Acls Drugs (Advanced)

Front 1

When Using a Peripheral IV

Back 1

Follow up administered drugs w/ 20 ml bolus, and then elevate extremity 10-20 seconds.

Front 2

Intraosseous (IO)

Back 2

Definition: inside the bone marrow.

Any drugs that can be delivered via IV can be delivered via IO.

Front 3

Endotracheal

Back 3

Definition: into the breathing tube.

IV/IO more recommended.

If endotracheal delivery is recommended, dilute drug to 10 ml volume w/ water/NS.

Front 4

Adrenosine

Back 4

First drug for MOST forms of SVT, especially those caused by "reentry." Can be considered for preparing for cardioversion.

Will not treat poison/drug-related tachycardia or heart block.

For IV push, place patient in Trendelenburg position, then administer 6ml dose over 1-3 seconds, followed by 20ml followup and elevation of extremity

Front 5

SVT

Back 5

SupraVentricular Tachycardia

Any elevated heart rate not caused by stress, exercise, or fever.

Can be symptomless, but symptoms include dizziness, shortness of breath, and chest pains.

Front 6

Amiodarone

Back 6

Extremely dangerous drug: prescribe only for these heart problems:

1. Recurrent VF

2. Recurrent hemodynamic unstable VT

Usually prescribed by licensed physicians, familiar with the drug's affects.

Front 7

Aspirin

Back 7

Administer to all patients with ACS/chest pains.

Works by preventing platelets from aggregating and arteries from constricting.

Do not administer to anyone w/ sensitivity to aspirin, or patients w/ bad ulcers and/or asthma.

Delivered as a 160-325 mg tablet.

Front 8

Atropine

Back 8

1st drug for symptomatic sinus bradycardia

2nd drug for bradycardic asystole (after epinepherine/vasopressin)

Do not use when patient is suffering hypoxia or ischemia

Bradycardia: 0.5 mg push every 3-5 minutes (max 3 doses)

Asystole: 1 mg push every 3-5 minutes (max 3 mg)

Front 9

ACS

Back 9

Acute Coronary Syndrome.

Caused by reduced blood flow to the heart.

Symptoms include chest pains, nausea, and shortness of breath.

Front 10

Symptomatic Bradycardia

Back 10

When symptoms of bradycardia begin to appear (<50 bpm)

Symptoms include tiredness, shortness of breath, and physical weakness.

Front 11

Cardioversion

Back 11

Administered for all cases of serious tachycardia

Electric shock delivered via defibrillation electrodes or handheld defibrillator paddles.

Premedicate whenever possible (example: adenosine)

Cannot treat poison-induced tachycardia

Front 12

Tachycardia

Back 12

Heart rate over 150 beats per minute

Front 13

Bradycardia

Back 13

Heart rate below 60 beats per minute

Front 14

Defibrillation

Back 14

First intervention for all cases of cardiac arrest

Always combine w/ CPR

Front 15

Dopamine

Back 15

Second-line drug for symptomatic bradycardia (after atropine)

Treats hypotension

If treating hypotension, correct hypovolemia first before administration.

NEVER mix with sodium bicarbonate.

IV: rate is 2-20 micrograms/kg per minute.

Front 16

Hypotension

Back 16

Blood pressure below 70-100 mm Hg.

Front 17

Epinepherine

Back 17

Primary drug treatment for cardiac arrest.

Can replace dopamine as 2nd line drug against bradycardia.

Can treat severe hypotension should atropine fail or if hypotension accompanies cardiac arrest.

IV: 1mg every 3-5 minutes during resuscitation

Endotracheal: 2-2.5 mg in 10 ml water.

Front 18

Fibrinolytic Agents

Back 18

Can be used to treat AMI and ischemic stroke, though not tested enough to recommend regular use for cardiac arrest.

Do not use if patient is bleeding, had recent surgery, or has uncontrollable hypertension.

Avoid aspirin until 24 hours after administration of fibrinolytic agents.

Front 19

AMI

Back 19

Acute Myocardiac Infarction

Medical term for "heart attack," when blood is blocked from reaching the heart.

Front 20

Lidocaine

Back 20

An alternative treatment to amiodarone for VT/VF cardiac failure.

IV: initial dose of 1 to 1.5 mg/kg, followed by 0.5-0.75 mg every 5-10 minutes IF NECESSARY.

Endotracheal: 2-4 mg/kg.

Front 21

Magnesium Sulfate

Back 21

Only recommended in cardiac arrest cases if torsades de points or suspected hypomagnesemia is present.

(For Cardiac Arrest cases)

IV: 1-2 g diluted in 10 ml of D5W IV/IO over 5-20 minutes.

Front 22

Torsades de Pointes

Back 22

Front 23

Morphine

Back 23

Painkiller: In this context, used for ACS-related chest pains.

Also indicated by cardiogenic pulmonary edema.

Use only if nitroglycerine fails.

Countered by nalaxone.

IV: 2-4 mg over 1-5 minutes every 5-30 minutes.

Front 24

Pulmonary Edema

Back 24

Condition when the lungs are filled with fluid.

Front 25

Nitroglycerine

Back 25

Initial response for suspected ischemic pains

Also best for hypertensive emergencies with ACS

Do not administer if patient has hypotension or either brady- or tachycardia, or if he's taken medicine for erectile dysfunction in the last 24 hrs.

IV: Bolus of 12.5-25 ml. Begin at 10-20 micrograms/minute. Titrate to effect, 10 micrograms/minute until desired effect is reached.

Tablets: 3 doses, one every 5-10 minutes.

Spray: 3 doses, 1-2 sprays every 5 minutes.

Front 26

Oxygen

Back 26

Administer for any suspected cardiopulmonary emergencies, complaints of shortness of breath, and ACS patients.

Delivered through a portable tank or device.

Front 27

Vasopressin

Back 27

An alternate choice to epinephrine for adult cardiac arrest patients.

Not recommended for patients with coronary heart disease.

IV: One 40 ml U IV/IO push; can replace either 1st or 2nd epinephrine dose.