Acls Drugs
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ACLS Drugsby Mark Jaimison
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ACLS protocol utilizes the highest quality pharmaceuticals in the field of emergency medicine. In order toprevent further injury, ACLS trained professionals initiate IV access or intubation in certain situationswhere immediate intervention is needed, such as serious cardiac events and stroke. In prehospitalsettings, these pharmaceuticals are vital to keep the person alive and stable during transport to amedical facility.
The pharmacology used by ACLS providers is the same used in hospitals by physicians working with thesame kind of medical emergencies. ACLS certification courses provide a vast amount of informationabout these drugs, and trainees learn to determine which drug to use in any given clinical situationthrough the different ACLS algorithms.
Here are some of the most commonly used drugs for various cardiovascular events utilized in ACLSprotocol:
Ventricular Fibrillation/ Ventricular Tachycardia
Vasopressin: Used in the pulseless arrest algorithm to raise blood pressure and induce moderatevasoconstriction. Has been shown to be more effective than epinephrine during asystolic cardiacarrest.Epinephrine: A drug with powerful vasoconstrictive effects, used to increase cardiac output. Can begiven through IV/IO and endotracheal tube.Amiodarone: Antiarrhythmic agent used for various tachyarrythmias, administered through IV/IO.Lidocaine: Used as an alternative in VT/VF cardiac arrest when amiodarone is ineffective.
Bradycardia
Epinephrine: Increases heart rate, heart contractility, and conductivity through the AV node.
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Atropine: Increases activity in the SA node by blocking the vagas nerve and increasing heart rate.Most commonly used drug for bradycardia.Dopamine
Tachycardia
Adenosine: The main drug used to treat supraventricular tachycardia (stable narrowcomplex). Itinterrupts reentry through the AV node and restores normal sinus rhythm. It is quickly absorbedby red blood cells before being metabolized by the body.Betablockers: Neutralizes the effects of stress hormones and epinephrine (adrenaline), which cantrigger or exacerbate tachyarrhythmias.DilitiazemDigoxinAmiodarone
Asystole/PEA
VasopressinEpinephrine
Acute Coronary Syndomes
AspirinOxygenMorphineNitroglycerin
Acute Stroke
tPAtissue: Breaks down blood clots in the treatment of embolic or thrombotic stroke.Glucose (D50)Plasminogen Activator
All of these drugs have specific conditions and dosages for use. These drugs are very powerful, and alsocome with some serious sideeffects, so ACLS providers must exercise caution and accurately determinethe correct drug and dosages to use. ACLS training features comprehensive algorithms whichprofessionals follow stepbystep to ensure that optimal pharmaceutical care is provided.
Our ACLS Pharmaceuticals Review & Tips:
As previously noted, ACLS is a series of medical procedures put in to action using step by step methods,in order to save a patient suffering from cardiac arrest or certain other similar medical emergencies. Inaddition to procedures and techniques, drugs and medications are also used to help manage a patientand bring him back to life.
There are several sets of medications that are administered throughout the algorithms to keep thepatient recovering, step by step. Furthermore, certain medications are to be administered immediately orin prehospital settings while other sets of medications are to be administered in the emergency room
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afterwards.
For ACLS students, it is very important to thoroughly understand a few points regarding medicationadministration:
It is very important to know the nature of the drug/drugsIt is crucially important to understand the proper time for administering medicationsIt is also very important to understand the proper method of drug administrationThe affect of medication is also to be understood, carefully.
ACLS medications are administered for several purposes i.e. to keep a person alive and protecting andpreparing the heart for later interventions.
The American Heart Association has provided protocols for proper medication distribution and regularlyupdates these protocols from time to time. Hence, it is very important for all medical professionals tolearn the ACLS protocols and keep updating themselves as needed. Here is a short outline of themedications administered throughout the Advanced Cardiac Life Support algorithm.
PreHospital Medications
At the beginning of the Life Support procedure, there are several drugs that can be administered. Thesemedications are aimed at instant relief and preparing a patient for further treatment. These medicationsmay be administered:
OrallyThrough Intravenous Injections also known as IVInjected in Bones/IOThrough ET tube
Only Paramedics are certified for drug administration and EMTs are not allowed to administermedications in an ambulance. However, under some conditions they are allowed to administernitroglycerin for relieving chest pain and aspirin.
The typical medications that are used during prehospital settings or in an ambulance are:
AtropineDiltiazemAdenosineEpinephrineLidocaineMagnesiumVerapamilVasopressin
There are certain other drugs that are carried by ambulance personnel for relieving chest pain and othersymptoms arising from cardiac arrest, aside from the aforementioned pharmaceuticals. A few of themare:
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AspirinDopamineSodium bicarbonateMorphineCalcium
Emergency Room Medications
After the patient reaches the emergency room, he is to be administered with several other medicationsfor proper treatment. These drugs may belong to the primary or secondary groups of Advance CardiacLife Support drugs. Primary ACLS medications are those which are to be administered to keep thepatient alive and are generally administered in prehospital settings. However, due to storage or costissues, there are certain drugs that cannot be carried in the ambulance and are given to the patient assoon as he arrives to the emergency room. On the other hand, secondary drugs are those which are tobe administered to weed the root cause out.
The medications that are normally administered in the emergency room settings are:
Digoxin or Amiodarone for normalizing abnormal heart rhythmsDrugs for flushing clots out of heartDrugs for normalizing Blood pressure i.e. Beta blockers or ACE inhibitorsDrugs for thinning blood to prevent clot formation inside heart or arteries.
In addition to these drugs, several other drugs are detailed in the ACLS protocols issued by the AmericanHeart Association. The guidelines for Advanced Cardiac Life Support provide detailed algorithms fortreating several cardiac conditions that may end up in arrest and procedures to fight these conditions inorder to save lives. When proper clinical guidelines are coupled with proper or prescribed drugs, therecovery of patients is effective and fastidious.
Ventricular Fibrillation
EpinephrineVasopressinAmiodaroneLidocaineMagnesium
Asystole/PEA
EpinephrineVasopressin
Bradycardia
AtropineEpinephrineDopamine
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Tachycardia
AdenosineDiltiazemBetablockersAmiodaroneDigoxinVerapamilMagnesium
Acute Coronary Syndrome
OxygenAspirinNitroglycerineMorphineFibrolynic TherapyHeparinBetablockers
Acute Stroke Care
tPA (tissue plasminogen activator)GlucoseLabetoloNitroprussideNicardipineAspirin
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