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ACLS Pharmacology (Atropine Sulfate Can be given via endotracheal tube…

- - - - 0.5 mg IV every 3 to 5 minutes as needed, not to exceed total dose of 0.04 mg/kg (total 3 mg)
      - Use shorter dosing interval (3 minutes) and higher doses in severe clinical conditions
    - - Extremely large doses (2 to 4 mg or higher) may be needed
- - - - First dose: 300 mg lV/IO
        push
      - Second dose (if needed):
        150 mg IV/IO push
    - - Rapid infusion: 150 mg IV over first 10 minutes (15 mg per minute). May repeat rapid
        infusion (150 mg lV) every 10 minutes as needed
      - Slow infusion: 360 mg IV over 6 hours (1 mg per minute)
      - Maintenance infusion: 540 mg iv over 18 hours (0.5 mg per minute)
- - - - lV/IO dose:
        
        1 mg (10 mL of 1:10 000 solution) administered even/ 3 to 5 minutes
        during resuscitation. Follow each dose with 20 mL flush, elevate arm for 10 to 20 seconds after dose
      - Higher dose:
        
        up to 0.2 mg/kg) in B-blocker or calcium channel
        blocker overdose)
      - Continuous infusion:
        
        initial rate: 0.1 to 0.5 mcg/kg per
        minute (for 70—kg patient: 7 to 35 mcg per minute): titrate to
        response
      - Endotracheal route:
        
        2 to 2.5 mg diluted in 10 mL NS
    - - 2 to 10 mcg per minute infusion: titrate to patient response
- - - - Usual infusion rate is 2 to 20 mcg/kg per minute
      - Titrate to patient response; taper slowly
- - - - Initial dose: 1 to 1.5 mg/kg IV/IO
      - For refractory VF, may give additional 0.5 to 0.75 mg/kg IV
        push, repeat in 5 to 10 minutes; maximum 3 doses or
        total of 3 mg/kg
    - - Doses ranging from 0.5 to 0.75 mg/kg and up to 1 to 1.5 mg/kg may be used
      - Repeat 0.5 to 0.75 mg/kg every 5 to 10 minutes; maximum total dose: 3 mg/kg
    - - 1 to 4 mg per minute (30 to 50mcg/kg per minute)
- - - - place patient in mid reverse Trendelenburg position before administration of drug
      - initial bolus of 6mg given rapidly over 1-3 seconds followed by NS bolus of 20mL, then elevate the extremity
      - a second dose 12 mg can be given in 1-2 mins if needed
    - - record rhythm strip during administration
      - draw up adenosine dose and flush in 2 separate syringes
      - attach both syringes to IV injection port closest to patient
      - clamp IV tubing above injection port
      - push IV adenosine asap 1-3 seconds
      - while maintaining pressure on adenosine plunger, push NS flush ASAP after adenosine
      - unclamp IV tubing
- - - - 1-2 g (2 to 4mL of a 50%
        solution diluted in 10 mL [eg,
        D5W, normal saline] given IV/IO)
    - - Loading dose OH to 2 9 mixed
        in 50 to 100 mL of diluent (eg,
        D5,W, normal saline) over 5 to
        60 minutes IV
        
        Follow with 0.5 to 1 g per
        hour |V (titrate to control
        torsades)