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PharmacotherapyFirst: A Multimedia Learning Resource

Quick Facts

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Overview

Guidelines and Landmark Trials

  • 1. Kudenchuk PJ, Brown SP, Daya M, et al.. Amiodarone, lidocaine, or placebo in out-of-hospital cardiac arrest. N Engl J Med. 2016;374:1711–1722. Crossref, MedlineGoogle Scholar,
  • 2. Gueugniaud PY, David JS, Chanzy E, et al.. Vasopressin and epinephrine vs epinephrine alone in cardiopulmonary resuscitation. N Engl J Med. 2008;359:21–30. Crossref, MedlineGoogle Scholar,
  • 3. Perkins GD, Ji C, Deakin CD, et al.. A randomized trial of epinephrine in out-of-hospital cardiac arrest. N Engl J Med. 2018;379:711–721. Crossref, MedlineGoogle Scholar,
  • 4. Nielsen N, Wetterslev J, Cronberg T, et al.. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med. 2013;369:2197–2206. Crossref, MedlineGoogle Scholar,

Patient Presentation

  • 1. Al-Khatib SM, Stevenson WG, Ackerman MJ, et al.. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Circulation. 2018;138:e272-e391. MedlineGoogle Scholar,
  • 2. Callaway CW, Donnino MW, Fink EL, et al.. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S465–482. Crossref, MedlineGoogle Scholar,
  • 3. Taccone FS, Cronberg T, Friberg H, et al.. How to assess prognosis after cardiac arrest and therapeutic hypothermia. Crit Care. 2014;18(1):202. Crossref, MedlineGoogle Scholar,
  • 4. Neumar RW, Otto CW, Link MS, et al.. Part 8: Adult advanced cardiovascular life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 suppl 3):S729–767. Crossref, MedlineGoogle Scholar,

Treatment Goals

  • 1. Mancini ME, Diekema DS, Hoadley TA, et al.. Part 3: Ethical issues: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S383–396. Crossref, MedlineGoogle Scholar,
  • 2. Kleinman ME, Brennan EE, Goldberger ZD, et al.. Part 5: Adult basic life support and cardiopulmonary resuscitation quality: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S414–435. Crossref, MedlineGoogle Scholar,
  • 3. Link MS, Berkow LC, Kudenchuk PJ, et al.. Part 7: Adult advanced cardiovascular life support: 2015 American Heart Association Guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S444–464. Crossref, MedlineGoogle Scholar,
  • 4. Callaway CW, Donnino MW, Fink EL, et al.. Part 8: Post-cardiac arrest care: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S465–482. Crossref, MedlineGoogle Scholar,

Disease State Management

  • 1. Kronick SL, Kurz MC, Lin S, et al.. Part 4: Systems of care and continuous quality improvement: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S397–413. Crossref, MedlineGoogle Scholar,
  • 2. Kleinman ME, Brennan EE, Goldberger ZD, et al.. Part 5: Adult basic life support and cardiopulmonary resuscitation quality: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S414–435. Crossref, MedlineGoogle Scholar,
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  • 5. Callaway CW, Donnino MW, Fink EL, et al.. Part 8: Post-cardiac arrest care: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S465–482. Crossref, MedlineGoogle Scholar,
  • 6. Zeiner A, Holzer M, Sterz F, et al.. Hyperthermia after cardiac arrest is associated with an unfavorable neurologic outcome. Arch Intern Med. 2001;161(16):2007–2012. Crossref, MedlineGoogle Scholar,
  • 7. Scirica BM. Therapeutic hypothermia after cardiac arrest. Circulation. 2013;127(2):244–250. Crossref, MedlineGoogle Scholar,
  • 8.
    Hypothermia after Cardiac Arrest Study Group
    . Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002;346(8):549–556. Crossref, MedlineGoogle Scholar,
  • 9. Nielsen N, Wetterslev J, Cronberg T, et al.. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med. 2013;369(23):2197–2206. Crossref, MedlineGoogle Scholar,
  • 10. Badjatia N. Therapeutic temperature modulation in neurocritical care. Curr Neurol Neurosci Rep. 2006;6(6):509–517. Crossref, MedlineGoogle Scholar,
  • 11. Badjatia N, Strongilis E, Gordon E, et al.. Metabolic impact of shivering during therapeutic temperature modulation: the Bedside Shivering Assessment Scale. Stroke. 2008;39(12):3242–3247. Crossref, MedlineGoogle Scholar,
  • 12. Mokhtarani M, Mahgoub AN, Morioka N, et al.. Buspirone and meperidine synergistically reduce the shivering threshold. Anesth Analg. 2001;93(5):1233–1239. Crossref, MedlineGoogle Scholar,
  • 13. Doufas AG, Lin CM, Suleman MI, et al.. Dexmedetomidine and meperidine additively reduce the shivering threshold in humans. Stroke. 2003;34(5):1218–1223. Crossref, MedlineGoogle Scholar,
  • 14. Kimberger O, Ali SZ, Markstaller M, et al.. Meperidine and skin surface warming additively reduce the shivering threshold: a volunteer study. Crit Care. 2007;11(1):R29. Crossref, MedlineGoogle Scholar,
  • 15. Wadhwa A, Sengupta P, Durrani J, et al.. Magnesium sulphate only slightly reduces the shivering threshold in humans. Br J Anaesth. 2005;94(6):756–762. Crossref, MedlineGoogle Scholar,
  • 16. Choi HA, Ko SB, Presciutti M, et al.. Prevention of shivering during therapeutic temperature modulation: the Columbia anti-shivering protocol. Neurocrit Care. 2011;14(3):389–394. Crossref, MedlineGoogle Scholar,
  • 17. Lascarrou JB, Le Gouge A, Dimet J, et al.. Neuromuscular blockade during therapeutic hypothermia after cardiac arrest: observational study of neurological and infectious outcomes. Resuscitation. 2014;85(9):1257–1262. Crossref, MedlineGoogle Scholar,
  • 18. Weant KA, Martin JE, Humphries RL, Cook AM. Pharmacologic options for reducing the shivering response to therapeutic hypothermia. Pharmacotherapy. 2010;30(8):830–841. Crossref, MedlineGoogle Scholar,
  • 19. Link MS, Berkow LC, Kudenchuk PJ, et al.. Part 7: Adult advanced cardiovascular life support: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S444–464. Crossref, MedlineGoogle Scholar,
  • 20. Wenzel V, Krismer AC, Arntz HR, et al.. A comparison of vasopressin and epinephrine for out-of-hospital cardiopulmonary resuscitation. N Engl J Med. 2004;350(2):105–113. Crossref, MedlineGoogle Scholar,
  • 21. Panchal AR, Berg KM, Kudenchuk PJ, et al.. 2018 American Heart Association focused update on advanced cardiovascular life support use of antiarrhythmic drugs during and immediately after cardiac arrest: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2018;138(23):e740-e749. Crossref, MedlineGoogle Scholar,
  • 22. Kudenchuk PJ, Leroux BG, Daya M, et al.. Antiarrhythmic drugs for nonshockable-turned-shockable out-of-hospital cardiac arrest: the ALPS study (amiodarone, lidocaine, or placebo). Circulation. 2017;136(22):2119–2131. Crossref, MedlineGoogle Scholar,
  • 23. Kudenchuk PJ, Brown SP, Daya M, et al.. Amiodarone, lidocaine, or placebo in out-of-hospital cardiac arrest. N Engl J Med. 2016;374(18):1711–1722. Crossref, MedlineGoogle Scholar,
  • 24. Markel DT, Gold LS, Allen J, et al.. Procainamide and survival in ventricular fibrillation out-of-hospital cardiac arrest. Acad Emerg Med. 2010;17(6):617–623. Crossref, MedlineGoogle Scholar,
  • 25. Bottiger BW, Arntz HR, Chamberlain DA, et al.. Thrombolysis during resuscitation for out-of-hospital cardiac arrest. N Engl J Med. 2008;359(25):2651–2662. Crossref, MedlineGoogle Scholar,
  • 26. Abu-Laban RB, Christenson JM, Innes GD, et al.. Tissue plasminogen activator in cardiac arrest with pulseless electrical activity. N Engl J Med. 2002;346(20):1522–1528. Crossref, MedlineGoogle Scholar,
  • 27. Larsen MP, Eisenberg MS, Cummins RO, Hallstrom AP. Predicting survival from out-of-hospital cardiac arrest: a graphic model. Ann Emerg Med. 1993;22(11):1652–1658. Crossref, MedlineGoogle Scholar,
  • 28. Sasson C, Rogers MA, Dahl J, Kellermann AL. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2010;3(1):63–81. Crossref, MedlineGoogle Scholar,
  • 29. Swor R, Khan I, Domeier R, Honeycutt L, Chu K, Compton S. CPR training and CPR performance: do CPR-trained bystanders perform CPR? Acad Emerg Med. 2006;13(6):596–601. Crossref, MedlineGoogle Scholar,
  • 30. Pelinka LE, Thierbach AR, Reuter S, Mauritz W. Bystander trauma care—effect of the level of training. Resuscitation. 2004;61(3):289–296. Crossref, MedlineGoogle Scholar,
  • 31. Lindner TW, Soreide E, Nilsen OB, Torunn MW, Lossius HM. Good outcome in every fourth resuscitation attempt is achievable—an Utstein template report from the Stavanger region. Resuscitation. 2011;82(12):1508–1513. Crossref, MedlineGoogle Scholar,
  • 32. Wissenberg M, Lippert FK, Folke F, et al.. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA. 2013;310(13):1377–1384. Crossref, MedlineGoogle Scholar,
  • 33. Lick CJ, Aufderheide TP, Niskanen RA, et al.. Take Heart America: a comprehensive, communitywide, systems-based approach to the treatment of cardiac arrest. Crit Care Med. 2011;39(1):26–33. Crossref, MedlineGoogle Scholar,
  • 34. Rivera NT, Kumar SL, Bhandari RK, Kumar SD. Disparities in survival with bystander CPR following cardiopulmonary arrest based on neighborhood characteristics. Emerg Med Int. 2016;2016:6983750. Crossref, MedlineGoogle Scholar,
  • 35. Starks MA, Schmicker RH, Peterson ED, et al.. Association of neighborhood demographics with out-of-hospital cardiac arrest treatment and outcomes: where you live may matter. JAMA Cardiol. 2017;2(10):1110–1118. Crossref, MedlineGoogle Scholar,
  • 36. Sasson C, Magid DJ, Chan P, et al.. Association of neighborhood characteristics with bystander-initiated CPR. N Engl J Med. 2012;367:1607–1615. Crossref, MedlineGoogle Scholar,

Medications

  • 1. Link MS, Berkow LC, Kudenchuk PJ, et al.. Part 7: Adult advanced cardiovascular life support: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S444–464. Crossref, MedlineGoogle Scholar,
  • 2. Neumar RW, Otto CW, Link MS, et al.. Part 8: Adult advanced cardiovascular life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(suppl 3):S729–767. Crossref, MedlineGoogle Scholar,
  • 3. Donnino MW, Salciccioli JD, Howell MD, et al.. Time to administration of epinephrine and outcome after in-hospital cardiac arrest with non-shockable rhythms: retrospective analysis of large in-hospital data registry. BMJ. 2014;348:g3028. Crossref, MedlineGoogle Scholar,
  • 4. Goto Y, Maeda T, Goto Y. Effects of prehospital epinephrine during out-of-hospital cardiac arrest with initial non-shockable rhythm: an observational cohort study. Crit Care. 2013;17(5):R188. Crossref, MedlineGoogle Scholar,
  • 5. Callaham M, Madsen CD, Barton CW, Saunders CE, Pointer J. A randomized clinical trial of high-dose epinephrine and norepinephrine vs standard-dose epinephrine in pre-hospital cardiac arrest. JAMA. 1998;268(19):2667–2672. CrossrefGoogle Scholar,
  • 6. Hansen M, Schmicker RH, Newgard CD, et al.. Time to epinephrine administration and survival from nonshockable out-of-hospital cardiac arrest among children and adults. Circulation. 2018;137(19):2032–2040. Crossref, MedlineGoogle Scholar,
  • 7. Naganobu K, Hasebe Y, Uchiyama Y, Hagio M, Ogawa H. A comparison of distilled water and normal saline as diluents for endobronchial administration of epinephrine in the dog. Anesth Analg. 2000;91(2):317–321. MedlineGoogle Scholar,
  • 8. Dorian P, Cass D, Schwartz B, Cooper R, Gelaznikas R, Barr A. Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation. N Engl J Med. 2002;346(12):884–890. Crossref, MedlineGoogle Scholar,
  • 9. Tagami T, Matsui H, Tanaka C, et al.. Amiodarone compared with lidocaine for out-of-hospital cardiac arrest with refractory ventricular fibrillation on hospital arrival: a national database study. Cardiovasc Drugs Ther. 2016;30(5):485–491. Crossref, MedlineGoogle Scholar,
  • 10. Herlitz J, Ekstrom L, Wennerblom B, et al.. Lidocaine in out-of-hospital ventricular fibrillation: does it improve survival? Resuscitation. 1997;33(3):199–205. Crossref, MedlineGoogle Scholar,
  • 11. Kudenchuk PJ, Brown SP, Daya M, et al.. Amiodarone, lidocaine, or placebo in out-of-hospital cardiac arrest. N Engl J Med. 2016;374(18):1711–1722. Crossref, MedlineGoogle Scholar,
  • 12. Kudenchuk PJ, Leroux BG, Daya M, et al.. Antiarrhythmic drugs for nonshockable-turned-shockable out-of-hospital cardiac arrest: the ALPS study (amiodarone, lidocaine, or placebo). Circulation. 2017;136(22):2119–2131. Crossref, MedlineGoogle Scholar,
  • 13. Kerns W 2nd. Management of beta-adrenergic blocker and calcium channel antagonist toxicity. Emerg Med Clin North Am. 2007;25(2):309–331. Crossref, MedlineGoogle Scholar,
  • 14. Lavonas EJ, Drennan IR, Gabrielli A, et al.. Part 10: Special circumstances of resuscitation: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S501–518. Crossref, MedlineGoogle Scholar,
  • 15. Bottiger BW, Arntz HR, Chamberlain DA, et al.. Thrombolysis during resuscitation for out-of-hospital cardiac arrest. N Engl J Med. 2008;359(25):2651–2662. Crossref, MedlineGoogle Scholar,
  • 16. Bozeman WP, Kleiner DM, Ferguson KL. Empiric tenecteplase is associated with increased return of spontaneous circulation and short term survival in cardiac arrest patients unresponsive to standard interventions. Resuscitation. 2006;69(3):399–406. Crossref, MedlineGoogle Scholar,

Complementary and Integrative Health Approaches (CIHA)

  • 1. Siscovick DS, Barringer TA, Fretts AM, et al.. Omega-3 polyunsaturated fatty acid (fish oil) supplementation and the prevention of clinical cardiovascular disease: a science advisory from the American Heart Association. Circulation. 2017;135(15):e867-e884. Crossref, MedlineGoogle Scholar,

Monitoring and Follow Up

  • 1. Callaway CW, Donnino MW, Fink EL, et al.. Part 8: Post-cardiac arrest care: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S465–482. Crossref, MedlineGoogle Scholar,
  • 2. Nakashima R, Hifumi T, Kawakita K, et al.. Critical care management focused on optimizing brain function after cardiac arrest. Circ J. 2017;81(4):427–439. Crossref, MedlineGoogle Scholar,

Practical Clinical Management Tips

  • 1. Heavner MS, Rouse GE, Lemieux SM, et al.. Experience with integrating pharmacist documenters on cardiac arrest teams to improve quality. J Am Pharm Assoc. 2003;58(3):311–317. CrossrefGoogle Scholar,
  • 2. Draper HM, Eppert JA. Association of pharmacist presence on compliance with advanced cardiac life support guidelines during in-hospital cardiac arrest. Ann Pharmacother. 2008;42(4):469–474. Crossref, MedlineGoogle Scholar,
  • 3. Anson J. Vascular access in resuscitation: Is there a role for the intraosseous route? Anesthesiology. 2014;120(4):1015–1031. Crossref, MedlineGoogle Scholar,
  • 4. Petitpas F, Guenezan J, Vendeuvre T, et al.. Use of intra-osseous access in adults: a systematic review. Crit Care. 2016;20:102. Crossref, MedlineGoogle Scholar,
  • 5. Neumar RW, Otto CW, Link MS, et al.. Part 8: Adult advanced cardiovascular life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(suppl 3):S729–767. Crossref, MedlineGoogle Scholar,
  • 6. Hahnel JH, Lindner KH, Schurmann C, Prengel A, Ahnefeld FW. Plasma lidocaine levels and PaO2 with endobronchial administration: dilution with normal saline or distilled water? Ann Emerg Med. 1990;19(11):1314–1317. Crossref, MedlineGoogle Scholar,
  • 7. Naganobu K, Hasebe Y, Uchiyama Y, Hagio M, Ogawa H. A comparison of distilled water and normal saline as diluents for endobronchial administration of epinephrine in the dog. Anesth Analg. 2000;91(2):317–321. MedlineGoogle Scholar,

Cultural Sensitivities and Health Disparities

  • 1. Kim LK, Looser P, Swaminathan RV, et al.. Sex-based disparities in incidence, treatment, and outcomes of cardiac arrest in the United States, 2003–2012. J Am Heart Assoc. 2016;5(6). CrossrefGoogle Scholar,
  • 2. Blewer AL, McGovern SK, Schmicker RH, et al.. Gender disparities among adult recipients of bystander cardiopulmonary resuscitation in the public. Circ Cardiovasc Qual Outcomes. 2018;11(8):e004710. Crossref, MedlineGoogle Scholar,
  • 3. Becker LB, Han BH, Meyer PM, et al.. Racial differences in the incidence of cardiac arrest and subsequent survival: the CPR Chicago Project. N Engl J Med. 1993;329(9):600–606. Crossref, MedlineGoogle Scholar,
  • 4. Shah KS, Shah AS, Bhopal R. Systematic review and meta-analysis of and out-of-hospital cardiac arrest and race or ethnicity: black US populations fare worse. Eur J Prev Cardiol. 2014;21(5):619–638. Crossref, MedlineGoogle Scholar,
  • 5. Cowie MR, Fahrenbruch CE, Cobb LA, et al.. Out-of-hospital cardiac arrest: racial differences in outcome in Seattle. Am J Public Health. 1993;83(7):955–959. Crossref, MedlineGoogle Scholar,
  • 6. Rivera NT, Kumar SL, Bhandari RK, Kumar SD. Disparities in survival with bystander CPR following cardiopulmonary arrest based on neighborhood characteristics. Emerg Med Int. 2016;2016:6983750. Crossref, MedlineGoogle Scholar,
  • 7. Starks MA, Schmicker RH, Peterson ED, et al.. Association of neighborhood demographics with out-of-hospital cardiac arrest treatment and outcomes: where you live may matter. JAMA Cardiol. 2017;2(10):1110–1118. Crossref, MedlineGoogle Scholar,
  • 8. Sasson C, Magid DJ, Chan P, et al.. Association of neighborhood characteristics with bystander-initiated CPR. N Engl J Med. 2012;367:1607–1615. Crossref, MedlineGoogle Scholar,

Special Populations

  • 1. Topjian AA, Berg RA. Pediatric out-of-hospital cardiac arrest. Circulation. 2012;125(19):2374–2378. Crossref, MedlineGoogle Scholar,
  • 2. de Caen AR, Berg MD, Chameides L, et al.. Part 12: Pediatric advanced life support: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S526–542. Crossref, MedlineGoogle Scholar,
  • 3. Jeejeebhoy FM, Zelop CM, Lipman S. Cardiac arrest in pregnancy: A scientific statement from the American Heart Association. Circulation. 2015;132(18):1747–1773. Crossref, MedlineGoogle Scholar,
  • 4. Al-Dury N, Rawshani A, Israelsson J, et al.. Characteristics and outcome among 14,933 adult cases of in-hospital cardiac arrest: A nationwide study with the emphasis on gender and age. Am J Emerg Med. 2017;35(12):1839–1844. Crossref, MedlineGoogle Scholar,

Interprofessional Collaborative Practice

  • 1. Feih J, Peppard WJ, Katz M. Pharmacists involvement on a rapid response team. Am J Health Syst Pharm. 2017;74(5 suppl 1)S10–16. Crossref, MedlineGoogle Scholar,

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