ACLS Provider: Course

ACLS Medication Reference Table

This table summarizes the key medications used in Advanced Cardiac Life Support (ACLS), including indications, standard dosing, administration routes, and practical notes. Always consider the patient’s clinical context and consult your facility’s protocols as needed.

Medication	Indications	Standard Dosing	Route	Notes / Clinical Tips
Epinephrine	Cardiac arrest (VF, pVT, asystole, PEA)	1 mg every 3–5 minutes	IV/IO	Start ASAP during resuscitation; follow with flush. No max dose.
Amiodarone	Refractory VF/pVT	300 mg IV/IO bolus, then 150 mg if needed	IV/IO	Use after 3rd shock. Flush between meds and defibrillation.
Lidocaine	Alternative to amiodarone in VF/pVT	1–1.5 mg/kg, then 0.5–0.75 mg/kg q5–10min Max: 3 mg/kg	IV/IO	Consider for torsades or amiodarone allergy; monitor for CNS effects.
Atropine	Symptomatic bradycardia	0.5 mg every 3–5 minutes Max: 3 mg	IV	Ineffective in high-degree AV blocks. May worsen Mobitz II or 3° block.
Adenosine	Stable narrow-complex SVT	6 mg rapid push, then 12 mg if needed	IV (follow with flush)	Give quickly with immediate flush. Brief asystole common. Not for Afib/flutter.
Dopamine	Bradycardia (post-atropine) or hypotension	2–20 mcg/kg/min infusion	IV infusion	Titrate to patient response. Monitor for tachyarrhythmias.
Magnesium Sulfate	Torsades de Pointes Hypomagnesemia	1–2 g diluted in 10 mL D5W over 5–20 min	IV/IO	First-line for polymorphic VT with prolonged QT. Use cautiously in renal failure.
Naloxone	Suspected opioid overdose with respiratory depression	0.4–2 mg every 2–3 minutes Max: 10 mg	IV/IM/SC/IN	Not part of core ACLS algorithm, but critical in opioid-associated arrest.
Calcium Chloride	Hyperkalemia Hypocalcemia Calcium channel blocker overdose	500–1000 mg (5–10 mL of 10% solution)	IV slow push	Use cautiously; can precipitate with bicarbonate. Avoid in routine arrest.
Sodium Bicarbonate	Known metabolic acidosis Hyperkalemia Tricyclic overdose	1 mEq/kg bolus	IV	Use only in specific cases. Not routine. May worsen intracellular acidosis.