Cardiac Arrest Pharmacopeia: A Personalized Approach to Drug Administration During Cardiopulmonary Resuscitation

Abstract

In this article, we describe the potential for personalized cardiopulmonary resuscitation using physiology to guide drug administration. We also highlight the limitations of the current evidence to inform a more individualized approach. Several areas for possible modifications to drug management are ripe for investigation, including: vasopressor selection and titration based on diastolic blood pressure responses; special physiologic circumstances in which sodium bicarbonate or calcium may be beneficial; and certain electrophysiologic states in shockable cardiac arrest, which may favor lidocaine or amiodarone.

Keywords: Amiodarone; Calcium; Cardiac arrest; Epinephrine; Lidocaine; Sodium bicarbonate; Vasopressin.