Cardiac Drug Dosages — Adult

What is the adult dose of Epinephrine 1:10,000 for cardiac arrest with severe hypothermia (core temp <86°F)?

1 mg IVP/IO — one dose only, no repeats

What is the adult dose of Naloxone (Narcan) for cardiac arrest due to suspected opioid overdose?

2 mg IV/IO

What is the adult dose of Dextrose 10% (D10W) for cardiac arrest due to hypoglycemia (BGL <70)?

250 mL IV/IO

What is the adult dose of Calcium Chloride for cardiac arrest due to hyperkalemia/renal patient?

1 gram IV/IO

What is the adult dose of TXA (Tranexamic Acid) for cardiac arrest with suspected incompressible hemorrhage?

1 gram IV/IO over 10 minutes

What is the adult dose of Epinephrine 1:10,000 for cardiac arrest (Asystole/PEA/VT/VF)?

1 mg IV/IO, repeat every 3–5 minutes, max 3 doses

What is the adult dose of Sodium Bicarbonate for cardiac arrest (Asystole/PEA/VT/VF)?

50 mEq IV/IO

What is the adult dose of Amiodarone for cardiac arrest VT/VF, first antiarrhythmic dose?

300 mg IV/IO

What is the adult dose of Lidocaine 2% for cardiac arrest VT/VF, first antiarrhythmic dose (alternative to amiodarone)?

1 mg/kg IV/IO, max 100 mg

What is the adult dose of Amiodarone for cardiac arrest VT/VF, second antiarrhythmic dose?

150 mg IV/IO (if amiodarone given before)

What is the adult dose of Lidocaine for cardiac arrest VT/VF, maintenance infusion?

2 mg/min IV/IO, titrate to max 4 mg/min

What is the adult dose of Magnesium Sulfate for persistent VF/VT in cardiac arrest?

2 grams IV/IO over 1–2 minutes

What is the adult dose of Normal Saline for cardiac arrest fluid bolus?

1 Liter IV/IO

What is the adult dose of Norepinephrine for post-ROSC hypotension?

0.1 mcg/kg/min IV/IO, titrate to max 0.5 mcg/kg/min

What is the adult dose of Midazolam for post-ROSC sedation (not comatose)?

0.1 mg/kg IV/IO, may repeat in 10 min, max 10 mg/dose

What is the adult dose of Fentanyl for post-ROSC pain/sedation (not comatose)?

1 mcg/kg IV/IO, may repeat in 10 min, max total 300 mcg

What is the adult dose of Amiodarone for post-ROSC VT/VF with no antiarrhythmic given yet?

150 mg IV/IO over 10 minutes (HR must be >60 bpm)

What is the adult dose of Normal Saline for bradycardia fluid bolus?

500 mL IV/IO, may repeat, max 2 liters

What is the adult dose of Calcium Chloride for bradycardia with suspected calcium channel blocker overdose?

1 gram IV/IO

What is the adult dose of Atropine for bradycardia unresolved after fluid bolus?

1 mg IV/IO, repeat every 3–5 min, max 3 mg (not if 2nd/3rd degree block)

What is the adult dose of Ketamine for bradycardia, sedation for pacing?

0.5 mg/kg IV/IO, may repeat once after 5 min, max 500 mg total

What is the adult dose of Midazolam for bradycardia, sedation for pacing (SBP >90)?

0.1 mg/kg IV/IO/IN, repeat in 10 min, max 5 mg

What is the adult dose of Fentanyl for bradycardia, sedation for pacing?

1 mcg/kg IV/IO/IN, repeat in 10 min, max total 300 mcg

What is the adult dose of Epinephrine infusion for bradycardia not resolved with pacing?

2 mcg/min IV/IO, titrate to max 4 mcg/min

What is the adult dose of Norepinephrine for bradycardia not resolved?

0.1 mcg/kg/min IV/IO, titrate to max 0.5 mcg/kg/min

What is the adult dose of Aspirin for chest pain of suspected cardiac etiology?

81 mg x4 PO chewed OR one 325 mg PO chewed

What is the adult dose of Nitroglycerin for chest pain of suspected cardiac etiology?

0.4 mg SL, repeat every 3–5 min up to 3 doses if BP ≥90 (hold if BP <90 or inferior wall MI)

What is the adult dose of Normal Saline for chest pain, hypotensive with no CHF?

500 mL IV/IO, may repeat, max 2 liters

What is the adult dose of Fentanyl for chest pain, continued pain after nitroglycerin (SBP ≥90)?

1 mcg/kg IV/IO/IN if indicated

What is the adult dose of Normal Saline for LVAD patient fluid bolus?

250–500 mL IV/IO if indicated

What is the adult dose of Narcan (Naloxone) for LVAD patient with respiratory depression?

2 mg IV/IO/IN, max total 2 mg (consider 0.2 mg increments for chronic pain patients)

What is the adult dose of Fentanyl for LVAD patient pain management?

1 mcg/kg IV/IO/IM/IN, max 100 mcg/dose, repeat every 10 min, max total 300 mcg

What is the adult dose of DuoNeb (albuterol/ipratropium) for LVAD patient with wheezing?

one HHN dose (max)

What is the adult dose of Ondansetron for LVAD patient nausea?

4 mg IV/IM/PO

What is the adult dose of Adenosine for LVAD patient SVT with HR >150?

12 mg RIVP, may repeat once (do NOT give amiodarone or diltiazem)

What is the adult dose of Amiodarone for narrow complex tachycardia/AFib with RVR, unstable with WPW?

150 mg IV over 10 minutes

What is the adult dose of Magnesium Sulfate for narrow complex tachycardia with Torsades de Pointes?

2 grams IV/IO

What is the adult dose of Adenosine for stable regular SVT?

12 mg IV/IO rapid push + 20 mL saline flush, may repeat 12 mg once (start at 6 mg if central line, transplant, carbamazepine, or dipyridamole)

What is the adult dose of Adenosine for narrow complex tachycardia in a patient with a central line, heart transplant, or taking carbamazepine/dipyridamole?

Start at 6 mg (half the standard dose) IV/IO rapid push

What is the adult dose of Diltiazem for irregular rhythm (AFib/flutter) with rapid ventricular response, rate control?

20 mg slow IV/IO if SBP ≥90 (10 mg then repeat 10 mg in 5 min if age ≥60); may repeat dose in 15 min

What is the adult dose of Lidocaine 2% for narrow complex tachycardia, rhythm not converted after adenosine/diltiazem?

1 mg/kg, may repeat, max total 3 doses

What is the adult dose of Amiodarone for narrow complex tachycardia, rhythm not converted (alternative to lidocaine)?

150 mg IV/IO over 10 minutes

What is the adult dose of Ketamine for narrow complex tachycardia, sedation before cardioversion?

0.5 mg/kg IV/IO

What is the adult dose of Fentanyl for narrow complex tachycardia, sedation before cardioversion?

1 mcg/kg IV/IO/IN

What is the adult dose of Midazolam for narrow complex tachycardia, sedation before cardioversion (SBP >90)?

0.1 mg/kg IV/IO/IN, max 5 mg

What is the adult dose of Amiodarone for stable wide complex tachycardia, first dose?

150 mg IV/IO over 10 minutes (SBP >90)

What is the adult dose of Amiodarone for wide complex tachycardia, no rhythm change, second dose?

150 mg IV/IO over 10 minutes (SBP >90, HR >60)

What is the adult dose of Lidocaine 2% for wide complex tachycardia, no rhythm change after 2nd amiodarone dose?

1 mg/kg, may repeat, max total 3 doses

What is the adult dose of Ketamine for wide complex tachycardia, sedation before cardioversion?

0.5 mg/kg IV/IO

What is the adult dose of Fentanyl for wide complex tachycardia, sedation before cardioversion?

1 mcg/kg IV/IO/IN, max 300 mcg

What is the adult dose of Midazolam for wide complex tachycardia, sedation before cardioversion (SBP >90)?

0.1 mg/kg IV/IO/IN, max 5 mg

What is the adult dose of Amiodarone for wide complex tachycardia, after cardioversion?

150 mg IV/IO over 10 minutes (SBP >90, HR >60)