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ACLS drugs
| Question | Answer |
|---|---|
| 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
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