cardiac drug doses

Question 1

Adenosine dose

Answer 1

Adult
1st dose- 6mg rapid IVP followed by 20cc NS flush
2nd Dose- 12mg rapid IVP (Proximal vein) followed by 20cc NS flush

Pedi
1st Dose 0.1mg/kg rapid push (proximal vein) IV/IO max 6 mg
2nd dose 0.2mg/kg rapid push, max dose 12 mg

Question 2

Amiodarone dose

Answer 2

VF/pulseless Vt- 300mg IV/IO, repeat dose 150mg IV/IO in 3-5 minutes PRN

Vt with pulse- 150mg IV/IO over 10 minutes.

Maintainance 1mg/min, first 6 hours then 0.5mg/min

PEDI
Vf/pulseless vt- 5mg/mg IV/IO max dose 300mg max total dose 15 mg/kg

Vt with pulse- 5mg/mg IV/IO over 20-60 minutes max dose 300 mg

Question 3

Diltiazem

Onset-3minutes
Peak-7 minutes
Duration- 1-3 hours
1/2 life- 2 hours

Answer 3

Dose

Adult 1st dose- 0.25mg/kg slow IV/IO over 2 minutes (usual dose 15-20mg)

2nd dose- 0.35 mg/kg
Maintainance dose 5-15mg/hr

Question 4

Metoprolol lopressor

Onset immediate
Peak 20 minutes
Duration 13-19 hours
1/2 life 3-4 hours

Answer 4

Dose
5mg IV/IO max total 15 mg

Indications:
Rapid ventricular rates >150 associated with afib/a flutter

PSVT refractory to Adenosine

Question 5

Lidocaine xylocaine

Onset <3 minutes
Peak 5-7 minutes
Duration- 10-20 minutes
1/2 life- 1.5-2 hours

Answer 5

Adult
Vf/pulseless vt- 
1st dose 1-1.5mg/kg IV/IO 
2nd dose 0.5mg/kg IV/IO 
Then 1-4mg/min

Vt with pulse- 0.5-1.5mg/kg IV/IO then 1-4 mg/min
Pedi
Vf/pulse vt
1mg/kg IVP, repeat after 15 minutes PRN
Maintainance 20-50mcg/kg/min