Cardiac Arrest Pharmacology Flashcards

What is the recommended dose of vasopressin that may be used as an alternative to the first or second dose of epinephrine in cardiac arrest?

Answer: 40 units IV/IO

Vasopressin 40 units IV/IO may replace the first or second dose of epinephrine in cardiac arrest per older AHA guidelines.

A patient in refractory VF has received 3 shocks and 300 mg amiodarone. What is the correct supplemental dose of amiodarone?

Answer: 150 mg IV

After an initial 300 mg amiodarone dose, a single supplemental dose of 150 mg IV/IO may be given for refractory VF/pVT.

Which electrolyte disturbance is a Class I indication for magnesium sulfate administration during cardiac arrest?

Answer: Hypomagnesemia-induced torsades de pointes

Magnesium sulfate 1–2 g IV is a Class I indication specifically for torsades de pointes (polymorphic VT) associated with hypomagnesemia.

During a cardiac arrest secondary to tricyclic antidepressant overdose, which drug is the treatment of choice to reverse cardiotoxicity?

Answer: Sodium bicarbonate

Sodium bicarbonate alkalinizes the blood and reverses TCA-induced sodium channel blockade, narrowing the QRS and improving myocardial function.

What is the primary mechanism by which epinephrine improves outcomes in cardiac arrest?

Answer: Alpha-1 vasoconstriction increasing coronary perfusion pressure

Epinephrine's alpha-1 adrenergic effect causes peripheral vasoconstriction, raising aortic diastolic pressure and thus coronary perfusion pressure during CPR.

A patient arrests after administration of succinylcholine and develops peaked T-waves on the monitor. Which drug should be given first?

Answer: Calcium chloride

Calcium chloride (or gluconate) immediately stabilizes the myocardial membrane and is the first intervention for hyperkalemia-induced cardiac arrest.

Lidocaine is considered an acceptable alternative to amiodarone in which arrest rhythm?

Answer: Refractory ventricular fibrillation

Lidocaine 1–1.5 mg/kg IV/IO is an acceptable alternative antiarrhythmic for shock-refractory VF/pVT when amiodarone is unavailable.