EMERGENCY DRUGS

SUDDEN CARDIAC
ARREST
 CARDIAC ARREST

A cardiac arrest is when your heart suddenly stops pumping

blood round your body, commonly because of a problem with
electrical signals in your heart. When your heart stops
pumping blood, your brain is starved of oxygen. This causes
to fall unconscious and stop breathing.
LIDOCAINE
Classification: Amide local anesthetic, Anti-arrhythmic

MOA: - Decrease cardiac excitability

- Delayed cardiac contraction

Indication: -Cardiac dysrhythmia

- tachycardia

Dosage: IV: 1-1.5 mg/kg as a single dose, repeat dose at 0.5-0.75mg/kg every 10 to 15
minutes after initial dose for a maximum of 3 doses. Maximum dose of 3 mg/kg is given
Child: 1mg/kg

Maintenance: IV: 20 to 50 mcg/kg/min, Endotracheal: 1 mg/kg

Side effects: Sensation of cold, vomiting, confusion, tremor, lethargy, hypotension,

bradycardia, anaphylaxis
Nursing interventions:
1. Monitor EKG, BP, pulse, rhythm continuously.
2. Monitor serum lidocaine levels throughout therapy
3. Monitor intake and output.
4. Prepare dopamine at bedside.

EPINEPHRINE
Classification: alpha and beta-adrenergic
agonists ( sympathomimetics agents)

MOA: - Stimulates beta receptor in the lungs.

- Relaxes bronchial smooth muscle.
- Increase vital capacity: BP, HR, PR.
- Decrease airway resistance.
Indications: - Cardiac arrest
- Asthma
- Correct hypotension

Dosage: IV: Adults, Elderly: 1 mg. May repeat q3-5 minutes as needed.
Children: 0.01mg/kg. May repeat q3-5 minutes as needed.
Endotracheal: Adults, Elderly: 2-2.5mg, Children: 0.1mg/kg

Side effects: Nervousness, vertigo, tremor, headache, widened pulse pressure,

nausea

Nursing interventions: 1. Monitor VS and check for cardiac dysrhythmias.

2. Avoid IM use of parenteral suspension into the buttocks. Gas gangrene may
occur.
3. Massage site after IM injection to counteract possible vasoconstriction.
4. If blood pressure increases sharply, rapid acting vasodilators such as nitrates
or alpha blockers can be given to counteract its effect.
ATROPINE

Classification: anticholinergic or anti-parasympathetic

MOA: - Increase conduction

- Oppose action of vagus nerve blocks
- Blocks acetylcholine receptor sites
- Decrease bronchial secretion

Indications: - Restore cardiac rate and arterial pressure

- Antidote for cardiovascular collapse

Dosage: IV: Adults, Elderly: 0.5-1mg q5 minutes, maximum dose of 3mg or 0.04mg/kg.
Children: 0.02mg/kg, maximum dose of 0.5mg and minimum of 0.1mg

Side effects: Dry mouth, constipation, restlessness, insomnia,

tachycardia, urine retention, palpitations, thirst, nausea
Nursing interventions:
1. Monitor VS. Report in rapid increase of heart rate.
2. Monitor for constipation.
3. Instruct to take 30 minutes before meals.
4. Advice to use hard candy, ice chips, for dry mouth.

DOPAMINE

Classification: Catecholamines

MOA: Stimulates dopaminergic and alpha and beta

receptors of the sympathetic nervous system.
Action is dose-related.
Low dose (2.5mg/kg) : Dilates renal, cerebral, coronary blood vessels.
Moderate dose (5-10mg/kg) : Increases myocardial contractility
High dose (10mg/kg) : constrict renal and cerebral blood vessels

Indications: - Treat hypotension in shock states not caused by hypovolemia.

- Increase heart rate in bradycardic rhythms

Dosage: IV infusion: 2 to 50 mcg/kg/min, Injectable solution: 40 to

160mg/100ml

Side effects: Vomiting, headache, anginal pain, palpitations, asthma attacks

Nursing interventions: 1. During infusion, frequently monitor ECG, BP, cardiac

output, pulse rate.
2. Check for urine output. If urine flow decreases without hypotension, notify
physician.
3. Do not infuse sodium bicarbonate in the same line with dopamine.