ACLS Drugs: Adrenaline, Amiodarone, Atropine, Adenosine and More

ACLS uses a short list of drugs, each tied to a specific point in an algorithm. Learning them in context — not as a list — is what the ACLS course and the Megacode test.

Cardiac arrest

• Adrenaline (epinephrine) — given every 3 to 5 minutes; early in asystole and PEA, after initial shocks in VF and pulseless VT.
• Amiodarone or lidocaine — antiarrhythmics for VF or pulseless VT that persists after shocks.
• Magnesium — for torsades de pointes.

Bradycardia

• Atropine — first-line for symptomatic bradycardia, repeated to a maximum.
• Dopamine or adrenaline infusions — if atropine fails, as an alternative to pacing.

See the bradycardia algorithm.

Tachycardia

• Adenosine — rapid IV push with a flush, for stable regular narrow-complex tachycardia.
• Antiarrhythmic infusions — for stable wide-complex tachycardia, with expert advice.

See the tachycardia algorithm.

ACS and stroke

Aspirin, nitroglycerin, oxygen when hypoxaemic, and fibrinolytics in selected patients — see ACS and stroke.

Routes

IV is preferred; intraosseous access is used when IV access cannot be obtained quickly.

Learning them

Tie each drug to its place in an algorithm and practise saying the order aloud with closed-loop communication. Pharmacists on code teams have their own guide: ACLS for pharmacists.

This guide summarises what the ACLS course teaches for education only. It is not a clinical protocol: follow the current American Heart Association guidelines, linked below, and your institution’s policies.

More ACLS guides: ACLS algorithms and skills

• ACLS Course in Abu Dhabi — dates, format and booking
• ACLS Algorithms Explained: Cardiac Arrest, Bradycardia, Tachycardia and Post-Arrest Care
• The ACLS Systematic Approach: BLS, Primary and Secondary Assessment
• ACLS Cardiac Arrest: VF and Pulseless VT (the Shockable Pathway)
• ACLS Asystole and PEA: The Non-Shockable Pathway
• ACLS Bradycardia Algorithm: Atropine, Pacing and Infusions
• ACLS Tachycardia Algorithm: Stable vs Unstable Tachycardia
• ACLS Post-Cardiac Arrest Care: What Happens After ROSC
• The H's and T's of ACLS: Reversible Causes of Cardiac Arrest
• ACLS Rhythms: The ECG Rhythms You Need to Recognise
• ACLS Airway Management: From Bag-Mask to Advanced Airway
• Waveform Capnography in ACLS: What End-Tidal CO2 Tells You
• Acute Coronary Syndromes in ACLS: Recognition and First Steps
• Acute Stroke in ACLS: Recognition, Timing and First Steps
• ACLS Megacode: How It Works and How to Pass as Team Leader
• ACLS Electrical Therapy: Defibrillation, Cardioversion and Pacing
• All ACLS guides, by topic

Other life support and first aid courses: BLS Course · PALS Course · First Aid Course · Training calendar

Frequently asked questions

What is the main drug in cardiac arrest?

Adrenaline (epinephrine), given every 3 to 5 minutes.

When is amiodarone used?

For VF or pulseless VT that persists after shocks; lidocaine is an alternative.

What is atropine used for in ACLS?

Symptomatic bradycardia.

What is adenosine used for?

Stable regular narrow-complex tachycardia such as SVT.

Is vasopressin still in the ACLS algorithm?

It is not part of the current AHA adult cardiac arrest algorithm.

Sources and further reading

What we teach follows the awarding body and the UAE health authorities. For the definitive position on a course or licensing question, these are the places to check.

• CPR and ECC Guidelines — American Heart Association
• Advanced Cardiovascular Life Support (ACLS) — American Heart Association

Last reviewed 21 September 2026 by the training team at Safety First Medical Services, an American Heart Association training centre at Addax Office Tower, Al Reem Island, Abu Dhabi. Call +971 55 761 9841 or email training@safetyfirstmed.ae.