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ACLS Meds
ACLS - Summer Sem 2011
54
Medical
Graduate
06/28/2011

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Cards

Term
Epi Indications?
Definition
Cardiac Arrest
Sxs Bradycardia
Hypotension
Anaphylaxis
Asthma
Term
Epi Contraindications?
Definition
HTN, Angina, Hyperthyroidism
Term
Two methods of Epi supply?
Definition
1:10,000 (IV/IO)
1: 1,000 (ET)
Term
Epi dose for Cardiac Arrest?
Definition
1 mg q 3 -5 min
Term
Epi dose for anaphylaxis?
Definition
0.5mL IM inj for adults 0.3mL IM inj for peds
Term
Epi dose for Asthma?
Definition
0.3-0.5 SQ inj
Term
Indications for Lidocaine?
Definition
VT/VF
Cardiac Arrest
PVC
Term
Contraindications for Lidocaine?
Definition
Allergy, Bradycardia, second and third degree heart block, idioventricular rhythms
Term
SE of Epi?
Definition
Tachycardia
HTN
Term
Lidocaine supplied how?
Definition
IV solution = 2% concentration (100mg/5mL)
Term
Dosing for arrhythmic conversion using lidocaine?
Definition
1-1.5 mg/kg
Reduce by ½ for patients > 70, CHF, Shock
If 1.5 mg dose put maintenance drip at 2.0 (0.5 higher than was needed to convert them)
Term
SE of lidocaine?
Definition
HTN, Numbness, Drowsy, Seizures (elderly and HF)
Term
Indications for Amiodarone?
Definition
VF & Pulseless VT refractory to CPR, Shock delivery and Vasopressor
SVT refractory to other tx
Term
Contraindications of Amiodarone?
Definition
Hypersensitivity,
cardiogenic shock,
second and third degree heart block,
marked sinus brady
Term
Method of supply of Amiodarone?
Definition
3 mL ampuls with 50mg/mL
Term
Dosage of Amiodarone for VT w/a pulse?
Definition
150mL drip over 10 min (3mL or 1 ampule given)
Term
Dosage of Amiodarone for SVT refractory to other tx?
Definition
150mL (Rapid or Slow??)
Term
Dosage of Amiodarone for VF?
Definition
first dose = 300 mg IV/IO push (2 ampuls or 6mL)
second dose = 150 mg IV/IO push (1 ampul or 3 mL)
Term
Indications for Adenosine?
Definition
SVT, WPW (Wolfe-Parkinson White),
Term
Contraindications to Adenosine usage?
Definition
Second and third degree heart block,
sick sinus syndrome, asthma pts
wandering pacemaker
Term
Methods of Adenosine supply?
Definition
Rapid IV bolus = 6mg/2mL prep
Term
Dose of Adenosine for tx of SVT?
Definition
First dose 6 mg Rapid IV bolus followed by 20mL NS flush
Second dose 12 mg Rapid IV bolus followed by 20mL NS flush
Term
SE of Adenosine?
Definition
Palpitations, facial flushing, HA, CP, hypotension, SOB, tingling and numbness of extremities
Term
Indications for Nitroglycerin?
Definition
Angina
CAD
ACS
Term
Contraindications of NTG?
Definition
Early MI,
severe anemia,
↑ ICP,
use of PD5 inhibitors
Term
Method of supply for Nitro?
Definition
Sub Lingual - 0.3 - 0.6mg/tab
Spray - 400mcg per spray
Term
Dosing of Nitroglycerin for ACS or Angina?
Definition
SL - One 0.4mg tab q 5 min until pain is relieved
Spray - 1 MID q 5 min until pain is relieved
Term
SE of Nitro?
Definition
HA, flushing, lightheaded, dizziness, CP, Pale skin
Term
Indications for Morphine Sulfate?
Definition
CP unresponsive to nitrate
Pulmonary edema
Term
Contraindications of Morphine?
Definition
Significant respiratory depression, paralytic ileus
Term
Method of supply for Morphine?
Definition
1mg/mL (10mL and 30mL)
Term
dosing of Morphine for ACS with CP unresponsive to Nitro?
Definition
Initial dose 2-4 mg over 1 to 5 minutes every 5 to 30 minutes
Repeat dose 2 to 8 mg at 5 to 15 minute intervals
Term
SE of Morphine?
Definition
Respiratory depression, hypotension,
Term
FIRST-LINE Tx (pharmacological) for VF or pulseless VT?
Definition
Epinephrine 1mg rapid infusion followed by 20mL NS bolus
Term
SECOND-LINE vasopressor for VF or pulseless VT?
Definition
Vasopressin 40 units IV/IO push
Term
Tx for VF or pulseless VT refractory to CPR, shock and vasopressor?
Definition
Amiodarone
- 1st Dose = 300mg IV/IO push (followed by 20mL NS bolus)
- 2nd dose = 150mg IV/IO push (followed by 20mL NS bolus)
Term
FIRST-LINE Tx (pharmacological) for symptomatic bradycardia (not caused by hypoglycemia or hypovolemia)?
Definition
Atropine 0.5mg IV every 3 - 5 min
Term
SECOND-LINE Tx (pharmacological) for symptomatic bradycardia (not caused by hypoglycemia or hypovolemia)? (two of them)
Definition
Dopamine 2-10mcg/kg per min
Epinephrine 2 - 10mcg/kg per min
Term
SECOND-LINE non-pharmacological tx for symptomatic bradycardia (not caused by hypoglycemia or hypovolemia)?
Definition
Transcutaneous Pacing (begin at rate of 70bpm and current of 70J) - Make sure to confirm electrical and mechanical capture
Term
FIRST-LINE Tx (pharmacological) for Asystole or PEA?
Definition
Epinephrine 1mg q 3 - 5 min (followed by 20mL NS bolus)
Term
FIRST-LINE Tx for SYMPTOMATIC tachycardia w/pulse and narrow regular rhythm?
Definition
narrow regular = SVT
Valsalva/Vagal or Adenosine 6mg as rapid IV push followed by 20mL NS bolus. (IF rhythm doesn't convert give 12mg of Adenosine)
Term
FIRST-LINE Tx for SYMPTOMATIC tachycardia w/pulse and narrow irregular rhythm?
Definition
Narrow Irregular = A-fib
Synchronized Cardioversion 120J (120J to 200J for Biphasic) OR 200J for Monophasic
Term
FIRST-LINE Tx for SYMPTOMATIC tachycardia w/pulse with wide regular rhythm?
Definition
wide, regular rhythm = V-Tach (w/pulse) or SVT
Synchronized Cardioversion with 100J
Term
FIRST-LINE Tx for SYMPTOMATIC tachycardia with wide irregular rhythm?
Definition
wide irregular = PVT, a-fib with aberrancy
Tx with UNsynchronized Defibrillation Dose
Biphasic 200J - 300J
Monophasic 360J
Term
FIRST-LINE Tx for UNsymptomatic tachycardia w/pulse and regular narrow QRS?
Definition
Adenosine 6mg rapid IV infusion followed by 20mL NS push (second dose of 12mg may be necessary if 1st dose is unsuccessful)
Term
FIRST-LINE Tx for UN-Symptomatic tachycardia w/pulse and wide, regular and monomorphic rhythm?
Definition

Amiodarone - 150mg over 10 min (Repeat as needed if VT reoccurs)

Maint. Dose = 1mg/min for 6 hrs

Term
FIRST-LINE Tx for UN-Symptomatic tachycardia w/pulse and with wide, polymorphic VT?
Definition
Magnesium sulfate
-Loading dose of 1 - 2g mixed in 50 to 100mL of D5W over 5 to 60 min
Term
FIRST-LINE Tx for UN-Symptomatic tachycardia w/pulse and wide complex?
Definition
Amiodarone
1st dose - 150mg over 10 min; repeat as needed if VT reoccurs.
Maint Infusion - 1mg/min for first 6 hrs
Term
SECOND-LINE Tx for UN-Symptomatic tachycardia w/pulse and wide regular QRS?
Definition
Procainamide - 20 -50mg/min until arrhythmia suppressed, hypotension occurs, QRS duration increases (>50%) Sotalol - 100mg (1.5mg/kg) over 5 min
Term
FIRST-LINE Tx for ACS?
Definition
O-Oxygen
A - ASA 325mg chewable
N - 1 MID of Nitro spray or 0.4mg SL tab q 5 min
M - Morphine 2- 4 mg titrated to effect (dilute in 10cc and push over 10 min.
Term
Mainstay tx for STEMI?
Definition
early reperfusion w/ fibrinolytic or PCI
Term
Absolute contraindications for fibrinolytic therapy?
Definition
Intracranial hemorrhage
AV malformation
Intercranial neoplasm
Ischemic stroke w/in last 3 months
Suspected aortic dissection
Active bleeding or bleeding diathesis
Significant closed head trauma or facial trauma w/in 3 mon
Term
Treatment for ST depression or t-wave inversion?
Definition
Nitro or Heparin; PCI (Stent, drill, balloon)
Term
Treatment for ischemic stroke?
Definition
tPA (altepase) 0.9mg/kg (Max dose 90mg)
- 10% of med delivered in bolus over 1 min
- 90% over 60 min
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