Pharmacology is an important part of ACLS program. In ACLS Program,we are using many essential drugs for surviving cardiac arrest cases in Emergency department. We are introducing ACLS which is locally called ARC ( Advanced Resuscitation Course) started in Square Hospitals Ltd,Dhaka,Bangladesh. Hope it will help many health care provider to know the useful medication in case of CPR.

3. Medication using during cardiac
arrest:
Objectives of drug Treatment:
• To correct hypoxia.
• To correct metabolic acidosis.
• Increase cardiac perfusion during CPR.
• Stimulate cardiac contraction.
• Accelerate heart rate.
• Relieve pain &
• Treat pulmonary edema.

4. EMERGENCY MEDICATION
General Principles:
• All drugs must be given as bolus dose.
• No chance to give wrong dose.
• No time wasted.
• Always flush with 20 ml NS and raising
the arm.

5. EMERGENCY MEDICATION
Routes of administration:
• Intravenous: Peripheral or Central line.
• Oral route: Via ET tube: Dose is 2.5 times
the IV dose.
• Intracardiac: Cardiocenthesis technique.
• Intra osseous route: For the children
usually.

7. ACLS MEDICATION
• DRUG USED IN CARDIAC ARREST
Drug Indication Concentrati
on
Dose Remarks
Adenosine • Narrow
complex SVT
• 3mg/ml
in 2 ml
vial
(Total: 6
mg)
• 6 mg rapid
bolus ( 1-3
seconds).
• Repeat dose:
12 mg if no
response with
in 1-2 min.
• Half life: < 5 s
Side Effect:
• Flushing, Chest
pain, tightness,
• Sinus
bradycardia.
• Preg C.
Amiodarone • Recurrent VF
• AF, Flutter,
• Stable VT
• Unstable VT
refractory to
other
medication.
• 50
mg/ml in
3 ml
ampules.
• Total:
150 mg.
• For VT/VF with
Cardiac arrest:
300 mg rapid
infusion.
• Repeat 150 mg
over 3-5 min.
Side Effect:
• Hypotension,
• Prodysrhythmic,
• Preg D

8. Adenosine
• Adenosine is the primary drug used in the
treatment of stable narrow-complex SVT
(Supraventricular Tachycardia).
• Dosing: The first dose of adenosine should be
6 mg administered rapidly over 1-3 seconds
followed by a 20 ml NS bolus. If the patient’s
rhythm does not convert out of SVT within 1 to
2 minutes, a second 12 mg dose may be given
in similar fashion.
• Child: 100mcg/kg 1st dose. 2nd: 200mcg/kg.

9. Adenosine
• Caution: Prodysrhythmic, do not give in
preexisting 2nd or 3rd degree block,
Preg C.

10. ACLS MEDICATION
• DRUG USED IN CARDIAC ARREST
Drug Indication Concentrati
on
Dose Remarks
Adenosine • Narrow
complex SVT
• 3mg/ml
in 2 ml
vial
(Total: 6
mg)
• 6 mg rapid
bolus ( 1-3
seconds).
• Repeat dose:
12 mg if no
response with
in 1-2 min.
• Half life: < 5 s
Side Effect:
• Flushing, Chest
pain, tightness,
• Sinus
bradycardia.
• Preg C.
Amiodarone • Recurrent VF
• AF, Flutter,
• Stable VT
• Unstable VT
refractory to
other
medication.
• 50
mg/ml in
3 ml
ampules.
• Total:
150 mg.
• For VT/VF with
Cardiac arrest:
300 mg rapid
infusion.
• Repeat 150 mg
over 3-5 min.
• Child: 5mg/kg
over 3 min.
Side Effect:
• Hypotension,
• Prodysrhythmic,
• Preg D

11. Amiodarone
• MOA: Blocks K efflux (Class III antidysrhythmic); also has Na
channel blocking (class I),beta blocking (class II), and Ca
channel blocking (class IV) properties.
• Dose: Pulseless VF/VT: 300mg IV rapid push followed by
150mg IV rapid push if necessary at next pulse check
Stable wide complex tachycardias: 150mg IV over 10
minutes, followed by infusion of 1mg/min x 6hours, then 0.5
mg/min thereafter.
Child: 5mg/kg ( Max:300mg)
• Indications: Pulseless VF/VT, Wide complex
tachydysrhythmias.
• Caution: Causes hypotension, prodysrhythmic, Preg D

12. ACLS MEDICATION
• DRUG USED IN CARDIAC ARREST
Drug Indication Concentrati
on
Dose Remarks
Epinephrine • Cardiac arrest
• VT/VF,
• Asystole,
• PEA,
• Symptomatic
bradycardia after
Atropine.
• 0.1
mg/ml in
10 ml
syringe.
(1:
10,000
Soln)
• 1 mg IV every
3-5 mins.
• Child: 0.01-
0.03mg/kg
• Each 1 mg
bolus IV
dose
should be
flush of 20
ml fluid.
Dopamine • 2nd drug for
symptomatic
bradycardia.
• Significant
hypotention SPB
<70 mm of Hg.
• 40 mg/
ml in 5
ml
ampoule.
• Total:
200 mg.
• 5-10
mcg/kg/min IV
beta effects
• 10-20
mcg/kg/min IV
alpha effects
• Don’t mix
with
NaHco3:
Excessive
vasoconstri
ction.

13. EPINEPHRINE
MOA: Epinephrine, more commonly known as
adrenaline, is a hormone secreted by the medulla
of the adrenal glands.
Indication: Cardiac arrest VT/VF, Asystole, PEA,
Symptomatic bradycardia after Atropine.
Dose: 0.1 mg/ml in 10 ml syringe. (1: 10,000 Soln),
Adult: 1 mg IV every 3-5 mins.
Child: 0.01-0.03mg/kg
Caution: Each 1 mg bolus IV dose should be flush of
20 ml fluid, Hotness in site, SOB, Irregular pulse.

14. ACLS MEDICATION
• DRUG USED IN CARDIAC ARREST
Drug Indication Concentrati
on
Dose Remarks
Epinephrine • Cardiac arrest
• VT/VF,
• Asystole,
• PEA,
• Symptomatic
bradycardia
after Atropine.
• 0.1
mg/ml in
10 ml
syringe.
(1:
10,000
Soln)
• 1 mg IV every 3-
5 mins.
• Child: 0.01-
0.03mg/kg
• Each 1 mg
bolus IV
dose should
be flush of
20 ml fluid.
Dopamine • 3rdnd drug for
symptomatic
bradycardia.
• Significant
hypotention
SPB <70 mm of
Hg.
• 40 mg/
ml in 5
ml
ampoule.
• Total:
200 mg.
• 5-10
mcg/kg/min IV
beta effects
• 10-20
mcg/kg/min IV
alpha effects
• Don’t mix
with
NaHco3:
Excessive
vasoconstric
tion.

15. Dopamine
MOA: alpha1, beta1, and dopaminergic agonist
Dose: < 5 mcg/kg/min IV dopaminergic effects (not
recommended).
5-10 mcg/kg/min IV primarily beta effects ( Positive
inotropic & Vasodilation.)
10-20 mcg/kg/min IV primarily alpha effects
(Vasoconstriction)
Indications: Decompensated heart failure, hypotension.
Caution: Tachydysrhythmias, tissue necrosis if
extravasation or arterial administration therefore needs
to be given through central venous line, Preg C.

16. ACLS MEDICATION
• DRUG USED IN CARDIAC ARREST
Drug Indication Conc Dose Remarks
Dobutamine • CHF with SBP>100
& DBP Normal.
• 12.5
mg/ml in
20 ml
vials.
• 2-20microgm/
kg/min
• Avoid when
SBP <100.
• Tachyarrhythm
ia. Preg B
Magnesium
sulphate
• Cardiac arrest
associated with
Torsades de
Pointes.
• Suspected
hypomagnesemia
• 10 ml
ampoule
s 50%
MgSo4=5
gm mg.
• AMI: Loading
dose 1.2 gm.
• Helpful for
refractory
VT/VF after
Lidocaine or
Amiodarone
• Preg A
Lidocaine • Cardiac arrest:
VF/VT.
• Wide complex
Tachycardia.
• Venicular ectopy.
• 5 ml
syringe:
100
mg/5 ml
• Cardiac
arrest: 1-1.5
mg/kg initial
bolus.
• Refactory VF:
0.5-
0.75mg/kg.

17. Dobutamine
MOA: Synthetic catecholamine: Beta1 agonist >
beta2 agonist.
Dose: 2-20mcg/kg/min IV
Indications: Decompensated heart failure,
refractory hypotension.
Caution: Tachycardia, hypotension if not
euvolemic, PVCs. Preg B

18. ACLS MEDICATION
• DRUG USED IN CARDIAC ARREST
Drug Indication Conc Dose Remarks
Dobutamine • CHF with SBP>100
& DBP Normal.
• 12.5
mg/ml in
20 ml
vials.
• 2-
20microgm/
kg/min
• Avoid when
SBP <100.
• Tachyarrhythm
ia. Preg B
Magnesium
sulphate
• Cardiac arrest
associated with
Torsades de
Pointes.
• Suspected
hypomagnesemia
• Eclampsia,BA.
10 ml
ampoules
50% MgSo4=5
gm mg.
Infusion:
1g/100mL
2g/100mL
• AMI:
Loading
dose 2 gm.
• Child: 25-50
mg/kg.
• Helpful for
refractory
VT/VF after
Lidocaine or
Amiodarone
• Preg A
Lidocaine • Cardiac arrest:
VF/VT.
• Wide complex
Tachycardia.
• 5 ml
syringe:
100 mg/5
ml
• Cardiac
arrest: 1-1.5
mg/kg initial
bolus.
• Refactory VF:
0.5-
0.75mg/kg.

19. Magnesium Sulfate
• MOA: Participates in physiologic processes.
Dose: Eclampsia: 2-4 grams IV over 5 minutes
Pulseless torsades: 2 grams IV push. Asthma
exacerbation: 2 grams over 15 minutes.
Indications: Torsades, ventricular
dysrhythmias, eclampsia, status asthmaticus.
Caution: Respiratory depression, hypotension,
Preg A

20. ACLS MEDICATION
• DRUG USED IN CARDIAC ARREST
Drug Indication Conc Dose Remarks
Dobutamine • CHF with SBP>100
& DBP Normal.
• 12.5
mg/ml in
20 ml
vials.
• 2-20microgm/
kg/min
• Avoid when
SBP <100.
• Tachyarrhythm
ia. Preg B
Magnesium
sulphate
• Cardiac arrest
associated with
Torsades de
Pointes.
• Suspected
hypomagnesemia
• 10 ml
ampoule
s 50%
MgSo4=5
gm mg.
• AMI: Loading
dose 1.2 gm.
• Helpful for
refractory
VT/VF after
Lidocaine or
Amiodarone
• Preg A
Lidocaine • Cardiac arrest:
VF/VT.
• Wide complex
Tachycardia.
• Venicular ectopy.
• 5 ml
syringe:
100
mg/5 ml
• Cardiac
arrest: 1-1.5
mg/kg initial
bolus.
• Refactory VF:
0.5-
0.75mg/kg.

21. Lidocaine
MOA: Blocking Na Channel.
Indication: VT/VF refectory to other medication.
Dose: 1mg to 1.5 mg/kg IV bolus once; may
repeat if necessary at a dose of 0.5 to 0.75 mg/kg
IV every 5 to 10 minutes up to a maximum
cumulative dose of 3 mg/kg.
Caution: Sleepiness, muscle twitching, confusion,
Decrease BP.

22. ACLS MEDICATION
• DRUG USED IN CARDIAC ARREST
Drug Indication Conc Dose Remarks
Norepinephr
ine
• Cardiogenic shock
• Hypotention
refractory to IVF
• 2mcg/ml
in 2 ml
vials.
• Begin:0.1-
0.5mcg/
kg/min.
• Increase
myocardial o2
requirement.
• Induce
arrythmias.
• Tissue necrosis if
extravasation.
• Preg C .
Atropine • Symptomatic
bradycardia.
• Organophosphate
poisoning.
• 600mcg/
ml.
• 0.5-0.6mg
IV push
repeat up
to total
dose of
3mg if
needed.
• Hyperthermic
patients
tachydysrhythmi
as.
• Preg C

23. Norepinephrine
MOA: Alpha1 agonist > beta1 agonist
Dose: 1-30 mcg/min IV.
AHA: 0.1-0.5mcg/kg/min.
Indications: Hypotension refractory to IVF
Caution: Tachydysrhythmias, tissue necrosis if
catheter infltrates or administered through an
arterial line therefore needs to be given via a
central venous line, Preg C

24. ACLS MEDICATION
• DRUG USED IN CARDIAC ARREST
Drug Indication Conc Dose Remarks
Norepinephr
ine
• Cardiogenic shock
• Hypotention
refractory to IVF
• 2mcg/ml
in 2 ml
vials.
• Begin:0.5-
1mgm/
kg/min.
• Increase
myocardial o2
requirement.
• Induce
arrythmias.
• Tissue necrosis if
extravasation.
• Preg C .
Atropine • Symptomatic
bradycardia.
• Organophosphate
poisoning.
• 600mcg/
ml.
• 0.5-0.6mg
IV push
repeat up
to total
dose of
3mg if
needed.
• Hyperthermic
patients
tachydysrhythmi
as.
• Preg C

25. Atropine
• MOA: Direct anticholinergic.
• Dose: Organophosphate/carbamate toxicity: 1-6 mg IV
q 3-5 minutes PRN, until dry secretions (can double
dose each time until adequate response achieved)
Pedia: Bradycardia: 0.02 mg/kg IVx1; 0.5 mg max
single dose; 1 mg max.
Adult: Bradycardia: 0.5 mg IV, 3 mg max.
• Indications: Organophosphate/carbamate toxicity,
bradycardia.
• Caution: Hyperthermic patients, tachydysrhythmias,
Preg C. Physostagmin antidot.

26. Sodium Bicarbonate
MOA: Increases serum bicarbonate (increases buffer stores)
Dose: Hyperkalemia or metabolic acidosis: 50 mEq IV x 1 (1
amp = 50 mEq).
TCA toxicity: 1-2 mEq/kg IV bolus to achieve a serum pH of
7.45-7.55 and QRS narrowing; effective serum alkalinization
unlikely with continuous infusion.
Salicylate toxicity: 3 amps (150mEq) in 1 liter D5W given as 10-
20 ml/kg bolus,then 2-3ml/kg/hr; goal urine pH 7.5-8.0
Indications: hyperkalemia, TCA toxicity, salicylate toxicity,
metabolic acidosis.
Caution: Caution in CHF, overshooting into metabolic alkalosis,
hypernatremia, Preg C

27. BRADYCARDIA

29. RSI
RSI is the preferred method of endotracheal tube
intubation (ETTI) in the emergency department
(ED).
Steps of RSI: (6 Ps);
1. Plan.
2. Position.
3. Pre-Oxygenate & Pre treatment.
4. Preparation.
5. Paralyze.
6. Post intubation.

30. DRUG USED IN RSI
PRETREATMENT MEDICATIONS
Drug Indication Conc Dose Remarks
Fentanyl • To provide
sedation &
analgesia;
50 mcg/ml
in 2 ml
ampoules.
• 1-2 mcg/kg
slow IV push
(over 1-2
min)
• Duration of
action: 0.5-1 h.
• Preg C
Lidocaine • Useful with
asthma/COPD
• Decrease
hypertensive
response
20mg/ml in
50 ml vials.
• 1.5 mg/kg IV
push
• Duration of
action: 10-20
min

31. Fentanyl
• MOA: Opioid agonist producing analgesia
with adjunctive sedative effects.
Dose: 25-100 mcg IV q 1-2 hours;
Recommended dose 1 mcg/kg.
Indications: Pain control, sedation adjunct
Caution: Respiratory depression,
vasodilation (hypotension),laryngospasm,
Preg C

32. DRUG USED IN RSI
PRETREATMENT MEDICATIONS
Drug Indication Conc Dose Remarks
Fentanyl • To provide
sedation &
analgesia;
50 mcg/ml
in 2 ml
ampoules.
• 1-2 mcg/kg
slow IV push
(over 1-2
min)
• Duration of
action: 0.5-1 h.
• Preg C
Lidocaine • Useful with
asthma/COPD
• Decrease
hypertensive
response
20mg/ml in
50 ml vials.
• 1.5 mg/kg IV
push
• Duration of
action: 10-20
min
Vecuronium
(Norcuron)
• Decreases
fasciculation &
potassium
release from
cells;
10mg/vial
mix with 10
ml DW.
• Defasciculati
ng dose: 0.01
mg/kg IV
push
(typically
about 1 mg,
• Avoid higher
doses to
produce
paralytic effect.
• Preg B

33. Lidocaine
MOA: Blocking Na Channel.
Indication: Head injury to decrease ICP.
Decrease cough reflex in COPD,Asthma.
Dose: 1mg to 1.5 mg/kg IV bolus once; may
repeat if necessary at a dose of 0.5 to 0.75
mg/kg IV every 5 to 10 minutes up to a
maximum cumulative dose of 3 mg/kg.
Caution: Sleepiness, muscle twitching,
confusion, Decrease BP.

34. DRUG USED IN RSI
DRUG USING INDUCTION
Drug Indication Concentration Dose Remarks
Etomidate • Ultrashort-
acting
nonbarbiturate
hypnotic agent.
2mg/ml in 10
ml vials.
• RSI is 0.3
mg/kg IV,
or a typical
adult dose
of 20 mg.
• No analgesic
proparies.
• Does not
depress the
cardiovascular
system .
Ketamine • Ideal induction
agent for RSI
because it
produces rapid
sedation.
• Both analgesic
and amnesic
properties
50mg/ml in 10
ml vials.
• 2 mg/kg IV
with
clinical
recovery in
10-15
minutes.
• Ketamine is
highly lipid
soluble.
• Agent of choice
with
bronchospasm.
• Half-life : 7-11
minutes.
• Preg D

35. Etomidate
• MOA: GABA-like effects on brain stem
reticular formation causing hypnosis
Dose: 0.3 mg/kg IV
Indications: RSI induction
Caution: Cortisol depression, lowers
seizure threshold, Preg C

36. DRUG USED IN RSI
DRUG USING INDUCTION
Drug Indication Concentration Dose Remarks
Etomidate • Ultrashort-
acting
nonbarbiturate
hypnotic agent.
2mg/ml in 10
ml vials.
• RSI is 0.3
mg/kg IV,
or a typical
adult dose
of 20 mg.
• No analgesic
proparies.
• Does not
depress the
cardiovascular
system .
Ketamine • Ideal induction
agent for RSI
because it
produces rapid
sedation.
• Both analgesic
and amnesic
properties
50mg/ml in 10
ml vials.
• 2 mg/kg IV
with
clinical
recovery in
10-15
minutes.
• Ketamine is
highly lipid
soluble.
• Agent of choice
with
bronchospasm.
• Half-life : 7-11
minutes.
• Preg D

37. Ketamine
MOA: Acts on cortex and limbic system.
Dose: Subdissociative: 0.1-0.5 mg/kg IV
Procedural sedation: 0.5-1 mg/kg IV
RSI induction: 2 mg/kg IV
Indications: Analgesia, sedation, RSI induction
Caution: Emergence reactions (treat with
benzos or barbs),laryngospasm, IOP increase,
ICP increase, tachycardia, hypertension, Preg D

38. DRUG USED IN RSI
DRUG USING INDUCTION
Drug Indication Conc Dose Remarks
Propofol • Sedative
hypnotic.
10mg/ml in
20ml
ampoules.
• Induction
dose is 2
mg/kg,
• Short duration of
action of 10-15 min.
• Myocardial depressant,
• Decrease in MAP.
• Decreases cerebral
metabolism & ICP.
• Preg B
Midazolam • Seizure,
• RSI
• Procedural
sedation,
• Ventilator
sedation.
5mg/ml in 3
ml vials.
• RSI is 0.1
mg/kg,
Infusion:
1-10
mg/hour.
• Respiratory depression,
• Hypotensive effects,
• Preg D.

39. Propofol
MOA: GABAa agonist, Na channel blocker
Dose: Procedural Sedation: 1 mg/kg IV bolus
then 0.5 mg/kg q 3 minutes to effect
RSI induction: 1.5-2.5 mg/kg IV x 1
Ventilator Sedation: 5-50 mcg/kg/min)
Indications: Procedural sedation, RSI induction,
ventilator sedation.
Caution: Hypotension, anaphylaxis, bradycardia,
apnea, Preg B

40. DRUG USED IN RSI
DRUG USING INDUCTION
Drug Indication Conc Dose Remarks
Propofol • Sedative
hypnotic.
10mg/ml in
20ml
ampoules.
• Induction
dose is 2
mg/kg,
• Short duration of
action of 10-15 min.
• Myocardial depressant,
• Decrease in MAP.
• Decreases cerebral
metabolism & ICP.
• Preg B
Midazolam • Seizure,
• RSI
• Procedural
sedation,
• Ventilator
sedation.
5mg/ml in 3
ml vials.
• RSI is 0.1
mg/kg,
Infusion:
1-10
mg/hour.
• Respiratory depression,
• Hypotensive effects,
• Preg D.

41. Midazolam
MOA: Enhances inhibitory effects of GABA
Dose: RSI induction: 0.1 mg/kg IV
Usual continuous infusion: 1-10 mg/hour
Procedural Sedation: 0.02 - 0.04 mg/kg IV
Indications: Seizure abortion, procedural
sedation, ventilator sedation, RSI.
Caution: Respiratory depression, hypotensive
effects, Preg D

42. DRUG USED IN RSI
Drug using as Paralytic agent
Drug Indication Concentration Dose Remarks
Succinylcholine • Depolarizi
ng agent
used for
rapid
sequence
induction.
• Available as
a 20-
mg/mL
solution.
• Dose is
1.5 mg/kg
in adults
and 2
mg/kg in
children
younger
than 5
years.
• Rapid onset,
• Ultrashort
duration and
safety.
• Muscle
relaxation with
in 30 sec.
• Total paralysis in
45 sec, lasting 7-
10 minutes.
• Increase serum
potassium.
• Preg C .

43. Succinylcholine
MOA: Depolarizing neuromuscular agent
Dose: 1.5 mg/kg (or 3-4 mg/kg IM)
Rapid onset (45-60 seconds)
Short half-life (6-8 minutes of paralysis)
Indications: RSI paralysis.
Caution: Hyperkalemia, subacute burn/crush
with hyperkalemia, glaucoma (increases IOP),
increases ICP, Preg C

44. NORCURIUM
Vecuronium
(Norcuron)
• Decreases
fasciculation &
potassium
release from
cells;
10mg/vial
mix with 10
ml DW.
• Defasciculati
ng dose: 0.01
mg/kg IV
push
(typically
about 1 mg,
• Avoid higher
doses to
produce
paralytic effect.
• Preg B

45. Nocuronium
MOA: Non-depolarizing neuromuscular agent
Dose: 1mg/kg IV
Indications: RSI paralysis.
Can give hyperkaleamia pt.
Caution: Prolonged paralysis, Preg B

47. ACLS MEDICATION
DRUG USING ACS
Drug Indication Concentration Dose Remarks
Nitroglycerin • Chest pain
suspected
to be
cardiac
origin.
• Unstable
angina
• HTN crisis
• Tab SL: 0.3-
0.4 mg.
• Spray: 200
dose: 0.4
mg/dose.
• Ampoule:
8mg/10 ml.
• Sublingual: 0.2-
0.4 mg repeated
every 5 min.
• Spray: 0.4-0.8 SL.
• Infusion: 10-20
microgm/min
• With AMI
SBP drop
10%.
• HTN
emergency:
30% drop.
Morphine
Sulphate
• Analgesic
of choice
for AMI.
• Acute
pulmonary
oedema.
• 2-4 mg/ml
in Syringe.
• 2-5 mg IV slowly
over 1-5 min.
Repeat every 5-
30 min.
• May
respiratory
depression.
• Naloxone:
0.4-0.8 mg
IV for
reverse.

48. Nitroglycerin
MOA: Venodilator, stimulates cGMP production
Dose: 5-200mcg/min, increase 10 mcg q 3-5 min
until desired effect; higher doses are usually
required for pulmonary edema therefore
recommend starting at a dose > 5 mcg/min
Indications: CHF, angina
Caution: Hypotension, methemoglobinemia,
Preg C

49. ACLS MEDICATION
DRUG USING ACS
Drug Indication Concentration Dose Remarks
Nitroglycerin • Chest pain
suspected
to be
cardiac
origin.
• Unstable
angina
• HTN crisis
• Tab SL: 0.3-
0.4 mg.
• Spray: 200
dose: 0.4
mg/dose.
• Ampoule:
8mg/10 ml.
• Sublingual: 0.2-
0.4 mg repeated
every 5 min.
• Spray: 0.4-0.8 SL.
• Infusion: 10-20
microgm/min
• With AMI
SBP drop
10%.
• HTN
emergency:
30% drop.
Morphine
Sulphate
• Analgesic
of choice
for AMI.
• Acute
pulmonary
oedema.
• 2-4 mg/ml
in Syringe.
• 2-5 mg IV slowly
over 1-5 min.
Repeat every 5-
30 min.
• May
respiratory
depression.
• Naloxone:
0.4-0.8 mg
IV for
reverse.

50. Morphine sulfate
MOA: Opioid agonist producing analgesia with
adjunctive sedative effects
Dose: 2-10 mg IV q 2-6 hours. Recommended
dose 0.1 mg/kg IV
Indications: Pain control
Caution: Respiratory depression, vasodilation
(hypotension), Preg C
Antidot: Nalaxone: 0.4-2 mg IV stat.

51. SUMMERY
• Know dosages, indications, contraindications,
and side effects of drugs.
• Know concentrations of drugs.
• Know what drugs using in our organization.

52. Prevent Cardiac Arrest!!