acls medications refresher

7/31/2019 ACLS Medications Refresher

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ACLS Medications

Roy Smith


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Oxygen

Uses Increase supply of oxygen HYPOXIC EVENT

DoseAirway / BVM NR

Simple mask Cannula


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Nitroglycerine

Uses Vasodilatation AMI, CP, CHF

Dose Metered dose 0.4 mg SL 5 mcg/min increase every 5-10 min until desired

clinical response

Relative contraindications Viagra within 24 hrs Rt Ventricular Infarctions


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Morphine

Uses Decreases myocardial oxygen consumption

AMI,CHF

Dose 2-10 mg IVP


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Naloxone

Mechanism of action Competitive opioid antagonist

Uses Opioid antagonism

MS OD

Dose 0.4 2.0 mg


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Aspirin

Uses Stops platelet aggregation, Asprin blocks

secretion of thromboxane A2 from the

platelets, there by inhibiting plateletagregation.

Dose 162 - 325 mg oral


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Medications to manage cardiacdysrhythmias

Adenosine Amidarone Atropine Betablockers

Atenolol Esmolol Labetalol Metoprolol propranolol

Calcium channel blockers Verapamil Diltiazem


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Medications to manage cardiacdysrhythmias cont.

Lidocaine Magnesium Procainamide sotalol


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Adenosine

Mechanism of action Found naturally in all body cells

Slows sinus rate, slows conduction through

the AV Node.

Uses SVT, PERSISTENT PSVT

Dose 6,12,12 mg RIVP


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Amiodarone

Mechanism of action BLOCKS- sodium, potassium, sympathetic,

and calcium channels

Uses VT VF WCT

Dose 300 mg VT with pulse

150 mg x 2


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Atropine

Mechanism of action Parasympatholytic

Uses bradycardias

Dose

0.5 1.0 mg 0.04 mg/kg max dose


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Beta BlockersLopressor

Mechanism of action Blocks beta receptors decreasing contractileforce of the heart.

Uses Reduces BP, Reduces incidence ofdysrrythmias, Reduces risk of sudden death.

Dose 2.5-5 mg q 2-5 min up to 15 mg


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Calcium Channel BlockersCardizem

Mechanism of action Blocks calcium channels reducing contractile forse and

conduction through AV node

Uses Atrial tachycardias

A-fib, a-flutter

Dose Cardizem

0.25 g/kg


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Digoxin

Mechanism of action Suppresses SA node, prolongs AV conduction,positive inotrope, incr peripheral resistance viainhibition of Na/K-ATPase making more Ca

available to actin & myosin Uses

Reduces conduction through the AV node.

Dose 0.4-0.6 mg IV x1


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Epinepherine

Mechanism of action Stimulates both alpha and beta receptors, increaseschronotropic, iontropic effects. Increased contraction,rate, and vascular resistance.

Uses Pulseless cardiac arrest

Pea, asystole, vfib, vtach Dose

1 mg IVP 3-5 min


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Lidocaine

Mechanism of action Blocks sodium channels, decreasing myocardialcontraction

Uses Raises VF threshold

antiarrythmic

Dose 1-1.5 mg/kg IVP

3 mg/kg max


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Magnesium Sulfate

Mechanism of action Smooth muscle relaxant, reduces calcium

action in action potential.

Uses Torsades

Dose 1-2 G over 1-2 minutes


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Procainamide

Mechanism of action Decreases conduction velocity in the atria, ventricles,and His- Purkinje system, significant portionmetabolized by acetylprocainamide having significant

antiarrythmic activity.

Uses Stable SVT, A-Fib, A-Flutter, WPW, WCT, VT,VF

Dose 20-30 mg/min


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Medications used to improvecardiac output and blood pressure

Dopamine Norepinepherine Dobutamine

Vasopressin Calcium chloride Sodium nitroprusside


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Dopamine

Mechanism of action Immediate precursor of norepinephrine in thebody.

Uses Cardiogenic shock

Dose

2-20 mcg/kg/min


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Norepinepherine

Mechanism of action Perpherial vasoconstrictor, coronary arterydilator.

Uses Cardiogenic shock

Dose

8-12 mcg/min


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Dobutamine

Mechanism of action Stimulate alpha1, beta 1, and beta2, positiveinotrope.

Uses Cardiogenic shock due to chf, pulmonary

congestion.

Dose 2-20 mcg/kg/min


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Vasopressin

Mechanism of action Antidiuretic hormone Binds to specific receptors vasporessin receptors, V1(V1a,

V1b),V2

Vasopressin exerts a greater vasoconstrictive effect than api,causes a greater artery tonevasopressin does not increasemyocardium oxygen consumption, or excessive lactateproduction.

Uses Alternative to EPI in VT/VF

Dose 40 units 1 time.


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Calcium chloride

Mechanism of action Provides more calcium ion for an increase incontractile force.

Uses Hyperkalemia, hypocalcemia, calcium channel

blocker toxicity, magnesium toxicity, beta-

blocker toxicity

500-1000 mg IV over 5-10 minutes


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Sodium Bicarbonate

Mechanism of action Increases plasma bicarbonate, buffershydrogen.

Uses Hyperkalemia, acidosis, tricyclic,

antidepressant OD, hypercarbic lactic acidosis.

Dose 1 meq/kg


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Furosemide

Mechanism of action Inhibits reabsorption of sodium in the loop ofhenly,

Uses Loop diuretic

Dose 1 mg/kg 80 max

acls medications refresher

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