thyrotoxicosis or cardiac insufficiency
Myocardial ischemia
Unstable cardiac status during acute hemorrhage
GI obstructive disease or paralytic ileus
Severe ulcerative colitis
Obstructive uropathy
Myasthenia gravis (unless used to reverse adverse muscarinic effects secondary to therapy)

부작용

Dry mouth (xerostomia)
Dysphagia
Constipation
Vomiting
Thirst
Urinary retention or hesitancy
CNS stimulation, drowsiness, ataxia, seizures, respiratory depression
Blurred vision, pupil dilation (mydriasis), cycloplegia, photophobia
Sinus tachycardia (at higher doses)
Paradoxical bradycardia (initially or at very low doses)
Hypertension or hypotension
Arrhythmias (ectopic complexes)
Decreased gut motility (can induce colic in horses or rumen stasis in cattle)

주의

General Precautions:

Use with extreme caution in patients with known or suspected GI infections; decreased motility can prolong retention of causative agents or toxins.
Use with extreme caution in patients with autonomic neuropathy.
Use cautiously in patients with hepatic or renal disease, geriatric or pediatric patients, hyperthyroidism, hypertension, CHF, tachyarrhythmias, prostatic hypertrophy, or esophageal reflux.

Species-Specific Warnings:

Neonates: Reportedly not effective in treating bradycardias in puppies <14 days old or kittens <11 days old. May damage hypoxic myocardia in neonates.
Rabbits: Glycopyrrolate is preferred, as ~40% of rabbits possess endogenous atropinesterase, rendering atropine ineffective.
Horses: Systemic use may decrease gut motility and induce colic. May reduce arrhythmogenic doses of epinephrine.
Cattle: May result in inappetence and rumen stasis persisting for several days.
Food Animals: FARAD recommends a 28-day meat and 6-day milk withdrawal time when used at doses up to 0.2 mg/kg.