Drugs to know - Cardiac and respiratory arrest
This concise reference covers the small set of drugs you must memorise for adult cardiac arrest and for opioid‑related respiratory arrest in UK practice. Doses and roles follow Resuscitation Council UK adult Advanced Life Support guidance and UK toxin/antidote guidance - consult local drug charts, BNF/TOXBASE/NPIS for paediatric, toxin‑specific or post‑ROSC infusion regimens.
Key operational points
- Route: IV or intraosseous (IO) access is preferred for all resuscitation drugs; endotracheal absorption is unreliable and should not be relied on.
- Timing: many drugs are rhythm‑dependent in ALS (notably adrenaline and antiarrhythmics); prepare and label syringes in advance to avoid interruptions to chest compressions.
- Availability: these drugs should be immediately available on resuscitation trolleys per RCUK/RCEM quality standards.
- Local policy: always confirm local drug charts, BNF and TOXBASE/NPIS for toxicology doses and incompatibilities.
Quick reference (adult, UK practice)
Detailed notes
Adrenaline
- Mechanism: non‑selective α/β agonist - α effects increase systemic vascular resistance and central aortic pressure during CPR, improving coronary and cerebral perfusion; β1 effects increase contractility.
- Use: indicated in all ALS algorithms. Give 1 mg IV/IO every 3-5 minutes. Timing is rhythm‑dependent: give immediately in non‑shockable rhythms (asystole/PEA); in shockable rhythms (VF/pVT) give after the 3rd shock and then every 3-5 minutes thereafter.
- Practical: flush line after injection; IO acceptable if no IV access....