ACLS Drugs Flashcards by Jeffery Miller

Drugs given by peripheral I.V. route take how long to reach central cirulation?

1 to 2 min.

How well did you know this?

Not at all

Perfectly

If any drug is given peripherally I.V., administer it as follows:

Give as bolus inj. unless otherwise specified
Follow with 20mL flush
Elevate extremity for 10-20 sec

How well did you know this?

Not at all

Perfectly

Vasopressors

What drugs are used during cardiac arrest?

Epinephrine (1:10,000)

Vasopressin

How well did you know this?

Not at all

Perfectly

Vasopressors

Optimize what functions?

Cardiac output and blood pressure.

How well did you know this?

Not at all

Perfectly

Epinephrine

What dose is used during cardiac arrest?

1 mg IV/IO every 3-5 min

^Remember:

^{With peripheral inj. 20mL flush and elevate 10-20 sec}

How well did you know this?

Not at all

Perfectly

Vasopressin

What dose is used during cardiac arrest?

40 units once

May replace 1^st or 2^nd Epi dose.

How well did you know this?

Not at all

Perfectly

What drug & doseage is given in VF/ pulseless VT, unresponsive to CPR, Shock, and Vasopressors?

Amiodarone

^{(Class III antiarrhythmic)}

300 mg inital dose

_Remember:

_{With peripheral inj. 20mL flush and elevate 10-20 sec}

How well did you know this?

Not at all

Perfectly

Amiodarone

If needed one additional dose can be considered for VF/ Pulseless VT, what is the dose?

Amiodarone

^{(Class III antiarrhythmic)}

150 mg inital dose

_Remember:

_{With peripheral inj. 20mL flush and elevate 10-20 sec}

How well did you know this?

Not at all

Perfectly

If amiodarone is not available, providers may administer what other antiarrhythmic drug and dosage for VF/ Pulseless VT?

Lidocain

^{(Class 1B antiarrhythmic)}

1 to 1.5 mg/kg IV/IO inital dose

_Remember:

_{With peripheral inj. 20mL flush and elevate 10-20 sec}

How well did you know this?

Not at all

Perfectly

Lidocaine

Repeat if indicated, during cardiac arrest from VF/VT, at what doseage?

0.5 to 0.75 mg/kg every 5-10min

to a max accumulation of 3mg/kg

_Remember:

_{With peripheral inj. 20mL flush and elevate 10-20 sec}

How well did you know this?

Not at all

Perfectly

Maximum total accumulation dosage of Lidocaine?

3 mg/kg

How well did you know this?

Not at all

Perfectly

What drug and dosage is given to recurrent or persistent VF/ pulseless VT associated with torsades de pointes(TdP)?

Magnesium Sulfate

1 to 2 g IV/IO diluted in 10 mL D₅W, given over 5 to 20 min.

How well did you know this?

Not at all

Perfectly

Magnesium sulfate

Indicated for patients with known or suspected low serum magnesium due to?

Alcoholism
Malnutrition
Hypomagnesemic states

How well did you know this?

Not at all

Perfectly

Magnesium sulfate

What is the dosage for TdP with a pulse or AMI with hypomagnesemia?

Loading Dose:

1 - 2 g mix in 50 to 100 mL of D₅W, infused over 5 to 60 min.

Follow up Dose:

0.5 to 1g /hr (titrate to control TdP)

How well did you know this?

Not at all

Perfectly

Drugs that may be used in Immediate Post-Cardiac Arrest Care?

Oxygen

Epinephrine IV infusion

Dopamine IV infusion

Norepinephrine IV infusion

How well did you know this?

Not at all

Perfectly

During Immediate Post-Cardiac Arrest Care when treating hypotention (SBP <90 mmHg).

What is first-line treatment of choice?

IV Bolus 1-2 L NS or LR

How well did you know this?

Not at all

Perfectly

Epinephrine

Infusion dosage for persistent hypotention (SBP <90 mmHg) after inital NS or LR bolus?

0.1 - 0.5 mcg/kg/min IV infusion

titrated to achieve minimum SBP >90mmHg or a MAP >65 mmHg

How well did you know this?

Not at all

Perfectly

Dopamine

Infusion dosage for persistent hypotention (SBP <90 mmHg) after inital NS or LR bolus?

5 - 10 mcg/kg/min IV infusion

titrated to achieve minimum SBP >90mmHg or a MAP >65 mmHg

How well did you know this?

Not at all

Perfectly

Treatment for severe hypotention (SBP <70mmHg) after inital NS or LR bolus?

Norepinephrine

0.1 - 0.5 mcg/kg/min IV infusion

titrated to achieve minimum SBP >90mmHg or a MAP >65 mmHg

How well did you know this?

Not at all

Perfectly

Drugs and dosages that can be given during PEA?

Epinephrine 1mg IV/IO q 3-5min

Vasopressin 40units once

Other medication based upon review of Hs & Ts

_Remember:

_{With peripheral inj. 20mL flush and elevate 10-20 sec}

How well did you know this?

Not at all

Perfectly

Immediate medication treatment for Acute Coronary Syndromes?

O₂ , if SpO2 <94%, at a rate 4L/min, titrate
Asprine (4 baby) =324 mg
Nitroglycerin 1 tab or spray every 3-5 min (for a total 3)
Mophrine, if chest discomfort unresponsive to nitro.

How well did you know this?

Not at all

Perfectly

Asprine

How is given to ACS patients with nausea, vomiting, active peptic ulcer disease, or other GI tract disorder?

300 mg suppositories

How well did you know this?

Not at all

Perfectly

Nitroglycerin

Contraindications?

SBP <90 mmHg
HR must be 50 -100 bpm
Phosphodiesterase use past 24h (Viagra)
Tadalafil use past 48h (Cialis)

How well did you know this?

Not at all

Perfectly

Analgesic drug and dosage of choice for STEMI ?

Morphine Sulfate

2 - 4 mg IV every 5 - 10 min

_Remember:

_{With peripheral inj. 20mL flush and elevate 10-20 sec}

How well did you know this?

Not at all

Perfectly

Analgesic drug and dosage for symtomatic UA/NSTEMI not responsive to nitro?

Morphine Sulfate 1 - 5 mg IV prn _Remember: _{With peripheral inj. 20mL flush and elevate 10-20 sec}

Naloxone HCl Typical IV dose for?

0.04 -0.4 mg, titrate until ventilation adequate.

Naloxone HCl Typical IM/SQ dose for?

0.4 - 0.8 mg

Drugs that may be used during Adult Bradycardia (with pulse)?

Atropin Dopamine infusion Epiephrine infusion

First-line drug and dosage of choice for Adult Bradycardia (w/ pulse) ?

Atropine inital dose: 0.5 mg IV/IO bolus _Remember: _{With peripheral inj. 20mL flush and elevate 10-20 sec}

Atropine Repeat dosages for Adult Bradycardia (w/ pulse)?

Atropine 0.5 mg IV/IO q 3 - 5min _Remember: _{With peripheral inj. 20mL flush and elevate 10-20 sec}

Atropine Maximum accumulating dosage?

3 mg

Second-line treatment options for symptomatic Adult Bradycardia (w/ pulse) after Atropine is ineffective?

# Choose of one of the following: TCP Dopamaine Epinephrine

Dopamine Infusion dosage for symptomatic Adult Bradycaria (w/pulse)?

2 - 10 mcg/kg/min

Epinephrine Infusion dosage for symptomatic Adult Bradycaria (w/pulse)?

2 - 10 mcg/min

Atropine Maximum accumulating dosage?

0.04 mg/kg (3mg)

Atropine Maximum accumulating dosage?

0.04 mg/kg (3mg)

Atropine Dosage of \<0.5 mg may result in?

Paradoxically, rsulting in further slowing of the heart.

Atropine Do not rely on for Adult Bradycardia associated with what type(s) of AV blocks?

2nd Degree type II or 3rd Degree (complete block)

Atropine Use caustiously in the presence of acute coronary ischemia or MI, why?

Atropine use increase HR that may worsen ischemia or increase infarct size.

Perferred inital interventions treatment for terminating narrow QRS adult tachycardia?

Vegal Maneuvers ^{(valsalva or carotid sinus massage)} Adenosine Expert consult / Transport

Vagal maneuvers alone terminate about what percentage of SVT?

25% ------ Adenosine is required for the remainder.

Adenosine Increase AV block and will terminate approx. what percent of reentry arrhythmias within 2 min.?

90%

Adenosine Will not terminate what arrhythmias?

Atrial flutter or Atrial Fibrillation ^{but will slow AV conduction allowing identifaction of flutter and fibrillation waves.}

Adenosine Can be used as test to determine AFib or AFlutter presence to do what?

Change therapy to beta-blockers or calcium channel blockers.

What inital drug and dosage is treatment for narrow-QRS SVT not responsive to vegal maneuvers?

Adenosine 6 mg IVP (lg vein) over 1sec ^Remember: ^{With peripheral inj. 20mL flush and elevate 10-20 sec}

Adenosine If SVT does not convert 1-2 min, give second dose at?

Adenosine 12 mg IVP (lg vein) over 1sec ^Remember: ^{With peripheral inj. 20mL flush and elevate 10-20 sec}

Adenosine Contraindicated in patients with?

* Poison/ drug induced tachycardia. * 2^_nd and 3^rd degree heart blocks * Asthma; *may cause bronchospasm*

Calcium Channel Blocker What are the two major categories?

Dihydropyridine Non dihydropyridine

Calcium Channel Blocker What category affects the peripheral vasculature causing dialation, with minimal SA/AV effect?

Dihydropyridine

Calcium Channel Blocker What category decreases HR and myocardial contractility, slows SA/AV conduction?

Non dihydropyridine

Calcium Channel Blocker What alternative drug(s) (after adenosine) used to terminate reentry SVT with narrow QRS associated with AFib / AFlutter?

Verapamil or Ditiazem

Diltiazem What is the inital dose for acute rate control of stable narrow-QRS tacycardia nonresponsive to vagal maneuvers or adenosine?

15 -20 mg (0.25 mg/kg) IV bolus over 2min. wait 15 min. _Remember: _{With peripheral inj. 20mL flush and elevate 10-20 sec}

Diltiazem May give an addtional dose of for acute rate control in 15min, what's the dose?

20 - 25 mg (0.35 mg/kg) IV bolus over 2min. _Remember: _{With peripheral inj. 20mL flush and elevate 10-20 sec}

Verapamil What is the dose for acute rate control of stable narrow-QRS tacycardia nonresponsive to vagal maneuvers or adenosine?

5 mg IV bolus over 3min every 15min. till accumulated dose of 30 mg _Remember: _{With peripheral inj. 20mL flush and elevate 10-20 sec}

Calcium Channel Blocker Shoudn't be given to patients with?

SBP \<90 mmHg & Wide-QRS tachycardias

*Beta* Blocker What alternative drug(s) (after adenosine) used to terminate reentry SVT with narrow QRS associated with AFib / AFlutter?

Propranolol

Propranolol ^{(Beta Blocker)} What is the dosage for acute rate control of stable narrow-QRS tacycardia nonresponsive to vagal maneuvers or adenosine?

0.5 - 1 mg IV bolus over 1min repeated as needed to accumulated dosage of 0.1 mg/kg _Remember: _{With peripheral inj. 20mL flush and elevate 10-20 sec}

What are the antiarrhythmic infusions used for stable wide-QRS tachycardia?

Procainamide Amiodarone Sotalol

Procainamide What is the infusioin dose for recurrent VF/VT stable wide-QRS tacycardia?

20 mg/min IV infusion to accumulated max dose of 17 mg/kg

Procainamide What are the indication to stop infusion?

Arrhythmia suppression Hypotention QRS widens by 50% Total max accumulated dose, 17 mg/kg, is given

Amiodarone What is the rapid infusioin dose for recurrent life-threating VT wide-QRS tacycardia arrhythmias?

150 mg IV over 10 min. repeat q 10 min PRN after arrhythmia termination follow with maint. infusion 1 mg/min for first 6h

Amiodarone What is the slow infusioin dose for recurrent life-threating VT wide-QRS tacycardia arrhythmias?

360 mg IV over 6hrs ^{(1mg/min for 6hrs)}

Sotalol What is the infusioin dose for recurrent life-threating VT wide-QRS tacycardia arrhythmias?

100 mg (1.5mg/kg) over 5min. ^{avoid if prolonged QT}