- ALS DRUGS - Flashcards
State the action of Adrenaline
- Stimulates alpha, beta 1&2 receptors resulting in cardiac stimulation. Acts on:
- alpha (causing vasoconstriction)
- beta 1 (causing increase in HR, increase in force of contractility)
- beta 2 (causing bronchodilation)
List the indications for adrenaline in ALS
- VF, pulseless VT, (after second shock, then every second loop) & PEA (initial then after every second loop
- After atropine with bradyarrythmias
- Severe hypotension
- Anaphylaxis
Outline the adult dose of Adrenaline in ALS
- 1mg in either 1:1,000 or 1:10,000 in arrest
- 10mcg/kg for anaphylaxis
- can also be nebulised, infusion, etc
Outline the paediatric dose of Adrenaline in PALS
10mcg/kg with a maximum dose of 1mg at a time
State the action of Amiodarone
- Class III anti arrhythmic drug
- prolongs phase 3 of the cardiac action potential (repolarization phase)
- Has effects on sodium, potassium and calcium channels
- This can slow cardiac tachyarrhythmias
List the indications for amiodarone in ALS
- Pulseless VT and VF (3rd shock)
- Prophylaxis of re-current VF/VT
Outline the adult dose of amiodarone in ALS
Dose @ 3rd shock - 300 mg.
Optional does @ 5th+ shock - 150 mg could be considered or an infusion.
Outline the paediatric dose of amiodarone in PALS
5mg/kg
State the action of Lignocaine
- acts as a sodium channel blocker
- acts in phase 0, preventing sodium influx and thus reducing occurrence of depolarization
List the indications for lignocaine in ALS
- VF/pulseless VT as an alternative to amiodarone
- Prophylaxis in the setting of recurrent VF or VT.
Outline the adult dose of lignocaine in ALS
1mg/kg bolus dose
Outline the paediatric dose of lignocaine in PALS
1mg/kg bolus dose
State the action of Atropine
- anticholinergic drug
- increase in symathetic nervous response
- increasing SA node automaticity and AV conduction
List the indications for atropine in ALS
- bradyarrythmias
Outline the adult dose of atropine in ALS
- 0.5 mg IV every 3-5 minutes as needed
- maximum total dosage that can be given is 3 mg
Outline the paediatric dose of atropine in PALS
- Atropine 0.02 mg/kg
- may repeat once; maximum single dose, 0.5 mg
List the indications for potassium in ALS
Persistent VF due to documented or suspected hypokalaemia
Outline the adult dose of potassium in ALS
A bolus of 5 mmol
Outline the paediatric dose of potassium in PALS
- 0.03 - 0.07 mmol/kg
- administered over several minutes
List the indications for magnesium in ALS
- ventricular tachyarrythmias associated with hypomagnesaemia
Outline the adult dose of magnesium in ALS
- bolus of 5 mmol of magnesium
- followed by infusion of 20 mmol over 4 hours
Outline the paediatric dose of magnesium in PALS
- 0.1-0.2 mmol/kg bolus
- followed by an infusion of 0.3mmol/kg over 4 hours
State the action of Calcium
- Essential for normal muscle and nerve activity
- Increases myocardial excitability and contractility and peripheral resistance
List the indications for calcium in ALS
- Hyperkalaemia
- Hypocalcaemia
- Overdose of calcium-channel blocking drugs.
Outline the adult dose of calcium in ALS
- bolus of 5-10 mL of 10% calcium chloride or gluconate
Outline the paediatric dose of calcium in PALS
- 0.2mL/kg of 10% calcium chloride
- 0.7mL/kg of 10% calcium gluconate
State the action of Sodium Bicarbonate
- Sodium bicarbonate is an alkalising solution
- which combines with hydrogen ions to form a weak carbonic acid
- This breaks down to produce CO2 and H2O
- reducing acidosis by acting as a buffer
List the indications for sodium bicarbonate in ALS
- Hyperkalaemia
- Treatment of documented metabolic acidosis (buffer)
- Overdose with tricyclic antidepressants
- Protracted arrest (greater than 15 mins)
Outline the adult dose of sodium bicarbonate in ALS
1mmol/kg, is initially given over 2-3 minutes, then as guided by arterial blood gases
Outline the paediatric dose of sodium bicarbonate in PALS
0.5-1 mmol/kg
