Atropine
Can be used as temporizing measure (while awaiting pacing and/or chronotropes)
Use cautiously in patients with ongoing ischemia (tachycardia may worsen ischemia)
Avoid and/or do not rely on in wide complex bradycardia, especially in setting of ischemia
1mg q3-5min (max 3mg or 3 doses)
May not work in 2nd/3rd degree heart block, heart transplant
Priority is to use external cardiac pacemaking
Block is below AV node so atropine will accelerate sinus rate, leading to worsening of block and increased fatigue of AV nodal cells
Chronotropes
Dopamine 5-20 mcg/kg/min, max 50 mcg/kg/min
Dobutamine 2-20 mcg/kg/min, max 40 mcg/kg/min
Epinephrine 2-10 mcg/min (~0.03-0.2 mcg/kg/min, max 1 mcg/kg/min)
Isoproterenol 2-10 mcg/min
Transcutaneous Pacing
Transvenous Pacing
Can be used as temporizing measure (while awaiting pacing and/or chronotropes)
Use cautiously in patients with ongoing ischemia (tachycardia may worsen ischemia)
Avoid and/or do not rely on in wide complex bradycardia, especially in setting of ischemia
1mg q3-5min (max 3mg or 3 doses)
May not work in 2nd/3rd degree heart block, heart transplant
Priority is to use external cardiac pacemaking
Block is below AV node so atropine will accelerate sinus rate, leading to worsening of block and increased fatigue of AV nodal cells
May not work in 2nd/3rd degree heart block, heart transplant
Priority is to use external cardiac pacemaking
Block is below AV node so atropine will accelerate sinus rate, leading to worsening of block and increased fatigue of AV nodal cells
Dopamine 5-20 mcg/kg/min, max 50 mcg/kg/min
Dobutamine 2-20 mcg/kg/min, max 40 mcg/kg/min
Epinephrine 2-10 mcg/min (~0.03-0.2 mcg/kg/min, max 1 mcg/kg/min)
Isoproterenol 2-10 mcg/min
Beta-Blocker Toxicity
Glucagon 5mg IV Q10min (rpt up to 3 doses)
Insulin 1U/kg bolus
Intralipid (ILE)
Calcium Channel Blocker Toxicity
Calcium gluconate 3g
Insulin 1U/kg bolus
Intralipid (ILE)
Digoxin Toxicity
Dig immune Fab 10-20 vials
Opioid Toxicity
Naloxone 0.4mg IV
Organophosphate Toxicity
Atropine 2mg IV, double dose q5-30m until secretions controlled
Pralidoxime 1-2g IV over 15-30min
Glucagon 5mg IV Q10min (rpt up to 3 doses)
Insulin 1U/kg bolus
Intralipid (ILE)
Calcium gluconate 3g
Insulin 1U/kg bolus
Intralipid (ILE)
Dig immune Fab 10-20 vials
Naloxone 0.4mg IV
Atropine 2mg IV, double dose q5-30m until secretions controlled
Pralidoxime 1-2g IV over 15-30min
ACLS: Bradycardia
Cardiac
PALS: Bradycardia
Inferior MI 
ACLS: Tachycardia
Sick sinus syndrome
PALS: Tachycardia
Neurocardiogenic/reflex-mediated