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 Antimuscarinic agent used for treatment of SLUDGE (salivation, lacrimation, urination, defecation, and gastroenteritis) that accompanies OP and carbamate insecticide toxicity.

 Competes with acetylcholine at the postganglionic parasympathetic sites.

 Dose 0.2–2 mg/kg. One‐quarter of the dose should be given IV and the remainder IM or SC. The dose will likely need to be repeated; heart rate and secretions should be used to guide redosing.

 It is important that enough atropine be provided, especially in large overdoses of OP or carbamates. Atropine should be given despite initial tachycardia, in order to adequately compete with acetylcholine. Without adequate therapy for OP toxicosis, patients may drown in their own secretions.