Which drug is used during CPR in an emergency?

Uttarakhand CHO - 2021

Pharmacology

Easy

Appeared in: Uttarakhand CHO - 2021

Explanation

Epinephrine is the primary vasopressor drug used in all forms of cardiac arrest as per Advanced Cardiac Life Support (ACLS) guidelines.
Its main beneficial effect in CPR comes from alpha-1 adrenergic stimulation, which causes potent vasoconstriction.
This vasoconstriction increases aortic diastolic pressure, which is crucial for improving coronary perfusion pressure (blood flow to the heart muscle) and cerebral perfusion pressure (blood flow to the brain) during chest compressions.
The standard ACLS protocol recommends administering 1 mg of Epinephrine IV/IO every 3 to 5 minutes throughout the resuscitation attempt.

Option A: Rantac (Ranitidine) is a histamine H2-receptor antagonist. Its function is to reduce stomach acid production.
Option B: Digoxin is a cardiac glycoside, a positive inotrope used to increase the force of heart contractions. It is not used in the acute management of cardiac arrest.
Option C: Diclofenac is a Non-Steroidal Anti-Inflammatory Drug (NSAID). Its primary actions are to relieve pain and reduce inflammation.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Pharmacology of drugs used in Cardiopulmonary Resuscitation (CPR) in acute care settings.
Administering Epinephrine promptly during CPR is a critical nursing action that can significantly increase the chances of achieving Return of Spontaneous Circulation (ROSC).
A major patient safety risk is medication error related to Epinephrine concentration. Nurses must be vigilant in using the 1:10,000 concentration for IV administration in CPR, as the 1:1,000 concentration is for other routes and can cause lethal arrhythmias if given IV.
What if? If a patient in cardiac arrest has a shockable rhythm (VF/pVT) that persists after defibrillation and Epinephrine, the next line of treatment involves administering an antiarrhythmic drug, such as Amiodarone or Lidocaine.

How to Approach the Question

First, identify the core of the question: it asks for a drug used specifically during CPR in an emergency.
This is a factual recall question based on emergency pharmacology and ACLS protocols.
Systematically evaluate each option's drug class and primary use.
Eliminate Rantac, as it's for stomach acid.
Eliminate Diclofenac, as it's a painkiller (NSAID).
Differentiate between Digoxin and Epinephrine. Recognize that Digoxin is for chronic heart failure/rate control, while Epinephrine is the primary vasopressor for acute cardiac arrest.

Concept Tested & Keywords

Concept Tested: Pharmacology of drugs used in Cardiopulmonary Resuscitation (CPR)
Stem keywords: drug, CPR, emergency
Lead-in keywords: Which
Clinical cues: The care setting changes urgency, monitoring level, and the expected nursing action.
Negative lead-in flag: false

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