ACLS Drugs dosages & uses
QUESTIONS AND ANSWERS
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
QUESTIONS AND ANSWERS
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
