ACLS DRUGS

ASYSTOLE/PEA ADRENALINE(Epinephrine) 1mg IV/IO repeat every 3-5 mins May give 1 dose of VASOPRESSIN 40 IU IV/IO in replace of 1st or 2nd doses of EPI May consider ATROPINE 1mg IV/IO repeat every 3-5 mins(upto 3doses); NOTE: dont give in VT VF/VT (Antiarrhythmics) AMIODARONE 300mg IV/IO once. Then consider additional 150mg IV/IO once. LIDOCAINE 1-1.5mg/kg 1st dose, then 0.5-0.75mg/kg IV/IO with max of 3 doses or 3mg/kg MAGNESIUM SULFATE loading dose 1-2g IV/IO for torsades de pointes in 10ml D5W given over 5-20mins. CHEST DISCOMFORT SUGGESTIVE OF ISCHEMIA ASPIRIN 160-325mg NITROGLYCERIN sublingual spray or IV MORPHINE IV if pain did not relieve by nitroglycerin. S-T ELEVATION MI BETA ADRENERGIC RECEPTOR BLOCKER CLOPIDOGREL HEPARIN (OFH OR LMWH) NON S-T ELEVATION MI HIGH RISK OF AV NITROGLYCERIN BETA ADRENERGIC RECEPTOR BLOCKER CLOPIDOGREL HEPARIN (OFH OR LMWH) GLYCOPROTEIN IIb/IIa INHIBITOR REPERFUSION THERAPY FOR HIGH RISK PATIENT ACE INHIBITORS/ANGIOTENSIN RECEPTOR BLOCKER (ARB) HMG COA REDUCTASE INHIBITOR BRADYCARDIA ATROPINE 0.5mg IV while waiting for pacing. May repeat to a total dose of 3mg Consider ADRENALINE 2-10mg/min or DOPAMINE 2-10mg/min all INFUSIONS

TACHYCARDIA NARROW QRS ADENOSINE 6mg IV push may repeat 12mg single dose DILTIAZEM BETA BLOCKER- AV Nodal blocking agent RE-ENTRY SVT, ATRIAL FLUTTER, ATRIAL TACHYCARDIA DILTIAZEM BETA BLOCKER- AV Nodal blocking agent WIDE QRS AMIODARONE 150mg IV over 10mins repeat as needed to max dose of 2.2g/24hrs

STROKE TPA(TISSUE PLASMINOGEN ACTIVATOR)-FIBRINOLYTIC THERAPY ASPIRIN-not candidate for fibrinolytic treatment

APPROACH TO ELEVATE BP IN ACUTE ISCHEMIC STROKE NOT ELIGIBLE FOR FIBRINOLYTIC SYSTOLIC > 220mmHg/ 121-140mmHg- LABETALOL 10-20mg IV for 1-2mins repeat or double every 10mins with max of 300mg NICARDIPINE 5mg/hr IV infusion titrate to desired effect by increase to 2.5mg/hr every 5mins DIASTOLIC 140mmHg- SODIUM NITROPRUSSIDE 0.5mg/kg/min IV infusion ELIGIBLE FOR FIBRINOLYTICS SYSTOLIC > 185mmHg; DIASTOLIC > 110mmHg LABETALOL 10-20 IV for 1-2mins DURING/AFTER TX; DIASTOLIC > 140mmHg SODIUM NITROPRUSSIDE 0.5mg/kg/min IV infusion SYSTOLIC > 230mmHg; DIASTOLIC 121-140mmHg LABETALOL AND NICARDIPINE SYSTOLIC 180-230mmHg; DIASTOLIC 105-120mmHg LABETALOL