Commonly Used Medications in ACLS

Studying for an Advanced Cardiac Life Support (ACLS) exam can be an uphill task, particularly for people who are taking the exam for the first time. The medications are perhaps the most important and time-consuming aspect of the material that need to be studied. Understanding commonly used medications in ACLS needs memorization. This is because one is required to know the real name of the drug, its primary used and the recommended dosages. Furthermore, knowledge of the cautions and general details is important in order to reinforce the knowledge base that a person has on the subject.
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Commonly used medications in ACLS
The following are some of the commonly used medications in ACLS:
Adenosine
This is an Antiarrhythmic drug. It is used for Supraventricular Tachycardia. It has side effects such as sweating, flushing, nausea, palpitations, hypotension, dyspnea, metallic taste, dizziness and headache. The first dose is 6 mg rapid IV and this is succeeded by saline bolus. The second dose is 12 mg rapid IV push and this should be administered in one to two minutes.
Amiodarone
This is also an Antiarrhythmic drug. Its uses are Ventricular Fibrillation (VF), Unstable Ventricular Tachycardia (VT) with pulses etc. The side effects associated with it are coagulation abnormalities, flushing, hair loss, skin discoloration, rash, diarrhea, vomiting, nausea, significant hypotension, tremors, dizziness and headache. The recommended dosage is 300 mg rapid bolus and a second dosage of 150 mg (if necessary).
Atropine
This ACLS drug is an Anticholinergic. It is used for overdoses, toxic poisonings and symptomatic bradycardia. It has different dosages depending on the particular use. It can lead to side effects such as dry skin, rash, painful urination, urinary retention, constipation, vomiting, nausea, hypertension, hypotension, tachycardia, dry mouth, pupil dilation, blurred vision, anxiety and dizziness.
Dopamine
It is an Inotrope or Catecholamine Vasopressor. It can be administered in bradycardia following Atropine. The recommended dose is 2 – 20 mcg/kg per minute. Side effects associated with its use are acute renal failure, nausea/vomiting, palpitations, dyspnea and headache.
Epinephrine
This drug can be classified as an Inotrope or Catecholamine Vasopressor. Its main uses in ACLS are for cardiac arrest, symptomatic bradycardia, anaphylaxis etc. 1mg IV is administered for cardiac arrest and this is followed quickly with 0.1-0.5 mcg/kg/min infusion that is titrated to response. Patients may experience side effects like vasoconstriction, hypokalemia, hyperglycemia, vomiting, nausea, hypertension, chest pain, palpitations, dyspnea, hallucinations and tremors.
Lidocaine
This Antiarrhythmic is used for cardiac arrest from Ventricular Tachycardia Wide complex tachycardia or Ventricular Fibrillation (VF). 0.5-1.5 mg/kg IV is the dosage for Wide complex tachycardia with pulse while 1-1.5 mg/kg IV bolus is the recommended dosage for cardiac arrest. Its side effects are rash, hypotension, blurred vision, tinnitus, drowsiness, tremor, dizziness, headache, vomiting, nausea, respiratory depression and dyspnea.
Magnesium Sulfate
It is a bronchodilator. Its uses are for Digitalis toxicity and Hypo- magnesemia. 1-2-gram IV bolus is the dosage for cardiac arrest caused by hypomagnesemia while a dosage of 1-2 gram IV that is administered over 5-60 minutes and infusion at 0.5-1 gram per hour IV follows. The side effects of this drug are sweating, flushing, muscle cramping, vomiting, nausea, respiratory depression and weakness.
Conclusion
The list of drugs outlined above is not exhaustive as there are much more of the commonly used medications in ACLS that have not been mentioned such as Vasopressin, Oxygen, Magnesium Sulfate etc.