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ACLS drugs

QuestionAnswer
vasopressin MOA vasoconstrictor
vasopressin indication cardiac arrest
vasopressin dose only 1 dose 40 u IV/IO, may be used in place of 1st or 2nd dose of epinephrine, can be given through trachea (2 to 2.5 times IV amount)
adenosine MOA slows sinus rate, slows conduction time through AV node, can interrupt reentry pathways through AV node, half-life <10 seconds
adenosine indication stable narrow QRS regular tachycardias, unstable narrow QRS while prepping for synchronized cardioversion, stable regular wide QRS tachycardias
adenosine dose 6mg rapid IV over 1 minute, if no response in 1-2 minutes, push 12mg rapid IV, may repeat dose in 1-2 minutes, follow dose with 20mL NS flush, raise arm for 10-20 seconds, start IV as proximal to heart as possible
diltiazem MOA calcium channel blocker, relaxes coronary muscle, causes coronary vasodilation, decreased SA and AV conduction, increased refractoriness, lowers myocardial oxygen demands, lowers myocardial contractility
diltiazem indication stable narrow QRS tachycardia (after vagal maneuvers and adenosine), to control ventricular rate with atrial fibrillation and atrial flutter
diltiazem dose 0.25 mg/kg IV bolus over 2 minutes, wait 15 minutes, 0.35 mg/kg
dopamine MOA medium dose (cardiac dose) increases myocardial contractility, increases SA node rate, increases impulse conduction
dopamine indication symptomatic bradycardia, HTN after spontaneous circulation
dopamine dose continuous IV infusion 2-10 mcg/kg/minute
epinephrine MOA stimulates alpha (vasoconstriction), beta (increased force of contraction, increased heart rate, increased work load, increased O2 requirement), and beta2 receptors (relaxes bronchial smooth muscles and dilates vessels in major muscles)
epinephrine indication symptomatic bradycardia and hypotension, cardiac arrest, VFib, PVT, asystole, PEA
epinephrine dose bradycardia and hypotension - continuous infusion at 2-10 mcg/minute, cardiac arrest - 1 mg IV/IO with flush and repeat 1 mg every 3 to 5 minutes, can be administered through trachea, post-cardiac - continuous IV infusion 0.1 to 0.5 mcg/kg/minute
atropine MOA increases heart rate, increases conduction, relaxes bronchial smooth muscle, decreases body secretions, dilates pupils
atropine indication first choice for symptomatic bradycardia
atropine dose 0.5 mg IV every 3-5 minutes, max dose 3 mg total
magnesium sulfate MOA neurochemical transmission and muscular excitability
magnesium sulfate indications polymorphic VTach with prolonged QT
magnesium sulfate dose pulseless - 1-2 grams IV diluted in 10mL D5W, pulse - 1-2 grams IV diluted in 50-100mL over 15 minutes
amiodarone MOA decreased automaticity of SA and AV, slow conduction through AV and accessory pathways of patients with WPW syndrome, inhibits alpha and beta adrenergic receptors, vagolytic & calcium channel blocking properties, vasodilator may increase output
amiodarone indications pulseless VTach VFib (use after CPR, defib & vasopressor), stable narrow QRS tachycardias, AFib, stable monomorphic VTach, polymorphic VTach with normal QT
amiodarone dose pulesless VTach or VFib - 300 mg IV bolus, followed by 150 mg IV bolus, for all others loading dose 150mg over 10 minutes, may repeat every 10 minutes, max dose 2.2grams/24hours
lidocaine MOA decreases conduction in ischemic cardiac tissue without affecting normal conduction
lidocaine indication stable monomorphic VTach and pulseless VTach and VFib after defib and vasopressor - 2nd choice to amiodarone
lidocaine dose initial 1 to 1.5mg/kg IV/IO, repeat 0.5 to 0.75mg/kg in 5-10 minutes, max dose 3 mg/kg, maintenance 1-4mg/minute, tracheal 2-3mg/kg
aspirin MOA inhibits prostaglandin production and platelet agression
aspirin indication acute chest pain
aspirin dose 162-325 mg PO ASAP (maintenance 75-162mg/day)
nitropresside MOA vasodilation of venous & arteriolar smooth muscle, decreases BP, decreases preload and after load
nitropresside indication hypertensive crisis, cardiac pump failure, cardiogenic shock
nitropresside dose 0.3mcg to 10mcg/kg/minute
procanimide MOA prolongs effective refractory period and action potential duration in atria, ventricle and HIS, suppresses ectopy in A and V tissue, prolongs PR and QT, peripheral vasodilator
procanimide indication AFib, stable monomorphic VTach
procanimide dose 20-50mg/minute IV or 100mg every 5 minutes until: dysrhythmia resolves, hypotension, QRS prolongs greater than 50% of original width, max dose 17mg/kg, maintenance 1-4mg/minute
sotolol MOA decreased heart rate & AV nodal conduction, increased AV nodal refractoriness, prologs effective refractory period of A muscle, V muscle and accessory pathways in both anterograde and retrograde directions, a negative inotrope
sotolol indication stable monomorphic VTach
sotolol dose 1.5mg/kg IV slow over 5 minutes
nitroglycerin MOA increased coronary blood flow (dilates coronary arteries), vasodilation, decreased preload, decreased myocardial O2 needs
nitroglycerin indications/contraindications acute chest pain, angina, hypertension, CHF with PEA, contraindicated w/ Viagra, low BP, low HR
nitroglycerin dose establish IV, sublingual 0.3 to 0.4 mg every 5 minutes, 3 tabs total
morphine MOA CNS depressant
morphine indication STEMI or UA/NSTEMI
morphine dose STEMI 2-4 mg IV with increments of 2-8mg IV repeated at 5-10 minute intervals
morphine dose NSTEMI 1-5 mg IV AFTER nitro
dobutamine MOA synthetic catecholamine, direct-acting inotropic, stimulates beta1 preoducing hypertensive mild chonotropic, vasodilative and arrhythmogengic effects
dobutamine indication heart failure or decreased cardiac output, acute MI, bradyarrythmia heart block
dobutamine dose decreased cardiac output 0.5-1.0 mcg/kg/minute IV, maintenance 2-40mcg/kg/minute
dobutamine dose heart failure initial and maintenance initial 0.5-1.0 mcg/kg/minute IV, maintenance 2-40mcg/kg/minute, post cardiac arrest care 5-10mcg/kg/minute IV
activase (TPA) MOA converts plasminogen to plasmin, degrades clot-bound fibrin
activase (TPA) indication acute MI, acute ischemic stroke, PE
activase (TPA) dose acute MI 100 mg IV over 3 hours, 15 mg IV bolus over 2minutes then give .75mg/kg (max 50 mg) over 30 minutes, then .5mg/kg (max of 35 mg) over next hour
activase (TPA) dose acute ischemic stroke give within 3 hours of stroke, 0.9mg/kg IV over 1 hour, max dose 90 mg, give 10% of total dose as IV bolus over 1 minute, remaining 90% over the next hour
activase (TPA) dose PE 100mg IV over 2 hours
lasix MOA diuretic that blocks absorption of sodium and chloride in kidney tubules
lasix indication CHF with pulmonary edema and hypertensive crisis
lasix dose 0.5-1.0mg/kg IV/IO slowly, max 2mg/kg
valium MOA GABA inhibitor, benzodiazapine derivative
valium indication anti-convulsant and sedation
valium dose 5-15mg IV slowly
narcan MOA opioid antagonist
narcan indication overdose and comas
narcan dose 0.4-2mg give IV/IO, repeat every 2 minutes, max 10 mg
heparin MOA prevents prothrombin conversion to thrombin and fibrin to fibrinogen
heparin indication AFib, PE, AMI
Created by: BrandiLynn