ACLS - Advanced Cardiovascular Life Support ACLS Emergency Pharmacology Questions and Answers — Questions and Answers
Question 1: A 58-year-old male presents with symptomatic bradycardia with a heart rate of 38 bpm. Initial intervention with atropine has been ineffective. Which of the following medication infusions is an appropriate next step according to ACLS guidelines?
- Amiodarone 1 mg/min
- Adenosine 6 mg IV push
- Epinephrine 2-10 mcg/min (Correct answer)
- Lidocaine 1 mg/min
Correct answer: Epinephrine 2-10 mcg/min
For symptomatic bradycardia that is unresponsive to atropine, the next line of treatment involves considering transcutaneous pacing or a vasopressor infusion. Epinephrine (2-10 mcg/min) or Dopamine (5-20 mcg/kg/min) are the recommended vasopressors to increase heart rate and blood pressure. Amiodarone and Lidocaine are antiarrhythmics used for tachyarrhythmias, and Adenosine is used for stable narrow-complex supraventricular tachycardia.
Question 2: A patient in cardiac arrest is in ventricular fibrillation (VF) and has been defibrillated three times. High-quality CPR is ongoing. Which of the following is the correct initial drug and dose to administer?
- Epinephrine 1 mg IV/IO
- Amiodarone 300 mg IV/IO (Correct answer)
- Lidocaine 0.5 mg/kg IV/IO
- Magnesium Sulfate 1-2 g IV/IO
Correct answer: Amiodarone 300 mg IV/IO
In the ACLS algorithm for VF/pulseless VT, after the third shock, an antiarrhythmic should be considered. The initial dose of Amiodarone is 300 mg IV/IO push. Epinephrine should have been given after the second shock. Lidocaine is an alternative to amiodarone, but the initial dose is 1-1.5 mg/kg. Magnesium sulfate is primarily used for Torsades de Pointes.
Question 3: A 45-year-old patient presents with a regular, narrow-complex supraventricular tachycardia (SVT) and is hemodynamically stable. Vagal maneuvers have failed. What is the recommended initial dose of Adenosine?
- 3 mg rapid IV push
- 12 mg rapid IV push
- 0.5 mg IV push
- 6 mg rapid IV push (Correct answer)
Correct answer: 6 mg rapid IV push
For stable, regular, narrow-complex SVT that does not respond to vagal maneuvers, the initial recommended dose of Adenosine is 6 mg administered as a rapid IV push, followed by a saline flush. If the first dose is ineffective, a second dose of 12 mg may be given. A 3 mg dose is considered for specific situations like patients on certain medications or with a central line.
Question 4: During a cardiac arrest scenario with a non-shockable rhythm (Asystole/PEA), what is the correct timing and dosage for Epinephrine administration?
- After the second shock, 1 mg every 3-5 minutes
- As soon as possible, 0.5 mg every 3-5 minutes
- As soon as possible, 1 mg every 3-5 minutes (Correct answer)
- After 5 cycles of CPR, 2 mg every 10 minutes
Correct answer: As soon as possible, 1 mg every 3-5 minutes
For non-shockable rhythms like Pulseless Electrical Activity (PEA) and Asystole, the ACLS guidelines recommend administering Epinephrine 1 mg IV/IO as soon as feasible or possible. Subsequent doses of 1 mg are given every 3-5 minutes for the duration of the arrest.
Question 5: Which of the following is the correct second dose of Amiodarone for a patient who remains in refractory ventricular fibrillation after an initial bolus and further defibrillation?
- 300 mg IV/IO
- 1 mg/kg IV/IO
- 150 mg IV/IO (Correct answer)
- 75 mg IV/IO
Correct answer: 150 mg IV/IO
Following an initial 300 mg bolus of Amiodarone for refractory VF/pVT, if the arrhythmia persists, a second and final dose of 150 mg IV/IO can be administered.
Question 6: A patient is being treated for symptomatic bradycardia. The provider administers 1 mg of Atropine IV every 3 minutes. What is the maximum total dose of Atropine that can be given?
- 1 mg
- 6 mg
- 3 mg (Correct answer)
- 0.5 mg
Correct answer: 3 mg
In the ACLS bradycardia algorithm, the recommended dose for Atropine is 1 mg IV/IO, which can be repeated every 3 to 5 minutes. The maximum total dose that should be administered is 3 mg.
ACLS - Advanced Cardiovascular Life Support ACLS Emergency Pharmacology Questions and Answers
A 58-year-old male presents with symptomatic bradycardia with a heart rate of 38 bpm.
Initial intervention with atropine has been ineffective.
Which of the following medication infusions is an appropriate next step according to ACLS guidelines?