The Pharmacologic Management of Cardiac Arrest

Emerg Med Clin North Am. 2023 Aug;41(3):559-572. doi: 10.1016/j.emc.2023.03.010. Epub 2023 May 10.

Abstract

The effectiveness of pharmacologic management of cardiac arrest patients is widely debated; however, several studies published in the past 5 years have begun to clarify some of these issues. This article covers the current state of evidence for the effectiveness of the vasopressor epinephrine and the combination of vasopressin-steroids-epinephrine and antiarrhythmic medications amiodarone and lidocaine and reviews the role of other medications such as calcium, sodium bicarbonate, magnesium, and atropine in cardiac arrest care. We additionally review the role of β-blockers for refractory pulseless ventricular tachycardia/ventricular fibrillation and thrombolytics in undifferentiated cardiac arrest and suspected fatal pulmonary embolism.

Keywords: Amiodarone; Cardiac arrest medications; Epinephrine; Lidocaine.

Publication types

  • Review

MeSH terms

  • Anti-Arrhythmia Agents / therapeutic use
  • Atropine
  • Epinephrine / therapeutic use
  • Heart Arrest* / drug therapy
  • Humans
  • Sodium Bicarbonate

Substances

  • Epinephrine
  • Atropine
  • Sodium Bicarbonate
  • Anti-Arrhythmia Agents