Commonly Used Medications in ACLS นพ.สุจริ ก ั ษ์ ศรีบูรพา

Commonly Used Medications in ACLS นพ.สุจริ ก ั ษ์ ศรีบูรพา

Adenosine Uses : Supraventricular Tachycardia (SVT) Dosage : 1st dose 6 mg rapid IV push followed by saline bolus, 2nd dose 12 mg rapid IV push in 1-2 minutes (double syringe) Side Effects : Headache, dizziness, metallic taste, dyspnea, hypotension, bradycardia or palpitations, nausea, flushing, sweating

Amiodarone Uses : Unstable VT with pulses, VF, VT without pulse and unresponsive to shock Dosage : 300 mg rapid bolus with 2nd dose of 150 mg if necessary to a maximum of 2.2 grams over 24 hours Side Effects : significant hypotension, dizziness bradycardia, torsades de pointes, tremors

Atropine Uses : Symptomatic bradycardia, organophosphate overdoses Dosage : Bradycardia: 0.5 mg IV every 3-5 minutes with 3 mg max dose; May be given by ETT Side Effects : flushing, blurred vision, dry mouth, photophobia, pupil dilation, constipation, urinary retention

Dopamine Uses : Can be given in bradycardia after Atropine, Can be given for Systolic BP 100 mm Hg with signs of shock Dosage : 2 to 20 mcg/kg per minute infusion titrated to response Side Effects : Headache, palpitations, PVC, VT, SVT, nausea/vomiting

Epinephrine Uses : Cardiac arrest, Anaphylaxis, Symptomatic bradycardia after atropine, Shock when pacing and atropine are not effective Dosage : Cardiac arrest: 1.0 mg (1:10000) IV or 2-2.5 mg (1:1000) per ETT every 3 to 5 minutes; follow with 0.1-0.5 mcg/kg/min infusion titrated to response Symptomatic bradycardia or shock: 2-10 mcg/minute infusion titrated to response Side Effects : Tremors, dizziness, SVT, VT, palpitations, chest pain, hypertension, nausea, vomiting, hyperglycemia, hypokalemia, vasoconstriction

Lidocaine Uses : Cardiac arrest from VF or Ventricular Tachycardia, Wide complex tachycardia (QT prolong) Dosage : Cardiac Arrest: 1-1.5 mg/kg IV bolus; may repeat twice at half dose in 5-10 minutes to total of 3mg/kg; followed with infusion of 1-4 mg per minute infusion Wide complex tachycardia with pulse: 0.5-1.5 mg/kg IV; may repeat twice at half dose in 5-10 minutes to total of 3mg/kg; followed with infusion of 1-4 mg per minute infusion Side Effects : Seizures, bradycardia, dyspnea, respiratory depression, nausea, vomiting, headache, dizziness, tremor, drowsiness, tinnitus, blurred vision, hypotension, rash

Magnesium Sulfate Uses : Torsades de pointes; Hypo- magnesemia; Digitalis toxicity Dosage : Cardiac arrest due to hypomagnesemia or Torsades: 1-2 gram IV bolus Torsades with a pulse: 1-2 gram IV over 5-60 minutes followed by infusion at 0.5-1 gram per hour IV Side Effects : confusion, sedation, weakness, respiratory depression, hypotension

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