Cardiopulmonary Resuscitation: A Promise as Yet Largely Unfulfilled
Highlights
- Pharmacologic interventions during CPR are restrained by (1) impaired
distribution of drugs or their metabolites such that they are incapable of
acting on their targets and (2) changes in the pharmacologic actions of the
drugs by acidosis, hypercarbia, hypoxemia, down regulation of receptors,
and altered organ function (View Highlight)
- 100 Dur-
ing CPR, adrenergic agents with predominant a, effect have been shown
to be more effective as vasoconstrictor drugs, presumably because
extrajunctional a,-receptors are more accessible to circulating catechola-
mines than postjunctional a,-receptors. This may explain why adrener-
gic amines that have predominant a, actions such as methoxamine
(Vasoxyl) and phenylephrine (Neo-Synephrine) are less effective than
epinephrine after prolonged cardiac arrest. (View Highlight)