ACLS Drug Chart

Question 1

Adenosine

Answer 1

First bolus 6 mg over 1-3 seconds followed by saline bolus 20 cc; then elevate the extremity. Second dose 12 mg in 1-2 minutes if needed.
No third dose recommended.

Question 2

Amiodarone: Cardiac Arrest

Answer 2

300 mg. Consider additional 150 mg in 3-5 minutes. Maximum cumulative dose of 2.2 g in 24 hours.

Infusion: 150 mg/100 cc over 1st 10 minutes (15 mg/min)

Question 3

Amiodarone: Wide Complex Tachycardias

Answer 3

Stable Patient only

1) Rapid Infusion: 150 mg over 1st 10 minutes (15 mg/min). May repeat rapid infusion every 10 minutes as needed.

2) Slow Infusion: 360 mg over 6 hours (1 mg/min).

3) Maintenance Infusion: 540 mg over 18 hours (0.5 mg/min).

Question 4

Atenolol (Tenormin)

Answer 4

5 mg over 5 minutes. Wait 10 minutes. 2nd dose of 5 mg over 5 minutes.

Question 5

Atropine

Answer 5

1 mg every 3-5 minutes as needed. Maximum dose of 3 mg.

Question 6

Diltiazem (Cardizem): Acute Rate Control

Answer 6

15-20 mg (0.25 mg/kg) over 2 minutes.
May repeat in 15 minutes at 20-25 mg (0.35 mg/kg) over 2 minutes.

Question 7

Diltiazem (Cardizem): Maintenance Infusion

Answer 7

5-15 mg/hour, titrated to heart rate.

Question 8

Dopamine

Answer 8

Infusion Rate: 5-20 mcg/kg/min, titrate to patient response.

Question 9

Epinephrine: PEA

Answer 9

1 mg (10 ml of 1:10,000 solution) every 3-5 minutes. Follow with 10-20 cc flush.

Question 10

Epinephrine: Bradycardia Infusion

Answer 10

Atropine ineffective.
2-10 mcg/min, titrate to patient response.

Question 11

Labetalol

Answer 11

10 mg over 1-2 minutes. May repeat or double dose every 10 minutes. Maximum 150 mg.

Question 12

Lidocaine: Cardiac Arrest (VF/VT)

Answer 12

1) 1-1.5 mg/kg
2) 0.5-0.75 mg/kg

Question 13

Lidocaine: Stable VT, Wide Complex Tachycardia

Answer 13

1) 1-1.5 mg/kg
2) 0.5-0.75 mg/kg
3) Maintenance Infusion 1-4 mg/min (30-50mcg/kg/min)

Question 14

Magnesium Sulfate: Cardiac Arrest

Answer 14

1-2 g (2-4 ml of 50% solution) diluted in 10 ml D5W

Question 15

Magnesium Sulfate: Torsades de pointes (NOT in arrest)

Answer 15

Loading dose of 1-2 g in 50-100 ml D5W over 5-60 minutes.
Follow with 0.5-1 g/hr titrated to control.

Question 16

Metoprolol (Lopressor)

Answer 16

5 mg slow at 5 minute intervals.
Total dose 15 mg.

Question 17

Procainamide

Answer 17

20-50 mg/min infusion.
Maximum dose of 17 mg/kg.
Continue until arrhtyhmia suppresses, hypotension occurs, or QRS duration increases 50%.
AVOID with prolonged QT, or if CHF presents.

Question 18

Sodium Bicarbonate (for VF cardiac arrest)

Answer 18

1 mEq/kg, 2nd dose 0.5 mEq/kg in 10 minutes
1) Known pre-existing hyperkalemia
2) Metabolic Acidosis
3) Tricyclic Antidepressant Overdose

Question 19

Sotalol

Answer 19

100mg (1.5mg/kg) over 5 minutes. Avoid if prolonged QT

Question 20

Verapamil

Answer 20

1st dose 2.5 - 5.0 mg over 2 minutes.
2nd dose 5 - 10 mg if needed in 15 - 20 minutes.

Maximum dose 20 mg.