Doses

Question 1

Electrical cardioversion

Answer 1

• Atrial Fibrillation: 100-200 Joules (biphasic), 200-360 Joules (monophasic).
• Atrial Flutter: 50-100 Joules (biphasic), 100-200 Joules (monophasic).
• Ventricular Tachycardia with a Pulse: 100 Joules (biphasic), 100-200 Joules (monophasic).

Question 2

Pharmacologic cardioversion

Answer 2

• Flecainide: 300 mg oral (if no structural heart disease).
• Propafenone: 600 mg oral (if no structural heart disease).
• Amiodarone: 150 mg IV over 10 minutes, followed by infusion.
• Ibutilide: 1 mg IV over 10 minutes (for atrial fibrillation/flutter).

Question 3

Protamine

Question 4

Tranexamic acid

Answer 4

1 gram IV within 10 mins followed by 1g over 8 h infusions

Question 5

Fomepizole

Answer 5

15-mg/kg loading dose, followed by 10 mg/kg every 12 hours for four doses, then 15 mg/kg every 12 hours until the patient is asymptomatic with normal acid-base status and decreasing serum methanol levels.

Question 6

Defibrillation

Answer 6

• Monophasic (360 J) or
• Biphasic (120-200J), 2nd and subsequent doses should be equivalent.

Question 7

NAC

Answer 7

• 150 mg/kg in over 1 hour
• 50 mg/kg over 4 hours
• 100 mg/kg over 16 hours.