ACLS review: Bradycardia part 6

Chronotropic drugs

·         For the treatment of adults with symptomatic and unstable bradycardia

·         Recommended as an alternative to pacing

Dopamine

5-20ug/kg/min

• Low dose 1-5ug/kg/min
• Moderate dose 5-10ug/kg/min
• High dose 10-20ug/kg/min

Note:

At lower doses dopamine has a more selective effect on inotropy and heart rate; at higher doses (>10 mcg/kg per minute), it also has vasoconstrictive effects. Dopamine infusion may be used for patients with symptomatic bradycardia, particularly if associated with hypotension, in whom atropine may be inappropriate or after atropine fails

Epinephrine 2-10ug/min

·         Epinephrine infusion

·         Mix 1mg in 250 NS

Note

Epinephrine infusion may be used for patients with symptomatic bradycardia, particularly if associated with hypotension, for whom atropine may be inappropriate or after atropine fails

Isoproterenol 2-10ug/min

·         Mix 4mg in 500cc of NS

·         Increased myocardial ischemia,

·         Hypotension

·         Peripheral vasodilation

Reviewed 2/28/16