How often should atropine be repeated if the patient remains symptomatic after an initial atropine dose in pediatric organophosphate poisoning?

• A. Every 1 minute
• B. Every 2 minutes
• C. Every 5 minutes
• D. Every 10 minutes

Answer: (C)

Muscarinic symptoms from organophosphate poisoning respond to atropine, so you titrate by giving another dose at short, regular intervals and reassessing. The standard practice in pediatric care is to repeat atropine every 5 minutes until signs of muscarinic excess are controlled—airway secretions dry up, heart rate improves, and bronchospasm/bronchorrhea lessen. This 5-minute interval lets you quickly gauge the patient’s response and avoid both under-treatment and unnecessary delays. If symptoms persist despite adequate atropinization, additional therapies (such as pralidoxime) and supportive care are needed.