ACLS meds

Question 1

Adenosine (adenocard)

Answer 1

Use: SVT
Dose: (1) 6mg IV Push (+20mL NS flush)
(2) 12mg IV Push

Question 2

Amiodarone (cordarone)

Answer 2

Use: VF, VT, atrial dysrhythmias
Dose:
cardiac arrest: (1) 300mg IV/IO
(2) 150mg IV/IO 3-5min later

tachy algorithm:
(1) 150mg IV over 10 minutes q10min
(2) 360mg/6hrs
(3) 540mg/18hrs

Question 3

Atropine

Answer 3

Use: symptomatic bradycardia
Dose: 1mg IV q3-5min (MAX: 3mg)
*ETT = 1-2mg in 10mL NS

Question 4

Dopamine (Indocin)

Answer 4

Use: hypotension not r/t hypovolemia
Dose: (1) 5-20 IV mcg/kg/min

       (1 Alt) IV infusion: 400-800mg in 250mL D5W = 1600-3200mcg/mL -> infuse @ 2-5 mcg/kg/min and titrate up to 50mcg/kg/min

Question 5

Epinephrine (Adrenalin)

Answer 5

Use: VF, pVT, PEA, Asystole
Dose:
For the above: 1mg IV q3-5 min
*ETT = 2-2.5mg in 10mL NS q3-5min

   IV infusion (bradycardia) = 1mg in 250mL D5W/NS @ 2-10mcg/minute + titrate

Question 6

Lidocaine (xylocaine)

Answer 6

Use: VF, VT, cardiac arrest (amiodarone sub)
Dose: (1) 1-1.5 mg/kg IV/IO
(2) 0.5-0.75 mg/kg q5-10min (may be repeated MAX 3 TIMES or 3mg/kg)

       *ETT = 2-4mg/kg in 10mL NS
        * IV Infusion = 1g in 250mL OR 2g in 500 mL D5W over 5-60 minutes

Question 7

Magnesium

Answer 7

Use: torsades
Dose: (1) cardiac arrest: 1-2g IV/IO in 10mL D5W over 5-20min

       (1) nonarrest: 1-2g IV in 50-100mL D5W over 5-60 minutes

Question 8

Norepinephrine (Levophed)

Answer 8

Use: hypotension (NOT FIRST LINE)
Dose: 0.1-0.5mcg/kg/min- titrate up to MAX 30 mcg/min

      *IV infusion: 4mg in 250mL D5W

Question 9

Sodium Bicarbonate

Answer 9

Use: hyperkalemia, metabolic acidosis
Dose: (1) 1mEq/kg IV Push
(2) subsequent doses based on bicarbonate levels

Question 10

Phenylephrine (Neo)

Answer 10

Use: hypotension
Dose: 20-400 mcg/min (let’s say <200 mcg/min- can bolts 40-100mcg beforehand)
Mix: 80mg in 250 mL

Question 11

Dobutamine (Dobutrex)

Answer 11

Use: ^ CO (for HF)
Dose: 2.5-10 mcg/kg/min

Question 12

Procainamide

Answer 12

Use: decrease PVCs (antiarrythmia)
Dose: (1) Loading: 20-50 mg/min (MAX 17 mg/kg)
(2) Maintenance: 1-4 mg/min

*avoid if prolonged QT or CHF

Question 13

Sotalol

Answer 13

Use: antiarrythmic, hypertension
Dose: 100 mg (1.5 mg/kg) over 5 min

*avoid if prolonged QT interval

Question 14

Lorazepam (Ativan)

Answer 14

Use: sedation
Dose: 2mg IV Push (before cardioversion)

Question 15

Dexmedetomidne (Precedex)

Answer 15

Use: sedation
Dose: (1) Loading: 0.5-1 mcg/kg
(2) maintenance: 0.2-0.7 mcg/kg (can be titrated up to 0.7)

Question 16

Midazolam (Versed)

Answer 16

Use: sedation
Dose: 0.5-1mg over 2 minutes (wait 2-3 min)

Question 17

Labetalol (normadyne)

Answer 17

Dose: 5-10 mcg IV Push

Question 18

Esmolol (brevibloc)

Answer 18

Dose: IV DRIP
(1) loading: 0.25-0.5 mg/kg IVP over 1 min
(2) 0.05-0.1 mg/kg/min for 4 minutes

Question 19

Diltiazem (cardizem)

Answer 19

Use: atrial flutter, atrial fibrillation
Dose: 0.25 mg/kg (average 20mg/dose) over 2 min

Question 20

Verapamil (Calan, Veralan)

Answer 20

Dose: 2.5-5mg over 2 min

Question 21

Vasopressin

Answer 21

Dose: 0.03-0.04 units/min (IV drip)

can also be give intranasally, subQ, iv drip