ACLS Medications To Study

A quick guide to everything you need to know about ACLS drugs in order to pass your exam.

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Studying for your Advanced Cardiac Life Support (ACLS) can be a stressful experience – especially to those taking it for the first time. There are several different aspects of the material to study, but perhaps none require more time than the medications.

There are some components of the exam where you can get by with your practical medical knowledge and experience, but understanding the ACLS medications requires more memorization. In addition to knowing the actual names of the drugs, you’ll also need to be familiar with the primary uses and dosages for each particular medication. It’s also highly recommended to know a few general details and cautions about each in order to strengthen your knowledge base on the subject.

In order to make the studying process easier and more organized, we have provided a list of every ACLS medication you’ll be tested on, accompanied by the most important details you’ll need to know about each drug.

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Adenosine

Primary Uses:

• SVT/PSVT
• Wide QRS Tachycardia

Dose:

• First Dose: 6 mg IV Push
• Second Dose: 12 mg IV Push

Cautions/Notes:

• Must be given as a bolus, followed by a flush
• Can cause bronchospasm – use caution in asthmatics
• Flushing/chest tightness are common

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Amiodarone

Primary Uses:

• Pulseless VT
• Ventricular Fibrillation (V-Fib)
• Recurrent Hemodynamically Unstable Ventricular Tachycardia
• Hypertrophic Cardiomyopathy
• Supraventricular Tachyarrhythmias

Dose:

• VT / V-Fib: 300 mg IV/IO. May give 150 mg after the initial dose
• Tachy / VT: 150 mg IV/IO over 10 minutes. Continuous infusion of 1 mg/min IV for 6 hours, 0.5 mg/min IV for next 18 hours

Cautions/Notes:

• Atrial fibrillation, hypertrophic cardiomyopathy, and supraventricular arrhythmias are often treated with the oral form of amiodarone
• Rapid infusion causes hypotension
• If cumulative dosing exceeds 2.2 grams in 24 hours, significant hypotension can occur. Avoid administration with any drug that may prolong QT interval

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Atropine

Primary Uses:

• Symptomatic Bradycardia
• Cardiac Arrest

Dose:

• 0.5 mg IV (Repeat every 3 – 5 minutes
• Max dose: 3 mg

Cautions/Notes

• Dose less than 0.5 mg may cause paradoxical bradycardia

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Dopamine

Primary Uses:

• Bradycardia
• Hypotension

Dose:

• 2 – 20 mcg/kg/min infusion
• Titrated based on clinical response; tapered on/off slowly

Cautions/Notes

• Extravasation causes tissue damage and necrosis
• Use caution if giving high doses through a peripheral IV site
• May cause excessive vasoconstriction/tachyarrhythmias
• Adequate volume resuscitation is required before initiating dopamine therapy

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Epinephrine

Primary Uses:

• Cardiac Arrest
• Symptomatic Bradycardia
• Anaphylaxis / Severe Allergic Reactions
• Severe Hypotension

Dose:

• 1 mg (10 mL of 1:10,000 solution)
• Repeat every 3 – 5 minutes
• IV fluid Flush following each dose

Cautions/Notes

• Higher doses are often needed in cases of beta-blocker or calcium channel blocker overdoses. A continuous infusion may be required
• High dose does not improve survival / neurological outcome
• High dose ceases myocardial dysfunction in the post-resuscitation period

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Lidocaine

Primary Uses:

• Ventricular Tachycardia
• Ventricular Fibrillation

Dose:

• Cardiac Arrest from VT / VT: 1 – 1.5 mg/kg IV/IO
• Refractory VF: Additional 0.5 – 0.75 mg/kg IV/IO; Repeat every 5 – 10 minutes for max of 3 doses, or 3 mg/kg
• Stable VT: 0.5 – 0.75 mg/kg up to 1.5 mg/kg; Repeat in 0.5 – 0.75 mg/kg doses to max of 3 mg/kg
• Maintenance Infusion: 1 – 4 mg/min

Cautions/Notes:

• Not recommended routinely after Cardiac Arrest, but can be used following ROSC
• Can also be used for stable polymorphic ventricular tachycardia with normal baseline QT AND torsades
• Decrease maintenance doses if left ventricular dysfunction or if impaired liver function
• Not used prophylactically after myocardial infarction

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Magnesium

Primary Uses:

• Torsades de Pointes
• Hypomagnesemia (low magnesium)
• Digitalis Toxicity

Dose:

• Initial Dose: 1 – 2 g IV/IO diluted in 10 mL D₅W
• Infusion Dose: 0.5 – 1 g/hour

Cautions/Notes:

• Rapid administration may drop blood pressure
• Very high doses can cause respiratory distress (calcium is an antidote)
• Use with caution for patients with renal failure

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Procainamide

Primary Uses:

• Ventricular Arrhythmias
• Supraventricular Arrhythmias

Dose:

• Loading Dose: 15 – 17 mg/kg IV. Give over at least 30 minutes
• Max: 1.5 grams

Cautions/Notes:

• Serious reactions can occur for ventricular fibrillation, asystole, seizures, decreased platelets, neutrophils (and can result in hemolytic anemia)
• Other common reactions include hypertension, bradycardia, angioedema, flushing, and urticarial

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Additional ACLS Study Material:

• How To Pass Your ACLS Certification Exam
• ACLS Practice Exam Questions and Answers
• How To Choose An Online ACLS Provider

Once you're ready to proceed, feel free to check out our cost-friendly, 100% online ACLS courses! For more information on our ACLS, PALS, and BLS certifications, submit your questions to us.

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