Advanced Cardiovascular Life Support (ACLS) Practice Exam

What is the recommended drug and dose for managing a patient in refractory ventricular fibrillation?

1. Lidocaine 150 mg

2. Adenosine 6 mg

3. Amiodarone 300 mg

4. Ephedrine 1 mg

The correct answer is: Amiodarone 300 mg

The recommended drug and dose for managing a patient in refractory ventricular fibrillation is amiodarone at 300 mg. This is because amiodarone is an antiarrhythmic medication that is effective in stabilizing life-threatening ventricular arrhythmias. In cases of refractory ventricular fibrillation, especially when initial treatments such as defibrillation and CPR have not restored a normal heart rhythm, the use of amiodarone is indicated to improve the chances of converting the rhythm back to a stable one. Amiodarone works by prolonging the duration of the action potential and refractory period in myocardial tissues, thereby helping to restore a more normal electrical rhythm. The initial dosing of 300 mg in a bolus, followed by additional doses if necessary, aligns with current ACLS guidelines and reflects the critical nature of ventricular fibrillation as a time-sensitive emergency. The use of this medication can significantly enhance the likelihood of successful resuscitation in such scenarios.