ACLS Drugs dosages & uses
For poor perfusion with Bradycardia Treat with which first line treatment? - ANSWER:
Atropine 1mg IV
(repeat to a total of 3mg IV)
For poor perfusion with Bradycardia Treat, if the first line of treatment is ineffective, what
should be provided and what med should be given? - ANSWER: Transcutaneous
pacing
Dopamine 5-20mcg/kg/minute infusion
OR
Epinephrine 2-10mcg/min infusion
What is the first line drug for acute stable bradycardia and how do you administer it? -
ANSWER: Atropine given as 1mg IV q 3-5minutes (up to 3mg IV)
Hoe does Atropine work? - ANSWER: Reverses the cholinergic-mediated decreases in
the heart rate and AV node conduction
Which two AV block types will not respond to Atropine? - ANSWER: Mobitz type II
second-degree AV block and third-degree AV block
What is the preferred treatment for Mobitz type II second-degree AV block and third-
degree AV block? - ANSWER: TCP or B-adrenergic (dopamine, epinephrine) support
until transcutaneous pacing can be achieved
If only 0.5mg of IV Atropine is given what consequence could it have? - ANSWER: It
can further lower the HR
What can be used if bradycardia is unresponsive to Atropine? - ANSWER: B-adrenergic
infusions (dopamine or epinephrine)
What must you consider before giving B-adrenergic infusions in bradycardia? -
ANSWER: The pt's BP/intravascular volume status for hypovolemia
What can be given for bradycardia when vasoconstriction is not desired? - ANSWER:
Dobutamine (b-adrenergic agonist)
Epinephrine should be given at what dose/rate for Bradycardia? - ANSWER: 2-
10mcg/min
, Dopamine should be given at what dose/rate for Bradycardia? - ANSWER:
5-20mcg/kg/min
How does Transcutaneous Pacing (TCP) work and when should it be used? -
ANSWER: It delivers pacing impulses to the heart through skin via cutaneous
electrodes.
for unstable bradycardia (hypotension, AMS, shock, ischemic chest pain)
For light sedation within the RN scope of practice give which 3 things should be given
before TCP if the pt's condition allows for it? - ANSWER: -Parenteral narcotic
-Parenteral benzodiazepine
-Chronotropic infusion
How much of a safety margin (energy above the dose at which consistent capture is
observed) should you allow when using the transcutaneous pacemaker? - ANSWER: 2
mA
The HR that takes on clinical significance and is more likely to contribute to arrhythmia
in tachycardia is what rate? - ANSWER: 150/min or greater
What are the 7 rhythms associated with unstable tachycardia? - ANSWER: 1. Sinus
Tachycardia
2. Atrial fibrillation
3. Atrial Flutter
4. Superventricular Tachycardia (SVT)
5. Monomorphic Ventricular Tachycardia (giant shark teeth-looking)
6. Polymorphic Ventricular Tachycardia (Mutiple random shark teeth-looking)
7. Wide-complex tachycardia of uncertain type
What is the first line treatment for unstable tachycardia? - ANSWER: Immediate
Synchronized Cardioversion
if the QRS complex is ----seconds or greater, consider expert consultation. - ANSWER:
0.12 seconds
If the width of the ORs complex is 0.12 or less treat with what two things? - ANSWER:
Vagal maneuvers and Adenosine
What is the therapy for a narrow QRS with regular rhythm (4)? - ANSWER: -Vagal
maneuver
-give Adenosine
-give a B-blocker/calcium channel blocker
-consider expert consultation
For poor perfusion with Bradycardia Treat with which first line treatment? - ANSWER:
Atropine 1mg IV
(repeat to a total of 3mg IV)
For poor perfusion with Bradycardia Treat, if the first line of treatment is ineffective, what
should be provided and what med should be given? - ANSWER: Transcutaneous
pacing
Dopamine 5-20mcg/kg/minute infusion
OR
Epinephrine 2-10mcg/min infusion
What is the first line drug for acute stable bradycardia and how do you administer it? -
ANSWER: Atropine given as 1mg IV q 3-5minutes (up to 3mg IV)
Hoe does Atropine work? - ANSWER: Reverses the cholinergic-mediated decreases in
the heart rate and AV node conduction
Which two AV block types will not respond to Atropine? - ANSWER: Mobitz type II
second-degree AV block and third-degree AV block
What is the preferred treatment for Mobitz type II second-degree AV block and third-
degree AV block? - ANSWER: TCP or B-adrenergic (dopamine, epinephrine) support
until transcutaneous pacing can be achieved
If only 0.5mg of IV Atropine is given what consequence could it have? - ANSWER: It
can further lower the HR
What can be used if bradycardia is unresponsive to Atropine? - ANSWER: B-adrenergic
infusions (dopamine or epinephrine)
What must you consider before giving B-adrenergic infusions in bradycardia? -
ANSWER: The pt's BP/intravascular volume status for hypovolemia
What can be given for bradycardia when vasoconstriction is not desired? - ANSWER:
Dobutamine (b-adrenergic agonist)
Epinephrine should be given at what dose/rate for Bradycardia? - ANSWER: 2-
10mcg/min
, Dopamine should be given at what dose/rate for Bradycardia? - ANSWER:
5-20mcg/kg/min
How does Transcutaneous Pacing (TCP) work and when should it be used? -
ANSWER: It delivers pacing impulses to the heart through skin via cutaneous
electrodes.
for unstable bradycardia (hypotension, AMS, shock, ischemic chest pain)
For light sedation within the RN scope of practice give which 3 things should be given
before TCP if the pt's condition allows for it? - ANSWER: -Parenteral narcotic
-Parenteral benzodiazepine
-Chronotropic infusion
How much of a safety margin (energy above the dose at which consistent capture is
observed) should you allow when using the transcutaneous pacemaker? - ANSWER: 2
mA
The HR that takes on clinical significance and is more likely to contribute to arrhythmia
in tachycardia is what rate? - ANSWER: 150/min or greater
What are the 7 rhythms associated with unstable tachycardia? - ANSWER: 1. Sinus
Tachycardia
2. Atrial fibrillation
3. Atrial Flutter
4. Superventricular Tachycardia (SVT)
5. Monomorphic Ventricular Tachycardia (giant shark teeth-looking)
6. Polymorphic Ventricular Tachycardia (Mutiple random shark teeth-looking)
7. Wide-complex tachycardia of uncertain type
What is the first line treatment for unstable tachycardia? - ANSWER: Immediate
Synchronized Cardioversion
if the QRS complex is ----seconds or greater, consider expert consultation. - ANSWER:
0.12 seconds
If the width of the ORs complex is 0.12 or less treat with what two things? - ANSWER:
Vagal maneuvers and Adenosine
What is the therapy for a narrow QRS with regular rhythm (4)? - ANSWER: -Vagal
maneuver
-give Adenosine
-give a B-blocker/calcium channel blocker
-consider expert consultation
