ACLS Drugs Flashcards
Adenosine Indications
First drug. Stable narrow SVT.
Consider for unstable narrow-complex reentry tachycardia.
Regular and monomorphic wide-complex tachycardia, previously defined as reentry SVT
Adenosine Dosage
Mild reverse trendelenburg position before administration
Initial bolus of 6mg given rapidly over 1-3 seconds, followed by NS bolus 20mL
Second dose of 12mg can be given 1-2 minutes later
Amiodarone Indications
VF/pulseless VT unresponsive to shock delivery, CPR, and a vasopressor
Recurrent, hemodynamically unstable VT
Amiodarone Contraindications/Precautions
Rapid infusion may lead to hypotension
Amiodarone Dosage for VF/pVT Cardiac Arrest Unresponsive to CPR, Shock, Vasopressor
1st Dose: 300mg IV/IO push
2nd Dose: 150mg IV/IO push
Amiodarone Dosage for life threatening arrhythmias
Max cumulative: 2.2g IV over 24hrs
Rapid Infusion: 150mg IV over first 10min. May Repeat every 10 min.
Slow Infusion: 360mg IV over 6 hrs
Maintenance Infusion: 540mg IV over 18 hrs(0.5mg/min)
Atropine Indications
1st drug for symptomatic sinus brady
Organophosphate poisoning
Atropine Precautions/Contraindications
Use caution in presence of myocardial ischemia and hypoxia
Avoid in hypothermic bradycardia
Doses
Atropine Dosage Bradycardia
0.5mg IV every 3-5min, not to exceed total of 0.04mg/kg (3mg)
Atropine Organophosphate Dosage
Extremely large doses (2-4 mg or higher)
Dopamine Indications
2nd drug for symptomatic bradycardia
Use for hypotension (70-100 mmHG) with signs and symptoms of shock
Dopamine Precautions
Correct hypovolemia with volume replacement before initiating dopamine
Caution in cardiogenic shock with CHF
May cause tachyarrhythmias
Do not mix with sodium bicarbonate
Dopamine Dosage
Usual infusion rate is 2-20mcg/kg per minute, titrate to pt response
Epinephrine Indications
Cardiac arrest, VF, pVT, asystole, PEA
Symptomatic bradycardia, after atropine alternative infusion to dopamine
Severe hypotension. When pacing and atropine fail, when hypotension accompanies bradycardia, or with phosphodiesterase enzyme inhibitor
Anaphylaxis, severe allergic reactions
Epinephrine Precautions/Contraindications
Raising BP and Increasing heart rate may cause myocardial ischemia, angina, and increased myocardial O2 demand
Epinephrine Cardiac Arrest Dosage
IV/IO 1mg (10mL of 1:10000) administrated every 3-5min during resuscitation. Follow each dose with 20mL flush
Higher Doses up to 0.2mg/kg may be used for specific indications
Continuous infusion: initial rate 0.1 to 0.5mcg/kg per min, titrate to response
ET route: 2-2.5mg diluted to 10mL NS
Epinephrine Profound Bradycardia of Hypotension Dosage
2-10mcg per min infusion, titrate to response
Lidocaine Indications
Alternative to amiodarone in Cardiac arrest from VF/pVT
Stable monomorphic VT with preserved ventricular function
Stable polymorphic VT with normal baseline QT interval and preserved LV function when ischemia is treated and electrolyte balance is corrected
Lidocaine Contraindication
Prophylactic use in AMI
Lidocaine Cardiac Arrest from VF/pVT Dosage
Initial 1-1.5 mg/kg
Refractory VF, may give 0.5 to 0.75 mg/kg IV
Max 3 doses or total of 3mg/kg
Lidocaine Perfusing Arrhythmia
Stable VT, wide complex tachycardia of uncertain type
Doses ranging from 0.5 to 0.75 mg/kg and up to 1 to 1.5 mg/kg
Repeat 0.5 to 0.75 mg/kg every 5-10min, max 3mg/kg
Lidocaine Maintenance Infusion
1-4 mg per minute
Magnesium Sulfate Indications
Cardiac arrest only if torsades de pointes or suspected hypomagnesemia is present
Life threatening ventricular arrhythmias due to digitalis toxicity
Mag Sulfate Precautions/Contraindications
Occasional fall in BP with rapid admin
Mag Sulfate Cardiac Arrest (Torsades/hypomagnesemia) Dosage
1 to 2 g (2 to 4 mL of a 50% solution diluted in 10mL given IV/IO
Mag Sulfate Torsades with a pulse or AMI with hypomagnesemia
Loading dose of 1 to 2 g mixed in 50-100 mL of diluent over 5-60 minutes
Follow with 0.5 to 1 g per hour IV
Sodium Bicarb Dosage
1meq/kg with suspected metabolic acidosis or Tricyclic overdose
Bradycardia w/ pulse
Prepare for TCP Atropine 0.5 mg up to 3 mg Consider EPI or Dopamine Dope: 2-10 mcg/kg/min EPI: 2-10mcg/min
Adenosine Basics
6mg, 12mg rapid IV/IO
Amiodarone Basics
VF/pVT: 300mg IV/IO once, 150mg in 3-5 minutes
Atropine Basics
Brady: 0.5mg IV/IO Max 3mg
Dopamine Basics
Brady: 2-10 mcg/kg/min drip
EPI Basics
VF/pVT 1 mg
Brady: 2-10 mcg/min drip
Lidocaine basics
VF/pVT 1-1.5mg/kg IV/IO (0.5-0.75mg/kg 2nd dose) max 3 doses or 3mg/kg
Hang drip after conversion number of bolus +1
Mag Sulfate Basics
VF/pVT 1-2g IV or dilute 1-2 g in 100mL NS over 1-2 minutes
Sodium Bicarb Basics
VF/pVT suspected metabolic acidosis or TCA overdose
5 H’s
Hypovolemia Hypoxia Hydrogen Ion Hyper/hypokalemia Hypothermia
5 T’s
Toxins Tamponade Tension Pneumothorax Thrombosis (pulmonary) Thrombosis (coronary)
Sync Cardioversion
50 Joules: SVT, A-Flutter
100 Joules: VT w/pulse
120 Joules: A-Fib
