ACLS Pharmacology Lecture PDF

Question 1

Preferred routes of administration for ACLS medications (2)

Answer 1

-IV or IO

Question 2

In cardiac arrest (Vfib and pulseless v tach) persists after at least 1 attempt of defib and 2 min of CPR, what should be administered?

Answer 2

Epi 1mg IV q3-5 min while CPR is performed continuously

Question 3

What may be administered in cardiac arrest (VF or pulseless VT) unresponsive to defibrillation, CPR, and epinephrine?

Answer 3

Amiodarone, 300mg IV, 150mg IV repeat dose

Question 4

When is magnesium sulfate (2g IV) used in cardiac arrest?

Answer 4

Polymorphic ventricuar tachycardia with torsades de pointes

Question 5

Asystole/PEA are nonshockable rhythms that after initiating CPR for 2 min can give this drug

Answer 5

1mg epi every 3-5min IV/IO

Question 6

1st line treatment for nonstable bradycardia (BPM <50)

Answer 6

atropine .5mg bolus repeat every 3-5 min max 3 mg

Question 7

2nd line treatment for nonstable bradycardia (BPM <50)

Answer 7

Dopamine infusion 2-10mcg/kg/min or epi (same dosing)

Question 8

1st line treatment for nonstable tachycardia (BPM >150)

Answer 8

Immediate syncronized cardioversion narrow regular 50-100J or narrow irregular 120-200J

Question 9

1st line treatment for narrow QRS stable SINUS tachycardia (BPM>150)

Answer 9

No medication indicated, just monitor

Question 10

1st line treatment for narrow QRS stable nonsinus tachycardia (BPM>150)

Answer 10

Adenosine 6mg IV push by 20mL saline flush, 2nd dose 12mg IV (warn the patient they will experience transient chest discomfort, dyspnea, flushing, short lived tho)

Question 11

2nd line treatment for narrow QRS stable nonsinus tachycardia (BPM>150) or control of heart rate in stable patients tachycardic patients (2)

Answer 11

• Rate control with IV nondihydropyradine ca2+ channel blocker such as diltiazem or verapamil
• B blocker (metoprolol, atenolol, labetalol)

Question 12

1st line treatment for wide QRS stable nonsinus tachycardia (BPM>150)

Answer 12

Amiodarone (150mg/10min)

Question 13

Morphine sulfate function

Answer 13

Opioid analgesic that also dilates blood vessels, IV morphine controls pain of MI and improves hemodynamics by promoting vasodilation, and reduces anxiety, useful in ACS but need to be cautious about respiratory depression, can reverse with naloxone (2-4mg IV)

Question 14

Lidocaine function

Answer 14

Suppress ventricular fibrillation by raising threshold of fibrillation via same ca2+ channel activity that inhibits pain, can be used as alternative to amiodarone in cardiac arrest (Vfib or pulseless vtach)

Question 15

B blocker use in ACLS

Answer 15

Used to suppress supraventricular tachycardia (atrial fib and flutter) and reduce myocardial ischemia in MI,

Question 16

Atropine adverse effects (4)

Answer 16

• blurred vision
• dilated pupils
• dry mouth/nose
• difficulty urinating

Question 17

Concurrent administration of ca2+ channels with IV B blockers can cause severe….

Answer 17

…hypotension

Question 18

These drugs antagonize effects of adenosine (2) and this drug potentiate it

Answer 18

• caffeine and theophylline

- dipyridamole

Question 19

Sotalol function

Answer 19

B Blocker that has antiarrhythmic properties but also proarrhythmic properties that are very pronounced and is thus indicated in treatment of ventricular and supraventricualr arrhythmias without structural heart disease