During CPR when bradycardia is observed on the monitor, which drug is indicated?

During CPR when bradycardia is observed on the monitor, which drug is indicated?

• A. Atropine
• B. Epinephrine
• C. Amiodarone
• D. Lidocaine

Answer: (A)

When bradycardia appears during CPR, the goal is to counteract excessive vagal influence on the heart to restore a faster, more effective rhythm. Atropine does this directly by blocking muscarinic receptors on the SA and AV nodes, removing parasympathetic slowing and thereby increasing heart rate and AV conduction. This makes it the first-line drug for symptomatic bradycardia in the CPR setting. The usual approach is a 0.5 mg IV dose, repeated every 3–5 minutes as needed, up to a total of 3 mg. If bradycardia persists after atropine, escalating to pacing or starting an epinephrine infusion can be considered. The other drugs listed have different primary roles: epinephrine is a vasopressor used in resuscitation and can assist if bradycardia remains refractory, while amiodarone and lidocaine are antiarrhythmics used for tachyarrhythmias like VT/VF, not bradycardia.

When bradycardia appears during CPR, the goal is to counteract excessive vagal influence on the heart to restore a faster, more effective rhythm. Atropine does this directly by blocking muscarinic receptors on the SA and AV nodes, removing parasympathetic slowing and thereby increasing heart rate and AV conduction. This makes it the first-line drug for symptomatic bradycardia in the CPR setting.

The usual approach is a 0.5 mg IV dose, repeated every 3–5 minutes as needed, up to a total of 3 mg. If bradycardia persists after atropine, escalating to pacing or starting an epinephrine infusion can be considered. The other drugs listed have different primary roles: epinephrine is a vasopressor used in resuscitation and can assist if bradycardia remains refractory, while amiodarone and lidocaine are antiarrhythmics used for tachyarrhythmias like VT/VF, not bradycardia.