Pharmacy Phriday #8: Atropine with Ketamine for Conscious Sedation of Pediatrics

<p><strong>Educational Pearls:</strong></p> <div dir="ltr"> <ol> <li>Atropine has been shown to reduce hypersalivation as well as nausea and vomiting induced by ketamine sedation.</li> <li>Atropine can increase the occurrence of a transient rash, as well as tachycardia.</li> <li>There are no guidelines that recommend for or against atropine use in pediatric patients undergoing ketamine induced sedation.</li> <li>Ultimately, it is the providers decision to include atropine when performing ketamine sedation.</li> <li>Pediatric dosing for atropine is 0.01mg/kg IM.</li> </ol> </div> <div dir="ltr"><strong style= "font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;"> References</strong><span style= "font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;"> </span></div> <div dir="ltr"> <p> </p> <ol> <li>Heinz P, Geelhoed GC, Wee C, Pascoe EM. Is atropine needed with ketamine sedation? A prospective, randomised, double blind study. Emerg Med J. 2006 Mar;23(3):206-9. doi: 10.1136/emj.2005.028969. PMID: 16498158; PMCID: PMC2464444. </li> <li>Chong JH, Chew SP, Ang AS. Is prophylactic atropine necessary during ketamine sedation in children? J Paediatr Child Health. 2013 Apr;49(4):309-12. doi: 10.1111/jpc.12149. Epub 2013 Mar 15. PMID: 23495827. </li> <li>Shi J, Li A, Wei Z, Liu Y, Xing C, Shi H, Ding H, Pan D, Ning G, Feng S. Ketamine versus ketamine pluses atropine for pediatric sedation: A meta-analysis. Am J Emerg Med. 2018 Jul;36(7):1280-1286. doi: 10.1016/j.ajem.2018.04.010. Epub 2018 Apr 5. PMID: 29656945. </li> </ol> <p><em>Presented and Summarized by Devan Naughton, 4th year pharmacy student | Edited by Ruben Marrero-Vasquez</em></p> </div>