| DRUG | MAIN ACLS USE | DOSE/ROUTE | NOTES |
| Adenosine | Narrow PSVT/SVTWide QRS tachy – avoid adenosine in irregular wide QRS | 6 mg IV bolus, may repeat with 12 mg in 1 to 2 min. | Rapid IV push close to the hub, followed by a saline bolusContinuous cardiac monitoring during administrationCauses flushing and chest heaviness |
| Amiodarone | VF/pulseless VTVT with pulseTachy rate control | VF/VT:300 mg dilute in 20 to 30 mLmay repeat 150 mg in 3 to 5 min | Anticipate hypotension, bradycardia and gastrointestinal toxicity Continuous cardiac monitoring Very long half life (up to 40 days) Do not use in 2nd or 3rd degree heart block Do not administer via the ET tube route |
| Atropine | Symptomatic bradycardia | 0.5 mg IV/ET every 3 to 5 minutesMax dose: 3 mg | Cardiac and BP monitoringDo not use in glaucoma or tachyarrhythmias Minimum dose 0.5 mg |
| Dopamine | Shock/CHF | 2 to 20 mcg/kg/ min Titrate to desired blood pressure | Fluid resuscitation first Cardiac and BP monitoring |
| Epinephrine | Cardiac Arrest | Initial: 1.0 mg (1:10000)IV or 2 to 2.5 mg (1:1000)ETT every 3 to 5 min Maintain: 0.1 to 0.5 mcg/kg/minTitrate to desire blood pressure | Continuous cardiac monitoring Note: Distinguish between 1:1000 and 1:10000 concentrations Give via central line when possible |
| Lidocaine (Lidocaine is recommended when Amiodarone is not available) | Cardiac Arrest (VF/VT) | Initial: 1 to 1.5 mg/kg IV loading Second: Half of first dose in 5 to 10 minMaintain: 1 to 4 mg/min | Cardiac and BP monitoringRapid bolus can cause hypotension and bradycardiaUse with caution in renal failure Calcium chloride can reverse hypermagnesemia |
| Magnesium Sulfate | Cardiac arrest/ Pulseless torsades | Cardiac Arrest: 1 to 2 gm diluted in 10 mL D5W IVP | Cardiac and BP monitoring Rapid bolus can cause hypotension and bradycardia Use with caution in renal failureCalcium chloride can reverse hypermagnesemia |
| Procainamide | Wide QRS tachycardia Preferred for VT with pulse (stable) | 20 to 50 mg/min IV until rhythm improves hypotension occurs, QRS widens by 50% or MAX dose is given MAX dose: 17 mg/kg Drip: 1 to 2 gm in 250 to 500 mL at 1 to 4 mg/min | Cardiac and BP monitoringCaution with acute MI May reduce dose with renal failure Do not give with amiodarone Do not use in prolonged QT or CHF |
| Sotalol | Tachyarrhythmia Monomorphic VT3rd line anti-arrhythmic | 100 mg (1.5 mg/kg) IV over 5 min | Do not use in prolonged QT |
