How do the pharmacokinetics differ for sublingual atropine compared to intravenous atropine?
Schwartz MD et al. performed a randomized phase 1 crossover trial in healthy volunteers to assess the bioavailability and pharmacokinetics of a single dose of atropine given sublingually. Compared to IV atropine, the 1.0 mg sublingual dose produced 0.60 of the overall concentration of atropine over time. Tmax was 107.1 minutes for sublingual atropine compared to 2 min for intravenous atropine. While further study is needed, sublingual atropine may be a potential therapy in mild organophosphate poisoned patients.
Schwartz MD et al. Systemic bioavailability of sublingual atropine ophthalmic solution: a Phase I study in Healthy volunteers with implications for use as a contingency medical countermeasure. JMT 2022; 18:187-197.