Acid/Base

Emergency Drugs
Atropine: Blocks the action of acetylcholine released from the vagus nerve. The vagus nerve is part of
the parasympathetic division of the nervous system that innervates the heart.

Epinephrine: (Adrenalin) makes the myocardium more responsive to the use of a defribulator that can
restore a normal rhythm. If the heart has stopped beating completely (asystole), epinephrine can
actually stimulate contractions of the myocardium. As epinephrine stimulates the heart to beat, it also
helps to maintain blood pressure flow to the heart and brain to improve the chances of a successful
resuscitative effort.

Calcium chloride: used to stimulate the myocardium to contract more forcefully and may even stimulate
a contraction when the heart is in asystole and has failed to respond to epinephrine.

Vasopressor Drugs
These drugs stimulate beta1 receptors to increase the hearty rate; they also stimulate alpha receptors in
the blood vessels to produce vasoconstriction and raise the blood pressure. Vasopressor drugs also
have the desirable effect of maintaining blood flow to the kidneys so that kidney ischemia does not later
result in renal failure, which would complicate an otherwise successful resuscitative effort.

Dopamine epinephrine (Adrenalin)

norepinephrine (Levophed) phenylephrine (Neo-Synephrine)

isoproterenol (Isuprel)

Drugs for Metabolic Acidosis

During cardiac arrest, the pH of the blood decreases rapidly as carbon dioxide and waste products
accumulate in the blood. In this environment of severe acidosis, the effectiveness of any emergency
drug is greatly diminished. These drugs correct acidosis by buffering excess hydrogen ions and returning
the blood pH to within a normal range. There is controversy as to the true effectiveness of sodium
bicarbonate. It may actually increase acidosis through a chemical reaction that releases more CO2 into
the blood. The American Heart Association guidelines recommend using it only after other measures
have failed.

Sodium bicarbonate

Tromethamine (Tham)