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Question 1

Adenosine (Adenocard)

Mx

Answer 1

Adenosine transiently blocks conduction through the AV node thereby terminating reentrant tachycardias involving the AV node. It is the drug of choice for AV nodal reentrant tachycardia (AVNRT, often referred to as “Paroxysmal Supraventricular Tachycardia [PSVT]”). It will not terminate dysrhythmias that do not involve the AV node as a reentrant limb (e.g. atrial fibrillation).

Question 2

Albuterol Sulfate (Proventil, Ventolin) 
Mx

Answer 2

Albuterol is a selective ß-2 adrenergic receptor agonist. It is a bronchodilator and positive chronotrope.

Question 3

Amiodarone (Cordarone)

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Answer 3

Amiodarone has multiple effects showing Class I, II, III and IV actions with a quick onset. The dominant effect is prolongation of the action potential duration and the refractory period.

Question 4

Aspirin (ASA)

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Answer 4

Aspirin inhibits platelet aggregation and blood clotting and is indicated for treatment of acute coronary syndrome in which platelet aggregation is a major component of the pathophysiology. It is also an analgesic and antipyretic.

Question 5

Atropine Sulfate

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Answer 5

Atropine is an endogenous antimuscarinic, anticholinergic substance. It is the prototypical anticholinergic medication with the following effects:
• Increased heart rate and AV node conduction
• Decreased GI motility
• Urinary retention
• Pupillary dilation (mydriasis)
• Decreased sweat, tear and saliva production (dry skin, dry eyes, dry mouth)

Question 6

Calcium Gluconate

Mx

Answer 6

• Cardioprotective agent in hyperkalemia.
• 10% calcium gluconate solution contains 1 g calcium gluconate per 10 mL, which is only 90mg of
elemental calcium.
• Doses below refer to dose of calcium gluconate solution, not elemental calcium.

Question 7

Dextrose 50% (D50)

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Answer 7

Glucose is the body’s basic fuel and is required for cellular metabolism. A sudden drop in blood sugar level will result in disturbances of normal metabolism, manifested clinically as a decrease in mental status, sweating and tachycardia. Further decreases in blood sugar may result in coma, seizures, and cardiac arrhythmias. Serum glucose is regulated by insulin, which stimulates storage of excess glucose from the blood stream, and glucagon, which mobilizes stored glucose into the blood stream.

Question 8

Diazepam (Valium)

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Answer 8

Benzodiazepine class sedative-hypnotic and anticonvulsant

Question 9

Diltiazem (Cardizem)

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Answer 9

Diltiazem is an Antiarrhythmic / Calcium Channel Blocker. As such it has the following effects:
• Slows conduction through the AV node.
• Vasodilation
• Decreases rate of ventricular response
• Decreases myocardial oxygen demand

Question 10

Diphenhydramine (Benadryl)

Mx

Answer 10

Antihistamine for treating histamine-mediated symptoms of allergic reaction. Also Anticholinergic and antiparkinsonian effects used for treating dystonic reactions caused by antiphsychotic and antiemetic medications (e.g.: haloperidol, droperidol, compazine, etc).

Question 11

Dopamine (Intropin)

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Answer 11

Endogenous catecholamine chemically related to epinephrine and norepinephrine. Increases blood pressure through combination of dopamine, alpha and beta receptor effects leading to increased heart rate, contractility and peripheral vasoconstriction.

Question 12

Epinephrine (Adrenalin)

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Answer 12

Endogenous catecholamine alpha, beta-1, and beta-2 adrenergic receptor agonist. Causes dose-related increase in heart rate, myocardial contractility and oxygen demand, peripheral vasoconstriction and bronchodilation.

Question 13

Fentanyl (Sublimaze)

Mx

Answer 13

Potent synthetic opioid analgesic. Fentanyl is 100 times more potent than morphine.

Question 14

Furosemide (Lasix)

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Answer 14

Rapid acting, potent loop diuretic; inhibits reabsorption of sodium chloride. It is also a venous dilator that decreases preload and causes venous pooling and subsequent hypotention.

Question 15

Glucagon

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Answer 15

Increases blood sugar concentration by converting liver glycogen to glucose. Glucagon also causes relaxation of smooth muscles of the stomach, duodenum, small bowel, and colon.

Question 16

Haloperidol (Haldol)

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Answer 16

Haloperidol is a dopamine antagonist antipsychotic medication. Haloperidol produces a dopaminergic blockade, a mild alpha-adrenergic blockade, and causes peripheral vasodilation. Its major actions are sedation and tranquilization.

Question 17

Ipratropium Bromide (Atrovent)
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Answer 17

Ipratorpium is a anticholinergic antimuscarinic bronchodilator chemically related to atropine.

Question 18

Lidocaine 2% solution

Mx

Answer 18

Local anesthetic for relief of pain during intraosseous fluid administration.

Question 19

Lorazepam (Ativan)

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Answer 19

Lorazepam is a benzodiazepine used for anxiety, sedation, and acute seizures or status epilepticus. It has a longer half-life than Diazepam and has a lower lipid solubility, resulting in longer duration of action.

Question 20

Magnesium Sulfate (MgSO₄)
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Answer 20

Magnesium sulfate reduces striated muscle contractions and blocks peripheral neuromuscular transmission by reducing acetylcholine release at the myoneural junction. In cardiac patients, it stabilizes the potassium pump, correcting repolarization. It also shortens the Q-T interval in the presence of ventricular arrhythmias due to drug toxicity or electrolyte imbalance. In respiratory patients, it may act as a bronchodilator in acute bronchospasm due to asthma or other bronchospastic diseases. In patients suffering from eclampsia, it controls seizures by blocking neuromuscular transmission and lowers blood pressure as well as decreases cerebral vasospasm.

Question 21

Metoclopramide (Reglan)

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Answer 21

Metoclopramide is a dopamine antagonist that works by blocking the CNS vomiting chemoreceptor trigger zone (CRT)

Question 22

Methylprednisolone (Solu-Medrol)

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Answer 22

Methylprednisolone is a synthetic steroid that suppresses acute and chronic inflammation and may alter the immune response. In addition, it potentiates vascular smooth muscle relaxation by beta-adrenergic agonists and may alter airway hyperactivity.

Question 23

Midazolam (Versed)

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Answer 23

Midazolam HCl is a water-soluble short acting benzodiazepine sedative-hypnotic. It is believed that benzodiazepines exert their effect on the GABA receptor to create anxiolysis, sedation and muscle relaxation.

Question 24

Morphine Sulfate

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Answer 24

Morphine sulfate is an opioid analgesic. Morphine causes analgesia, euphoria, respiratory depression and complex hemodynamic effects, including hypotension caused by histamine release.

Question 25

Naloxone (Narcan)

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Answer 25

Naloxone is a competitive opioid receptor antagonist.

Question 26

Nitroglycerine (Nitrostat, Nitroquick, etc)

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Answer 26

Short-acting peripheral venodilator decreasing cardiac preload and afterload.

Question 27

Ondansetron (Zofran)

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Answer 27

Ondansetron is a selective serotonin 5-HT3 receptor antagonist antiemetic.

Question 28

Oral Glucose (Glutose, Insta-Glucose)
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Answer 28

Glucose is the body’s basic fuel and is required for cellular metabolism.

Question 29

Phenylephrine (Intranasal)

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Answer 29

Used for topical nasal administration, phenylephrine primarily exhibits alpha adrenergic stimulation. This stimulation can produce moderate to marked vasoconstriction and subsequent nasal decongestion.

Question 30

Promethazine (Phenergan)

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Answer 30

Promethazine is a first-generation H1 receptor antagonist antihistamine and antiemetic medication which acts centrally and has sedative properties. It is related to the phenothiazine family and may cause extrapyramidal and anticholinergic symptoms.

Question 31

Racemic Epinephrine (Vaponephrine)
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Answer 31

Racemic epinephrine is an epinephrine preparation in a 1:1000 dilution for use by oral inhalation only. Inhalation causes local effects on the upper airway as well as systemic effects from absorption. Vasoconstriction may reduce swelling in the upper airway, and ß effects on bronchial smooth muscle may relieve bronchospasm.

Question 32

Sodium Bicarbonate

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Answer 32

Sodium bicarbonate is an alkalotic solution, which neutralizes acids found in the body. Acids are increased when body tissues become hypoxic due to cardiac or respiratory arrest.

Question 33

Topical Ophthalmic Anesthetics

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Answer 33

Used for topical administration as a pain reliever for eye irritation. Only proparacaine and tetracaine are approved for use.