Clinical pharmacy
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Use of endotracheal drug therapy during cardiopulmonary resuscitation (CPR) is reviewed. Endotracheal drug therapy--instillation of a drug solution directly into an endotracheal tube for absorption into the circulation via the alveoli--may be used during CPR when venous access is limited. Administration of drugs via a central vein is the most efficient route, but a central i.v. line may not be present and peripheral venous administration may not be possible because of vasoconstriction, trauma, other patient-related factors, or absence of personnel trained to insert i.v. catheters. ⋯ Usually, the same dose is administered endotracheally as by the i.v. route. Little is known about choice and volume of diluent and the best anatomic site of application. Endotracheal drug administration may replace intracardiac injection as the second-line alternative to intravenous drug injection during CPR.