Drug indications (all)

Question 1

Adensosine

Answer 1

Conversion of Paroxysmal SVT to sinus rhythm. Wolff-Parkinson-White Syndrome with narrow QRS complex.

Question 2

Amiodarone

Answer 2

1. Shock Refractory VF/pulseless VT; Polymorphic VT/wide complex tachycardia of uncertain origin.
2. Control of hemodynamically stable VT when cardioversion is unsuccessful.
3. Acceptable for termination of ectopic or multifocal atrial tachycardia with preserved LV function.
4. Used for rate control in treatment of atrial fibrillation or flutter when other therapies are ineffective.

Question 3

Aspirin

Answer 3

Suspected ischemic chest pain.

Question 4

Atropine

Answer 4

1. Cardiac rhythms < 60/min, associated with hypotension, decreased mentation, ventricular irritability (PVC’s), chest pain, symptomatic bradycardia.
2. Second or third degree heart block, asystole, however, often does not work.
3. Organophosphate anticholinesterase poisoning.
4. Nerve Agent Poisoning

Question 5

Calcium Chloride

Answer 5

1. Bradycardic renal dialysis patients secondary to hyperkalemia exhibiting tall, peaked T waves, prolongation of QRS, low P waves.
2. Calcium channel blocker or beta-blocker overdose.
3. Antidote for Magnesium Sulfate.
4. Crush Injury Syndrome.

Question 6

Diazepam (Valium)

Answer 6

1. Seizures secondary to head trauma/alcohol withdrawal.
2. Status epilepticus.
3. Prior to pacing, cardioversion, and RSI for relief of anxiety, tension, and diminish recall of procedures.
4. Envenomation resulting in muscle spasm.
5. Severe anxiety.

Question 7

Diltiazem (Cardizem)

Answer 7

1. Symptomatic A-fib/A-flutter

2. PSVT (narrow complex)

Question 8

Dopamine

Answer 8

1. Hypotension secondary to non-hypovolemic states.
2. Low cardiac output states such as cardiogenic, anaphylactic, septic or neurogenic shock.
3. Symptomatic bradycardia after atropine/pacing.

Question 9

Epinephrine (Adrenalin)

Answer 9

1. Cardiac arrest: VF, pulseless VT, asystole, PEA.
2. Anaphylactic shock.
3. Severe allergic reactions.
4. Status asthmaticus.
5. Bradycardia unresponsive to atropine, TCP, dopamine.
6. Croup.
7. Upper airway obstruction edema.

Question 10

Etomidate (Amidate)

Answer 10

1. Induction agent for RSI in adults and pediatric patients > 10 years old.
2. Sedation prior to cardioversion

Question 11

Fentanyl (Sublimaze)

Answer 11

1. Severe pain.

2. Acute low back pain with muscle spasm.

Question 12

Magnesium Sulfate

Answer 12

1. Seizures due to pre-eclampsia, eclampsia.
2. Life threatening ventricular arrhythmias due to digitalis toxicity, tricyclic overdose.
3. Torsades de Pointes.
4. Respiratory distress (Asthma)

Question 13

Midazolam (Versed)

Answer 13

1. Premedication prior to cardioversion (IV/IM).
2. Acute anxiety states (IV/IM).
3. Premedication prior to use of paralytics (IV/IM).
4. Post-intubation sedation (IV/IM).
5. Seizures (IV/IM/IN).

Question 14

Morphine Sulfate

Answer 14

1. Severe pain, i.e.; MI, burns, isolated extremity injuries, abdominal pain.
2. Adjunct in treating pulmonary edema.

Question 15

Naloxone (Narcan)

Answer 15

1. Respiratory depression secondary to narcotics and synthetic narcotic agents and related drugs.
2. Effective against MS, Demerol, Heroin, Codeine, Methadone, Percodan, Dilaudid, Fentanyl, Nubain, Talwin, Stadol, Darvon.

Question 16

Nitroglycerine

Answer 16

1. Chest pain.

2. CHF with pulmonary edema and adequate BP >100 systolic.

Question 17

Oxygen

Answer 17

1. Confirmed or suspected hypoxia.
2. Ischemic chest pain.
3. Respiratory insufficiency.

Question 18

Rocuronium (Zemuron)

Answer 18

1. Maintenance of paralysis AFTER intubation to assist ventilation during prolonged transport.
2. Initial means of paralysis for adult and pediatric patients with contraindications for Sux. (i.e. crush injury patients, personal or family history of malignant hyperthermia, inherited myopathies such as muscular dystrophy and pre-existing hyperkalemia.

Question 19

Sodium Bicarbonate

Answer 19

1. Correction of known hyperkalemia.
2. Correct known bicarbonate responsive acidosis; e.g. diabetic ketoacidosis or overdose of tricyclic antidepressant, aspirin, cocaine or diphenhydramine.
3. Prolonged resuscitation with effective ventilation; on ROSC after long arrest interval.
4. Crush Injury Syndrome.

Question 20

Succinylcholine (Anectine)

Answer 20

To facilitate endotracheal intubation in patients with an intact gag reflex.

Question 21

Vasopressin

Answer 21

1. Alternative pressor to epinephrine in the treatment of adult shock-refractory VF.
2. May be useful alternative to epinephrine in asystole, PEA.
3. May be useful for hemodynamic support in vasodilatory shock (e.g. septic shock).

Question 22

Vecuronium (Norcuron)

Answer 22

1. Maintenance of paralysis AFTER intubation to assist ventilation during prolonged transport.
2. Initial means of paralysis with Crush Injury Syndrome.

Question 23

Metoprolol (Lopressor)

Answer 23

AMI and dysrhythmias

Question 24

Clopidogrel Bisulfate (Plavix)

Answer 24

STEMI confirmed with medical control authorization required.

Question 25

Furosemide (Lasix)

Answer 25

Pulmonary Edema

Question 26

Heparin

Answer 26

STEMI confirmed with Medical Control authorization required.

Question 27

Ketamine (Ketalar)

Answer 27

Induction agent for RSI