Drugs used in CPR

1. Adrenaline/Epinephrine
▪ Action: It increases systemic vascular resistance and blood pressure;
improves coronary and cerebral perfusion and myocardial contractility.

▪ Indication:

- Give immediately in non-shockable rhythm.

- Given after the 3rd shock in shockable rhthym (VT/VF).

▪ Dose: 1mg IV (0.01mg/kg)

▪ Time of Administration:

- Repeated every 4 minutes (every other cycle )

- Once adrenaline ALWAYS adrenaline

▪ Other: Given as vasopressor for its two adrenergic effect. Not as an

inotrope.

▪ Nursing Considerations:

- Recognise that no lung damage occurs when used for less than 24hrs.
- Monitor dose by end-tidal cardiac output or pulse oximeter.

2. Amiderone
▪ Action: Prolongs duration of action potential and effective refractory
period, non-competitive α-β adrenergic inhibition.

▪ Indication : Given after the 3rd shock in shockable rhythm.

▪ Dose: 300mg IV bolus ( 5mg/kg )

▪ Time of Administration: A further dose of 150mg if VF/VT persists.

▪ Others: If Amiderone is not available lidocaine can be used instead.

▪ Nursing consideration:
 - Monitored the input and output ratio of patient.
- ECG continuously to determine drug effectiveness.
- Continuously monitored the blood pressure.

3. Lidocaine
▪ Action: Increases electrical stimulation threshould of ventrical,
Hispurkinje system, which stabilizes cardiac membrane, decreases
actomaticity.

▪ Indication: Given after 3rd shock in shockable rhythm.

▪ Dose: 100mgIV (1-1.5mg/kg )

▪ Time of Administration: A further dose of 50mg can be given if

necessary.

▪ Other: Total dose must not exceed 3mg/kg during the 1st hour.

▪ Nursing consideration:

- ECG continuously determine increased PR or QRS segments.

- Continuously monitored BP.
- Monitored the input and output ratio, electrolyte (K, Na, Cl).

4. Magnesium
▪ Action: It promotes adequate functioning of the cellular sodium
potassium group.

▪ Indication:

- Ventricular tachycardia
- Diqoxine toxicity with hypomagnesemia

▪ Dose: 2 g IV

▪ Time of Administration : May be repeated after 10-15 minutes.

▪ Nursing consideration:

- Administer initial dose an the basis of deficit calculated from arterial

blood gas values.
- Recognise that to prevent development of rebound metabolic alkalosis,
complete correction of acidosis is not indicated.

5. Sodium-bi-carbonate
▪ Action: It corrects acidosis.

▪ Indication:

- Routine use is not recommended.

- Hyperkalemia
- Overdose of TCA

▪ Dose: 50mmol IV.

▪ Time of Administration: may be repeated according to arterial blood gas

values.

▪ Other : Do not give calcium solution and sodium bicarbonate simultaneously

by the same route.

▪ Nursing consideration (MgSo4):

Moniter hypotention, asystole bradycardia, respiratory paralysis.