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ACLS Medications PDF
ACLS Medications PDF
Atropine
Dopamine infusion
Epinephrine infusion
Atropine
Mechanism of Action
Stimulates adrenergic
receptors; dose dependent.
Dopamine
Indications
Second-line drug for symptomatic bradycardia
Hypotension with signs and symptoms of shock
Precautions
Correct hypovolemia with volume before initializing
Use caution with cardiogenic shock and associated CHF
May cause tachydysrhythmias; excessive vasoconstriction
Don’t mix with sodium bicarbonate
IV Administration
Infusion at 5-20 mcg/kg/min.
Titrate to patient response; taper slowly
Epinephrine
Mechanism of Action
Severe hypotension
When atropine and pacing fail; hypotension accompanying
bradycardia; phosphodiesterase enzyme inhibitors
Anaphylaxis; severe allergic reactions
Combine with large fluid volume; corticosteroids;
antihistamines
Epinephrine
Precautions
May increase myocardial ischemia, angina, and oxygen
demand
High doses do not improve survival; may be detrimental
Higher doses may be needed for poison/drug induced shock
Dosing
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
SQ/IM 0.3-0.5 mg
Tachycardia
Adenosine
Diltiazem
Metoprolol
Amiodarone
Lidocaine
Magnesium Sulfate
Adenosine
Mechanism of Action
Decreases depolarization,
automaticity, and excitability of
ventricle during diastole by direct
action, reversing ventricular
dysrhythmias.
Lidocaine
Indications
Alternative to amiodarone in VF/VT arrest
Stable monomorphic VT
Malignant PVC’s
Can be used if Torsades is suspected
Contraindications/Precautions
Prophylactic use in AMI is contraindicated
Reduce maintenance dose in liver impaired patients
Discontinue infusion if toxicity develops
Lidocaine
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
Endotracheal dose 2-4 mg/kg
Perfusing Dysrhythmia
0.5-0.75 mg/kg up 1-1.5 mg/kg dosing range. Repeat if
necessary at lower range to total dose of 3 mg/kg
Maintenance Infusion
1-4 mg/min
Magnesium Sulfate
Mechanism of Action