What is the treatment for adult hypersalivation due to Ketamine?

• A. Glycopyrrolate 2 mg IV
• B. Benadryl 50 mg IM
• C. Atropine: 1 mg IV/IM/IO
• D. Scopolamine 0.4 mg IV

Answer: (C)

Hypersalivation from ketamine is driven by stimulation of muscarinic receptors in the salivary glands, so the best approach is a rapid anticholinergic to block those receptors and reduce secretions. Atropine at 1 mg given IV, IM, or IO works quickly to dry oral secretions, and its effects come on fast enough to be useful in airway-related situations. Its widespread availability and use in acute care make it a practical first-line option for this scenario. While other anticholinergics can also reduce saliva, atropine offers a reliable, fast-acting, multi-route option, which is why it is preferred here. Benadryl doesn’t target salivary secretion specifically, and scopolamine, though effective, has heavier central nervous system effects and a longer, more sedating profile, making atropine the more suitable choice in many acute settings.