ACLS MEDICATION
1.Bradycardia
Atropine
INDICATION
1.First drug for symptomatic sinus
bradycardia
2. Organophosphate poisoning; large
dose may be needed
Dopamine
infusion
1.Second-line drug for symptomatic
bradycardia
2. Hypotension with signs and
symptoms of shock
1l.Cardiac arrest due to :
VF (ventericular fibrallation); VT
(ventricular tachycardia ); asystole; PEA
2.Symptomatic bradycardia
After atropine; alternative to dopamine
3.Severe hypotension
4. Anaphylaxis; severe allergic reactions
Combine with large fluid volume;
corticosteroids; antihistamines
Epinephrine
infusion
DOSE
1. 0.5 mg IV every 3-5 minutes as needed; max. of 3
mg.
Use shorter dosing interval and higher doses in severe
clinical situations
2. Endotracheal Administration 2-3 mg diluted in 10
mL water or NS
3. Organophosphate Poisoning Large doses (2-4 mg or
higher) may be necessary
Infusion at 5-20 mcg/kg/min.
Titrate to patient response; taper slowly
Cardiac arrest 1 mg (1:10,000) IV/IO every 3-5 min.
High dose up to 0.2 mg/kg for specific drug OD’s
Infusion of 2-10 mcg/min.
Endotracheal of 2-2.5 times normal dose
SC/IM 0.3-0.5 mg
ACLS MEDICATION
2.Tachycardia
Adenosine
Indication
1st drug SVT (supraventricular
tachycardia).
Metoprolol
1.Second-line agent for SVT refractory to
adenosine
2.Emergency antihypertensive therapy
for acute hemorrhagic or ischemic
stroke
Controlling ventricular rate in atrial
fibrillation or flutter
1.Life threatening dysrhythmias
VF/pulseless VT unresponsive to shock,
CPR, and vasopressor
2. VF/VT
Diltiazem
Amiodarone
Lidocaine
Alternative to amiodarone in VF/VT
cardiac arrest
Magnesium Sulfate Cardiac Arrest
Vasopressin
Alternative to epinephrine in adult
refractory VF/VT
Alternative to epinephrine in asystole
Dose
6 mg rapid push followed by 20 mL flush
May repeat at 12 mg rapid push every 1-2 minutes if
unsuccessful
15-20 mg (0.25 mg/kg) IV over 2 minutes
1.Life threatening dysrhythmias
150 mg over 10 minutes. May repeat every 10 minutes
as needed
2. VF/VT – 300 mg IV/IO in 20-30 mL NS. Can follow with
ONE dose of 150 mg in 3-5 minutes, if needed
Cardiac Arrest : Initial dose is 1-1.5 mg/kg
Refractory VF 0.5-0.75 mg/kg in 5-10 min. Max 3 mg/kg
1-2 g over 5-20 min.
Single dose (one dose only) of 40 u that replaces either
the 1st or 2nd dose of epinephrine. Epinephrine can be
resumed 3-5 minutes after
ACLS MEDICATION