ACLS Cardiac Algorithms drug review

Question 1

What drugs are used in the bradycardia algorithm

Answer 1

Atropine, Epinephrine, Dopamine

Question 2

On your first dose of atropine, what amount are you giving the patient?

Answer 2

1 mg bolus

Question 3

What is the max dosage of atropine that you can give in the bradycardia algorithm?

Answer 3

3mg

Question 4

How often would you be administering atropine?

Answer 4

Every 3-5 mins

Question 5

What is the risk of under dosing a pt with atropine?

Answer 5

They can have worsened bradycardia

Question 6

Why is atropine not as effective for severe heart blocks, especially if they’re lower down the heart in origin?

Answer 6

1. atropine doesn’t stimulate the heart directly, it denies the function of the parasympathetic system on the AV and SA nodes.
2. It does nothing in regards to bypassing the heart blocks

Question 7

How does atropine work?

Answer 7

1. Atropine is an antimuscarinic, it blocks M2 receptors that are stimulated by ACh from the parasympathetic nervous system.
2. M2 receptors stimulation causes bradycardia. By blocking these receptors, the parasympathetic system is unable to stimulate a decrease in heart rate, so the sympathetic stimulus becomes dominant, causing a large increase in HR.

Question 8

What dosage of epinephrine is used in the bradycardia algorithm?

Answer 8

2-10mcg/min IV infusion

Question 9

What dosage of dopamine is used in the bradycardia algorithm?

Answer 9

5-20mcg/kg/min IV infusion

Question 10

What are the different doses for the dose dependent effects of dopamine?

1. renal dose
2. cardiac dose
3. vasopressor dose

Answer 10

1. [1-5 ug/kg/min] = renal dose

• (vasodilation + splanchnic arteries vasodilation = increased UO)

2. [5-10 ug/kg/min] = cardiac dose

• (B1 effects dominate causing increased HR+contractility = increased CO, plus increased UO because of increased renal perfusion)

3. [10-20 ug/kg/min] = vasopressor dose

• (vasoconstriction occurs)

Question 11

What drugs are used in the tachycardia algorithim?

Answer 11

1. Adenosine
2. Procainamide
3. Amiodarone
4. Sotalol