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Drug Indication Adult Dosage
Procainamide VF, Pulseless VT, may use for treatment of Recurrent VF/VT: 20mg/min IV
PSVT uncontrolled by adenosine/vagal infusion (max total dose: 17mg/kg).
maneuvers if BP is stable, stable wide complex Also see IV Drips section
tachycardia of unknown origin, atrial fibrillation
with rapid rate in WPW syndrome
Vasopressin VF, pulseless VT 40 units IV single dose. May be used as
an alternative pressor to epinephrine for
the 1st or 2nd dose. Epinephrine may be
administer 10 minutes after vasopressin
Verapamil Alternative drug (after adenosine) to terminate IV infusion:
Paroxysmal Supraventricular Tachycardia Initial: 2.5-5mg IV bolus over 2
(PSVT) minutes
May control ventricular response in patients with Second dose: 5-10mg if needed in
atrial fib, atrial flutter, and multipfocal atrial 15-30 minutes. Max dose:20 mg
tachycardia.
ACLS Medication IV Drips
Drug Concentration/Indication Adult Dosage
Dopamine Mix as: 800mg dopamine in 250cc D5W 2 – 20 mcg/kg/min and titrate to
(Intropin) Concentration: 3200mcg/ml patients response.
Indications:
Hypotension that occurs with symptomatic
bradycardia
Hypotension that occurs after return of
spontaneous circulation
Cardiogenic shock. May be used in
bradycardia to increase HR.
Lidocaine Mix as: 2 grams of Lidocaine in 500 cc D5W Maintenance infusion: 1-4mg/min
(Xylocaine) Concentration: 4mg/ml (20-50mcg/kg per minute)
Indications:
Significant ventricular ectopy (runs of VT, R Infusion rates:
on T, frequent or multiform PVc’s) seen in
the setting of AMI or ischemia 15cc/hr=60mg/hr=1mg/min
VT/VF that persists after defibrillation and 30cc/hr=120mg/hr=2mg/min
administration of epinephrine 45cc/hr=180mg/hr=3mg/min
VT with pulse 60cc/hr=240mg/hr=4mg/min
Wide complex tachycardia of uncertain origin
Norepinephrine Mix as: 8 mg Norepinephrine in 250cc D5W IV Infusion only: 0.5-1mcg/min
(Levophed) Concentration: 32mcg/ml titrated to improve BP
Indications: 30mcg/min
Treatment of profound hypotension unresponsive to volume loading & dopamine
Procainamide Mix as: 1 gram Procainamide in 250cc D5W Recurrent VF/VT: 20mg/min IV
Or infusion (max total dose of
2 grams Procainamide in 500 cc D5W 17mg/kg).
Concentration: 4mg/ml Administer at 20mg/min until one of
Indications: Treatment of ventricular the following occurs:
arrythmias Arrhythmia suppression
Hypotension
QRS widens by >50%
Total dose of 17mg/kg is given
Maintenance Infusion: 1-4mg/min
Renal or cardiac dysfunction: Max
total dose: 12 mg/kg.
Infusion Rates:
15cc/hr=60mg/hr=1mg/min