Final answer:
After two shocks and one dose of epinephrine in pulseless ventricular tachycardia, amiodarone 300 mg should be administered next as per ACLS guidelines, in an attempt to restore normal heart rhythm.
Step-by-step explanation:
When a patient is in pulseless ventricular tachycardia and has already received two shocks and one dose of epinephrine, the next drug that should be given according to Advanced Cardiac Life Support (ACLS) guidelines is amiodarone 300 mg. Adenosine is not used in pulseless arrest, and while lidocaine could be considered as an alternative to amiodarone, it is not the first choice. Additional doses of epinephrine are given at regular intervals during cardiac arrest, but not immediately after the first dose.
If a patient does not respond to the initial resuscitative efforts, including defibrillation and epinephrine, amiodarone is recommended to try and restore a stable rhythm. This medication works by affecting the electrical activity of the heart to help restore a normal rhythm and is given as part of Advanced Cardiac Life Support protocols.