The “Code Drugs in Cardiac Arrest”—the use of cardioactive medications in cardiac arrest resuscitation

In October of 2010, the American Heart Association (AHA) published the 2010 Guidelines on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. These guidelines place significant emphasis on 5 major areas of therapy in patient with cardiac arrest, including immediate recognition and activation of the emergency response team, effective chest compressions, rapid defibrillation, effective advanced life support (ALS), and integrated postresuscitation care. “Effective ALS” includes the placement of an advanced airway, establishment of parenteral access, and the administration of cardioactive medications. Advanced life support encompasses only 1 of these 5 major areas of cardiac arrest intervention—in sharp contrast to past renditions of the AHA guidelines in which ALS was significantly emphasized. In fact, recent research and the AHA guidelines note that ALS therapy is less important than previously thought. This article will briefly review the evidence regarding the use of the 5 principal medications—epinephrine, vasopressin, atropine, lidocaine, and amiodarone—used in Advanced Cardiac Life Support cardiac arrest algorithm.