Drug | IV Dosagea | Indications |
---|---|---|
Epinephrine | Low dosage (0.01 mg/kg); High dosage (0.1 mg/kg) after prolonged CPR; 10 times the dosage may be required when given IT | Administered every 3–5 minutes early in CPR (every other cycle) for asystole, ventricular fibrillation, PEAb |
Vasopressin | 0.4–0.9 U/kg | As an alternative to epinephrine every 3–5 minutes (every second BLS cycle) for asystole, bradycardia, PEA |
Atropine | 0.04 mg/kg; 0.1 mL/5 lb (0.5 mg/mL solution) | Sinus bradycardia, asystole, or PEA associated with high vagal tone |
Lidocaine | 2–4 mg/kg | Pulseless ventricular tachycardia, ventricular fibrillation resistant to defibrillation |
Sodium bicarbonate | 1 mEq/kg (1 mEq/mL solution) | Severe metabolic acidemia (pH < 7.0) associated with prolonged (>10–15 minutes) CPR efforts (must be adequately ventilated to be effective), hyperkalemia |
Calcium gluconate | 1 mL/5–10 kg (2% solution without epinephrine) | Routine use not recommended; treat cases with documented hypocalcemia or severe hyperkalemia |
Amiodarone | 5 mg/kg | Refractory ventricular fibrillation or pulseless ventricular tachycardia |
Magnesium sulfate | 30 mg/kg | Hypomagnesemia, torsades des pointes |
Defibrillation | 4–6 J/kg external monophasic; 2–4 J/kg external biphasic; 0.5–1 J/kg internal monophasic; 0.2–0.4 J/kg internal biphasic | Single shock for ventricular fibrillation or pulseless ventricular tachycardia; resume CPR efforts immediately after for one cycle (2 minutes) and reassess ECG, after which dosage escalation by 50% may occur (maximum dosage of 10 joules/kg) |
Reversal Agents | ||
Naloxone | 0.02–0.04 mg/kg | To reverse opioids |
Flumazenil | 0.01–0.02 mg/kg | To reverse benzodiazepines |
Atipamezole | 0.05 mg/kg (or same volume as dexmedetomidine) | To reverse dexmedetomidine |
a Dosage should be doubled if given via intratracheal route. | ||
b PEA = pulseless electrical activity |