Question

A 63 y/o female complains of chest pain. The monitor reveals a sinus bradycardia at 42. Vitals are P 42, R 15, BP 86/60, SaO2 of 94%. You have established IV access and administered the maximum dose of atropine. Pacing has failed to capture. What two medications may be ordered by the medical command physician?

[2] Medication 2 and initial dose

Answer 1

In cases of symptomatic bradycardia unresponsive to atropine and pacing, dopamine starting at 2 to 20 μg/kg/min and epinephrine at 2 to 10 μg/min may be administered to increase heart rate and blood pressure.

Step-by-step explanation:

In this scenario, two medications that a medical command physician may consider ordering are dopamine and epinephrine. Dopamine acts as a vasopressor and inotropic agent, which can increase heart rate and improve cardiac output. It is usually started at a dose of 2 to 20 micrograms per kilogram of body weight per minute, titrated to response. Epinephrine, another potent vasopressor and inotropic agent, can also be used to increase heart rate and blood pressure. It is typically initiated at a dose of 2 to 10 micrograms per minute, titrated according to the patient's response.