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ACLS Dosages Antiarrhythmics
ACLS Dosages Antiarrhythmics
15
Pharmacology
Professional
08/21/2012

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Term
Atropine Sulfate
Definition
•Intravenous bolus 0.5 to 1 mg every 3 - 5 minutes until symptoms have resolved
•The full vagolytic dose of .04mg/kg or 3mg total
•Asystole, a dose of 1mg every 3 - 5 minutes
Term
Epinephrine
Definition
•Standard dose is 1 mg
•Every 3 – 5 minutes during CPR
•Endotracheal tube is 2 times the normal IV dose
Term
Lidocaine
Definition
•Endotracheal tube administration
•2 - 2.5 times the intravenous dose (2 - 2.5mg/kg)
•Administer 100mg/10ml syringe
•Follow with several forceful insufflations of the ambu bag.
•In non-cardiac arrest an initial bolus of 1-1.5 mg/kg drip (2-4mg/min)
•2nd bolus of 0.5mg/kg after 10mins
•Additional bolus 0.5 - .75 mg/kg every 5-10min for a maximum dose of 3mg/kg
•Start a Lidocaine drip of 2 - 4 mg/min.
•Refractory V-fib or pulseless V-tach the initial bolus should be 1 - 1.5mg/kg
Term
Amiodarone (Cordarone)
Definition
•V-fib/V-tach arrest give 300mg IV bolus •Atrial or ventricular arrhythmias •150mg over 10min •Then, 1mg/min for 6hrs then 0.5mg/min •May repeat the 150mg slow bolus as needed •Maximum total dose is 2gm/day
Term
Procainamide (Pronestyl)
Definition
•For PVCs and V-tach dose is 20 - 30mg/min until: •Arrhythmia is suppressed •Hypotension occurs •QRS widens by 50% •17mg/kg is given •1.2 gm for 70kg patient) •In urgent situations up to 30mg/min can be given until the 17mg/kg is given. •The maintenance, continuous infusion rate is 1 - 4mg/min
Term
Magnesium Sulfate
Definition
•For V-fib or V-tach:
•1 - 2gm diluted in 100ml normal saline administered over 1 - 2 minutes
•Post MI:
•Loading dose = 1 - 2gm in 50 - 100 ml administered over 5 - 60 minutes
Term
Adenosine
Definition
•6 mg rapid bolus over 1 - 3 sec followed by a 20ml flush
•If no response within 1 - 2 min administer 12mg in the same manner.
•If there is still no response, administer another 12mg.
Term
Verapamil (Isoptin)
Definition
Initial dose is 2.5 - 5.0 mg IV over 2 minutes
Repeat doses are 5 - 10 mg given every 15 - 30 min to a maximum of 20mg.
Supplied in 5mg and 10mg ampules or syringes
Protect from light
Discard if precipitated or discolored
Term
Diltiazem (Cardizem)
Definition
•Initial bolus of 0.25 mg/kg (20 mg for the average patient) IV over 2 minutes
•For control of ventricular response rate in A-fib or A-flutter
•The bolus dose is followed by a maintenance infusion of 5 - 15 mg/hr titrated to the heart rate.
•Infusion duration exceeding 24hrs and infusion rates above 5mg/hr not recommended
•If satisfactory ventricular rate control is not achieved
•A 0.35 mg/kg bolus over 2 - 5 minutes may be given after initial bolus.
•For PSVT give a bolus of 0.25mg/kg over 2 minutes.
•If PSVT fails to convert:
•A second bolus of 0.35mg/kg can be given 15 minutes after the initial dose.
Term
Procardia (Niphedipine)
Definition
•10 - 20 mg TID for control of angina
•Maximum dosage is 180mg/day ()
Term
Propranolol
Definition
•IV 0.1mg/kg divided into 3 equal dosages at 2 - 3 minute intervals
•Rate of administration should not exceed 1mg/min.
Term
Metoprolol
Definition
•5 - 10mg slow IV push at 5 minute intervals
•Total of 15mg
Term
Esmolol
Definition
•5gm/500ml of normal saline or D5W for a concentration of 10mg/ml
•Loading dose
•250 - 500 mcg/kg/min for 1 min
•Followed by 25 - 50 mcg/kg/min infusion
•Titrate at 25 - 50 mcg/kg/min every 5 minutes to effect
Term
Atenolol (Tenormin)
Definition
•5 mg IV •If initial dose well tolerated repeat in 10 minutes •If IV dose well tolerated then give 50mg orally 10 minutes after last bolus. •Repeat in 12 hours.
Term
Calcium Chloride
Definition
•100mg/ml packaged in a 10ml prefilled syringe or ampule of a 10% solution
•2 - 4mg/kg IVP repeated every 10 minutes
•Calcium gluceptate
•500 - 700mg
•Calcium gluconate
•500 - 800mg
•Calcium chloride is preferred because it produces consistently higher plasma levels.
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