VASOPRESSIN
Has not shown any survival benefit over epinephrine
MECHANISM OFACTION
■ Nonadrenergic peripheral vasoconstrictor
■ Coronary and renal vasoconstriction
DOSE
■ Adult: 40 U IV/IO to replace either the first or second dose of epinephrine
■ Following the administration of vasopression, continue to give epinephrine
every 3–5 min as indicated.
■ Pediatrics: Not recommended
ATROPINE
Second-line for the treatment of slow-arrest rhythms (PEA and asystole)
MECHANISM OFACTION
■ Competitive antagonism of muscarinic acetylcholine receptors (parasym-
patholytic)→↑ HR,↑SVR,↑BP
DOSE
■ Adults: 1 mg IV, repeated every 3–5 minute to maximum of 3 mg as
needed
■ Pediatrics: 0.02 mg/kg IV/IO (minimum: 0.1 mg, maximum: 0.5–1 mg)
COMPLICATIONS
■ Small doses (< 0.1 mg) may produce paradoxical bradycardia in pediatric
patients.
AMIODARONE
Amiodarone is used in the treatment of VT and VFib. It has many other
nonarrest indications for the treatment of tachydysrhythmias.
MECHANISM OFACTION
■ A class III antidysrhythmic
■ K+channel blockade →prolongation of repolarization (phase 3).
■ Has multiple other effects (sodium/calcium channel effects, β-blockade)
DOSE
■ Adult: 300 mg IV/IO, followed by 150 mg IV/IO in 3–5 minutes for unsta-
ble tachydysrhythmias; 150 mg for stable tachydysrhythmias, repeated
every 10 minutes as needed
■ Pediatric: 5 mg/kg IV/IO, repeat up to 15 mg/kg to maximum of 300 mg
COMPLICATIONS
■ Hypotension, bradycardia, prolonged QT interval
RESUSCITATIONVasopressin is a
nonadrenergic peripheral
vasoconstrictor.Doses of atropine below the
minimum recommended may
produce paradoxical
bradycardia in children!Resuscitation drugs
that may be admin-
istered via ET tube—
LEAN
Lidocaine
Epinephrine
Atropine
Naloxone