Atropine can be given at peak dose to reach the target heart rate, as it works by blocking the effects of excess acetylcholine and helps in clearing bronchial secretions in nerve agent poisoning.
It is true that atropine may be given at peak dose if the target heart rate is not reached. Atropine acts as an antagonist to muscarinic acetylcholine receptors, which means it blocks the effects of excess acetylcholine. When dealing with nerve agent poisoning, the endpoint of atropine administration is the clearing of bronchial secretions. Similarly, when used in other situations like cardiac stimulation, atropine might be administered to reach a target heart rate when other measures fail or are insufficient.