ACLS Drugs dosages & uses
1. For poor perfusion with Bradycardia Treat with which first line treatment?-
: Atropine 1mg IV
(repeat to a total of 3mg IV)
2. For poor perfusion with Bradycardia Treat, if the first line of treatment is ineffective, what should
be provided and what med should be given?: Tran- scutaneous pacing
Dopamine 5-20mcg/kg/minute infusion OR
Epinephrine 2-10mcg/min infusion
3. What is the first line drug for acute stable bradycardia and how do you administer it?:
Atropine given as 1mg IV q 3-5minutes (up to 3mg IV)
4. Hoe does Atropine work?: Reverses the cholinergic-mediated decreases in the heart rate and
AV node conduction
5. Which two AV block types will not respond to Atropine?: Mobitz type II second-degree AV
block and third-degree AV block
6. What is the preferred treatment for Mobitz type II second-degree AV block and third-degree AV
block?: TCP or B-adrenergic (dopamine, epinephrine) sup- port until transcutaneous pacing can
be achieved
7. If only 0.5mg of IV Atropine is given what consequence could it have?: It can further lower the HR
8. What can be used if bradycardia is unresponsive to Atropine?: B-adrenergic infusions (dopamine
or epinephrine)
9. What must you consider before giving B-adrenergic infusions in bradycar- dia?: The pt's
BP/intravascular volume status for hypovolemia
10.What can be given for bradycardia when vasoconstriction is not desired?-
: Dobutamine (b-adrenergic agonist)
11.Epinephrine should be given at what dose/rate for Bradycardia?: -
2-10mcg/min
12.Dopamine should be given at what dose/rate for Bradycardia?: -
5-20mcg/kg/min
13.How does Transcutaneous Pacing (TCP) work and when should it be used?: It delivers
pacing impulses to the heart through skin via cutaneous elec- trodes.
for unstable bradycardia (hypotension, AMS, shock, ischemic chest pain)
14.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?: -Parenteral narcotic
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9
, ACLS Drugs dosages & uses
-Parenteral benzodiazepine
-Chronotropic infusion
15.How much of a safety margin (energy above the dose at which consistent capture is observed)
should you allow when using the transcutaneous pace- maker?: 2 mA
16.The HR that takes on clinical significance and is more likely to contribute to arrhythmia in
tachycardia is what rate?: 150/min or greater
17.What are the 7 rhythms associated with unstable tachycardia?: 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
18.What is the first line treatment for unstable tachycardia?: Immediate Syn- chronized
Cardioversion
19.------------------------------- if the QRS complex is seconds or greater, consider expert
consultation.-
: 0.12 seconds
20.If the width of the ORs complex is 0.12 or less treat with what two things?-
: Vagal maneuvers and Adenosine
21.What is the therapy for a narrow QRS with regular rhythm (4)?: -Vagal maneuver
-give Adenosine
-give a B-blocker/calcium channel blocker
-consider expert consultation
22.If SVT does not respond to Vagal maneuvers give in a large vein over 1
second.: Adenosine 6mg IV
23.what do you do with the pt immediately after giving Adenosine 6mg IV?: -
elevate the arm immediately
24.If SVT does not convert within 1-2 minutes after 1st dose of Adeosine 6mg, give .: A second
dose of Adenosine 12 mg IV.
25.Adenosine increased AV block and will terminate approx. % of reentry
arrhythmias within minutes.: 90%
2 minutes
26.What rhythms will Adenosine not terminate?: Atrial Flutter and Atrial Fibril- lation
but it can slow down the HR so these rhythms can be identified.
27.Adenosine is safe or unsafe during pregnancy?: SAFE
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9
1. For poor perfusion with Bradycardia Treat with which first line treatment?-
: Atropine 1mg IV
(repeat to a total of 3mg IV)
2. For poor perfusion with Bradycardia Treat, if the first line of treatment is ineffective, what should
be provided and what med should be given?: Tran- scutaneous pacing
Dopamine 5-20mcg/kg/minute infusion OR
Epinephrine 2-10mcg/min infusion
3. What is the first line drug for acute stable bradycardia and how do you administer it?:
Atropine given as 1mg IV q 3-5minutes (up to 3mg IV)
4. Hoe does Atropine work?: Reverses the cholinergic-mediated decreases in the heart rate and
AV node conduction
5. Which two AV block types will not respond to Atropine?: Mobitz type II second-degree AV
block and third-degree AV block
6. What is the preferred treatment for Mobitz type II second-degree AV block and third-degree AV
block?: TCP or B-adrenergic (dopamine, epinephrine) sup- port until transcutaneous pacing can
be achieved
7. If only 0.5mg of IV Atropine is given what consequence could it have?: It can further lower the HR
8. What can be used if bradycardia is unresponsive to Atropine?: B-adrenergic infusions (dopamine
or epinephrine)
9. What must you consider before giving B-adrenergic infusions in bradycar- dia?: The pt's
BP/intravascular volume status for hypovolemia
10.What can be given for bradycardia when vasoconstriction is not desired?-
: Dobutamine (b-adrenergic agonist)
11.Epinephrine should be given at what dose/rate for Bradycardia?: -
2-10mcg/min
12.Dopamine should be given at what dose/rate for Bradycardia?: -
5-20mcg/kg/min
13.How does Transcutaneous Pacing (TCP) work and when should it be used?: It delivers
pacing impulses to the heart through skin via cutaneous elec- trodes.
for unstable bradycardia (hypotension, AMS, shock, ischemic chest pain)
14.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?: -Parenteral narcotic
1/
9
, ACLS Drugs dosages & uses
-Parenteral benzodiazepine
-Chronotropic infusion
15.How much of a safety margin (energy above the dose at which consistent capture is observed)
should you allow when using the transcutaneous pace- maker?: 2 mA
16.The HR that takes on clinical significance and is more likely to contribute to arrhythmia in
tachycardia is what rate?: 150/min or greater
17.What are the 7 rhythms associated with unstable tachycardia?: 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
18.What is the first line treatment for unstable tachycardia?: Immediate Syn- chronized
Cardioversion
19.------------------------------- if the QRS complex is seconds or greater, consider expert
consultation.-
: 0.12 seconds
20.If the width of the ORs complex is 0.12 or less treat with what two things?-
: Vagal maneuvers and Adenosine
21.What is the therapy for a narrow QRS with regular rhythm (4)?: -Vagal maneuver
-give Adenosine
-give a B-blocker/calcium channel blocker
-consider expert consultation
22.If SVT does not respond to Vagal maneuvers give in a large vein over 1
second.: Adenosine 6mg IV
23.what do you do with the pt immediately after giving Adenosine 6mg IV?: -
elevate the arm immediately
24.If SVT does not convert within 1-2 minutes after 1st dose of Adeosine 6mg, give .: A second
dose of Adenosine 12 mg IV.
25.Adenosine increased AV block and will terminate approx. % of reentry
arrhythmias within minutes.: 90%
2 minutes
26.What rhythms will Adenosine not terminate?: Atrial Flutter and Atrial Fibril- lation
but it can slow down the HR so these rhythms can be identified.
27.Adenosine is safe or unsafe during pregnancy?: SAFE
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9
