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Flashcards in EMT Basic - Drug Review Deck (40)
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1
Q

Brand name of the medication

Select one:

A. Medical name

B. Generic name

C. Trade name

D. Chemical name

A

C. Trade name

A. Incorrect - Medical name

Drugs do not have medical names. They have Generic, Trade, and Chemical names

B. Incorrect - Generic name

Since the 1960s, the United States Adopted Names Program has been assigning generic (nonproprietary) names to all active drug ingredients sold in the United States.

D. Incorrect - Chemical name

Describes the atomic or molecular structure of the drug

2
Q

Drug that helps to constrict the blood vessels and relax airway passages; it may be used to counter a severe allergic reaction.

Select one:

A. Epinephrine

B. Nitroglycerin

C. Oxygen

D. Oral glucose

A

A. Epinephrine

Explanation - Conteracts allergic reactions (bronchoconstriction (spasm), hypotension secondary to vasodilation)

Epinephrine is an adrenergic receptor agonist for:

  • Alpha (α) Receptor - Constricts arteries in the body, with the exception of skeletal muscle blood vessels.
  • Beta-1 (β 1) Receptor - Increases the heart rate and the heart’s strength of contraction or contractility.
  • Beta-2 (β 2) Receptor - located in the bronchioles of the lungs and the arteries of the skeletal muscles. These dilate both bronchioles and skeletal muscle arteries.

B. Incorrect - Nitroglycerin

Vasodilator (opens) blood vessels. Used to treat Angina Pectoralis.

C. Incorrect - Oxygen

Gas that aids in reversing the effects of hypoxia.

D. Incorrect - Oral glucose

Gel that aids in the reverse of hypoglycemic emergencies

3
Q

Solid form of a drug; compressed powder.

Select one:

A. Capsule

B. Gel

C. Tablet

D. Suspension

A

C. Tablet

A. Incorrect - Capsule

Gelatinous shell filled with powder or liquid (pg 459)

B. Incorrect - Gel

Semiliquid substance, which has the consistency of paste or cream (pg 460)

D. Incorrect - Suspension

Mixture of ground particles that are distributed evenly throughout a liquid but do not dissolve (pg 460)

4
Q

Powder, usually pre-mixed with water, that will attach some poisons and help prevent them from being absorbed by the body.

Select one:

A. Activated Charcoal

B. Antiarrhythmic

C. Anticonvulsant

D. Anticholinergic

A

A. Activated Charcoal

Explanation

An adsorbent is a material that will allow a liquid, gas, or dissolved solid to adhere to its surface. (ex: activated charcoal)

This is different than an absorbent which actually involves taking in the liquid or gas and not just adhering it to the surface. (ex: digestion, sponge)

Activated charcoal can adhere to the surface of certain substances, and make it more difficult to be absorbed through the digestive tract.

B. Incorrect - Antiarrhythmic

Antiarrhythmic agents are a group of pharmaceuticals that are used to suppress abnormal rhythms of the heart (cardiac arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation.

C. Incorrect - Anticonvulsant

Anticonvulsants are a diverse group of pharmacological agents used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of bipolar disorder and borderline personality disorder since many seem to act as mood stabilizers and for the treatment of neuropathic pain.

D. Incorrect - Anticholinergic

Anticholinergics are a group of substances that inhibit the parasympathetic nervous system by selectively blocking the binding of acetylcholine (ACh) to its receptor in nerve cells. (Hot as a hare, blind as a bat, dry as a bone, red as a beet, mad as a hatter.)

5
Q

This gas, in its pure form, is used as a drug to treat any patient whose medical or traumatic condition causes them to be hypoxic.

Select one:

A. Carbon dioxide

B. Hydrogen

C. Nitric oxide

D. Oxygen

A

D. Oxygen

6
Q

Activated charcoal is given to a patient because it:

Select one:

A. Can be used in a patient without a gag reflex

B. Prevents the toxic effects of some poisons by absorbing the substance

C. Will bind to the surface of some poisons

D. Will induce vomiting

A

C. Will bind to the surface of some poisons

Explanation

An adsorbent is a material that will allow a liquid, gas, or dissolved solid to adhere to its surface. (ex: activated charcoal)

This is different than an absorbent which actually involves taking in the liquid or gas and not just adhering it to the surface. (ex: digestion, sponge)

Activated charcoal can adhere to the surface of certain substances, and make it more difficult to be absorbed through the digestive tract.

A. Incorrect - Can be used in a patient without a gag reflex

Contraindication for any oral treatment is an intact gag reflex to protect the airwar

B. Incorrect - Prevents the toxic effects of some poisons by absorbing the substance

Activated charcoal does not absorb poisons (takes the substance inside itself). It adsorbs, or adheres, to the surface.

D. Incorrect - Will induce vomiting

Nausea and emesis are possibilities with activated charcoal due to its gritty feeling, but not the reason it is administered.

7
Q

Poorly managed diabetes can cause:

Select one:

A. Absorption of poisons

B. Hypoxia

C. Dilation of coronary arteries

D. Altered mental status

A

D. Altered mental status

Explanation

Altered Mental Status is a sign of both hyperglycemia & hypoglycemia

  • Hyper - Altered Mental Status (Drowsiness, Lethargy)
  • Hypo - Altered Mental Status (Aggressive, Confused, Lethargic, Unusual Behavior)
  • A. Incorrect - Absorption of poisons*

Diabetes does not create a circumstance that protects from poisons

B. Incorrect - Hypoxia

Although a severe diabetic crisis can evolve into abnormal breathing which in turn creates a situation of hypoxia, diabetes itself does not create the hypoxic situation.

C. Incorrect - Dilation of coronary arteries

This is possible as hypotension develops in the pathology with both hyperglycemia & hypoglycemia but it was wide vasodilation and not just the coronary arteries.

8
Q

Oral glucose is given between the patient’s cheek and gum because:

Select one:

A. This area will cause the patient to regurgitate the stomach’s contents

B. It will assist in dilating the coronary vessels as much as possible

C. This area contains blood vessels that allow easy absorption into the bloodstream

D. It will not be aspirated if the patient suddenly becomes unconscious

A

C. This area contains blood vessels that allow easy absorption into the bloodstream

A. Incorrect - This area will cause the patient to regurgitate the stomach’s contents

This has a low probability of activating the gag reflex in an alert patient.

B. Incorrect - It will assist in dilating the coronary vessels as much as possible

In a hypoglycemic patient, this will aid in the system correcting, which may include vasoconstriction to correct foe the hypotension.

D. Incorrect - It will not be aspirated if the patient suddenly becomes unconscious

As this is an oral medication, it can have a high index of aspiration in a patient that becomes unconscious.

9
Q

Examples of medications a patient may have in his possession that the EMT-B may assist the patient in taking under the appropriate circumstances are:

Select one:

A. Epinephrine auto-injector, a prescribed inhaler, and nitroglycerin

B. Insulin, antihypertensives, and anticonvulsants

C. Activated charcoal, glucose injections, and anticonvulsants

D. Home oxygen, antihypertensives, and anti-inflammatories

A

A. Epinephrine auto-injector, a prescribed inhaler, and nitroglycerin (pg 466-466)

B. Insulin, antihypertensives, and anticonvulsants

These are not in the scope of an EMT-Basic

C. Activated charcoal, glucose injections, and anticonvulsants

Glucose Injections & Anticonvulsants are outside the scope of EMT-Basic

D. Home oxygen, antihypertensives, and anti-inflammatories

Antihypertensives are outside the scope of EMT-Basic. Some NSAID’s are in the scope but not all anti-inflammatories.

10
Q

Patients who have a medical history of asthma, emphysema, and chronic bronchitis may carry

Select one:

A. An epinephrine auto-injector

B. A bronchoconstrictor

C. Nitroglycerin

D. A bronchodilator

A

D. A bronchodilator

Explanation

A bronchodilator can treat or prevent bronchospasm.

A. An epinephrine auto-injector

This is carried for anaphylaxis

B. A bronchoconstrictor

This would increase the severity of asthma, emphysema, and chronic bronchitis

C. Nitroglycerin

This is for cardiac chest pain

11
Q

The drug nitroglycerin is used to _______ vessels.

Select one:

A. Constrict the peripheral

B. Dilate the peripheral

C. Constrict the coronary

D. Dilate the coronary

A

D. Dilate the coronary

Explanation

Vasodilation of the coronary arteries will cause increased blood flow to the heart, increasing perfusion. In outpatient use, it is prescribed to take as prophylaxis for anginal chest pain.

A. Constrict the peripheral

Nitroglycerin is a vasodilator, not a vasoconstrictor.

B. Dilate the peripheral

Even though dilating the venous preload leads to a decreased demand on the cardiac muscle, nitroglycerin is mainly prescribed for angina pectoris secondary to coronary artery disease. Relaxing the coronary artery allows may allow for an obstacle to move and restore perfusion.

C. Constrict the coronary

Nitroglycerin is a vasodilator, not a vasoconstrictor.

12
Q

The government publication listing all drugs in the United States is called:

Select one:

A. U.S. Hazmat Protocols

B. U.S. Pharmacopeia

C. Physician’s Desk Reference

D. National Medicine Guidebook

A

B. U.S. Pharmacopeia

A. Incorrect - U.S. Hazmat Protocols

Not a single publication that contains drugs

C. Incorrect - Physician’s Desk Reference

Reference book compiled by drug manufacturers (not a government publication) and includes information on all drugs that are approved for use by the FDA.

D. Incorrect - National Medicine Guidebook

Not a publication

13
Q

A circumstance in which a drug should not be used because it may cause harm to the patient or offer no effect in improving the patient’s condition or illness is called a(n):

Select one:

A. Adverse Reaction

B. Contraindication

C. Side Effect

D. Indication

A

B. Contraindication (pg 481)

A. Incorrect - Adverse Reaction

Marketing term, not medical

C. Incorrect - Side Effect

Any action taken by medication other than the desired ones. There are two types: Unintended Effects and Untoward Effects (pgs 481-482)

D. Incorrect - Indication

The therapeutic uses for a specific medication (pg 482)

14
Q

An action of a drug that is other than the desired action is called.

Select one:

A. Adverse Reaction

B. Contraindication

C. Side Effect

D. Overdose

A

C. Side Effect (pg 482)

A. Incorrect - Adverse Reaction

Marketing Term, not medical

B. Incorrect - Contraindication

A circumstance in which a drug should not be used because it may cause harm to the patient or offer no effect in improving the patient’s condition or illness (pg 821)

D. Incorrect - ​Overdose

An excessive quantity of a drug that, when taken or administered, can have toxic or lethal consequences.

15
Q

Prior to administering a medication to a patient, you must know all of the following EXCEPT:

Select one:

A. The route of administration

B. The proper dose

C. The actions the medication will take

D. The right generic & chemical names

A

D. The right generic & chemical names

Explanation

The “six rights” (pg 462) The above is not one of them.

  1. Right Patient
  2. Right Medication
  3. Right Dose
  4. Right Route
  5. Right Time
  6. Right Documentation
16
Q

Drugs prescribed to relax the smooth muscles of the bronchial tubes are called:

Select one:

A. Vasodilators

B. Bronchodilators

C. Bronchoconstrictors

D. Vasoconstrictors

A

B. Bronchodilators

A. Incorrect - Vasodilators

Relax the blood vessels

C. Incorrect - Bronchoconstrictors

Constrict the bronchial tubes

D. Incorrect - Vasoconstrictors

Constrict the blood vessels

17
Q

Which medication does Adrenergic refer to?

Select one:

A. Oxygen

B. Epinephrine

C. Acetylsalicylic Acid (Aspirin)

D. Activated Charcoal

A

B. Epinephrine

Explanation

Adrenergic drugs stimulate the nerves in your body’s sympathetic nervous system.

EMT-Basic Scope Medications that Adrenergic

  1. Epinephrine (Alpha, Beta-1, Beta-2 Receptor Agonist)
  2. Albuterol Sulfate (Beta-2 Receptor Agonist)
18
Q

Which of the following is a contraindication for nitroglycerin administration?

Select one:

A. Blood pressure of 120 mm Hg systolic

B. Respiratory rate of 24

C. Patient feels anxious

D. Pulse of 108

A

D. Pulse of 108

Explanation:

The AHA guidelines state “tachycardia in the absence of heart failure (>100 bpm) and in patients with right ventricular infarction is contraindicated.”

While the tachycardia may be a relative contraindication, none of the other choices alone are a contraindication for nitroglycerin.

Other Contraindications:

  1. Systolic Blood Pressure < 100 mm Hg
  2. Known sensitivity to nitrate medications
  3. Taken Erectile Dysfunction Medication within the last 24 hours
  4. Severe Anemia
  5. Hypersensitivity
19
Q

Your service has switched to drawing up epinephrine in a syringe. To administer 0.3mg IM of a 1:1000 solution, you would draw up how much epinephrine?

Select one:

A. 0.3 mL

B. 1 mL

C. 3 mL

D. 0.01 mL

A

A. 0.3 mL

Explanation:

While many services have a kit with preloaded syringes, it is helpful to know how much epinephrine to give. You would administer 0.3 mL of epinephrine for an adult patient and 0.15 mL for a pediatric patient.

20
Q

A female, 23, has overdosed on oxycontin. Which of the following best describes the appropriate way to deliver intranasal naloxone to this patient?

Select one:

A. Depress the syringe plunger rapidly

B. Depress the syringe plunger slowly

C. Remove the atomizer device before administering

D. Dilute the naloxone 1:1 with saline for maximum absorption

A

A. Depress the syringe plunger rapidly

Explanation:

Intranasal delivery of medication requires a rapid delivery to best achieve atomization of the medicine. Therefore, you should depress the plunger of the syringe rapidly.

A slow depression of the plunger would likely mean much of the medication would be delivered in a slow stream and absorbed orally instead of in the nasal mucosa.

You should use an atomizing device if available to best create the atomization and coat the intranasal passages with medication.

21
Q

Male patient, 66, is experiencing severe squeezing chest discomfort. Vital signs: P 96, R 18, BP 148/92, SpO2 96%. For oxygen admin, you should:

Select one:

A. Administer oxygen via the nasal cannula at 2 L/min

B. Do not administer oxygen to this patient

C. Administer oxygen nonrebreather mask at 10 L/min

D. Administer oxygen by nonrebreather & titrate to the reduction of chest pain

A

B. Do not administer oxygen to this patient

Explanation:

With a saturation of 96%, this patient should not be given oxygen. His mental status is alert. Transport is the most significant prehospital care for this patient. Monitor for the stability of ABC’s.

22
Q

An epinephrine auto-injector is administered in the:

Select one:

A. Posteromedial Thigh

B. Anterolateral Thigh

C. Posterolateral Thigh

D. Anteromedial Thigh

A

B. Anterolateral Thigh

Explanation

The auto-injector is administered in the anterolateral thigh. Remember lateral is the “outside” surface of the leg and the medial surface is “inside” or closer to the midline.

23
Q

Your patient has been stung by a bee and is experiencing anaphylaxis. You administer an epinephrine auto-injector knowing:

Select one:

A. The beta-adrenergic component will reduce airway edema

B. The alpha-adrenergic component will cause vasoconstriction

C. The beta-adrenergic component will increase capillary permeability

D. The alpha-adrenergic component will reduce bronchoconstriction

A

B. The alpha-adrenergic component will cause vasoconstriction

Explanation:

In the context of anaphylaxis, the alpha-adrenergic parts of epinephrine cause vasoconstriction. This is important since vasodilation and hypotension are serious effects of anaphylaxis.

  • Alpha-receptors are located on the arteries. When the alpha receptor is stimulated by epinephrine or norepinephrine, the arteries constrict. This increases the blood pressure and the blood flow returning to the heart. In this case, vasoconstriction can reduce edema.
  • Beta-2 receptors are located in the bronchioles of the lungs and the arteries of the skeletal muscles. When these receptors are stimulated, they increase the diameter of the bronchioles to let more air in and out during breathing and they dilate the vessels of the skeletal muscles so they can receive the increased blood flow produced by stimulating the alpha and beta 1 receptors.
  • Beta-1 receptors are located in the heart. When beta-1 receptors are stimulated they increase the heart rate and increase the heart’s strength of contraction or contractility.
24
Q

A woman is complaining of chest heaviness and shortness of breath. Vital signs: P 88, R 18, BP 162/82 SpO2 98%. Which medication would you give first?

Select one:

A. Metered Dose Inhaler (MDI)

B. Oxygen

C. Acetylsalicylic Acid

D. Nitroglycerin

A

C. Acetylsalicylic Acid

Explanation

In this patient, the most beneficial medication is aspirin as it helps to stop platelet aggregation and may limit the size of the heart attack. It would be administered first. Aspirin is carried on most ambulances and available at the EMT level. Nitroglycerin must be prescribed and may not be available.

25
Q

You arrive on scene to find a patient with an altered mental status. You quickly scan the scene. Which of the following items will help to point you in the right direction in finding a cause of the altered mental status?

Select one:

A. Unkept house with animal fur and dirt on the floor

B. Medications including high blood pressure, anxiety and depression

C. A smell of dirty clothes and cat feces

D. Over the counter (OCT) pain relievers

A

B. Medications including high blood pressure, anxiety and depression

26
Q

Your patient is not responding to your loud verbal stimuli. You find the following medications: Glucophage and Lipitor. What is the likely cause of the patient’s problem?

Select one:

A. High cholesterol

B. High blood pressure

C. Diabetic reaction

D. Coronary Artery Disease

A

C. Diabetic reaction

27
Q

Your neuro assessment of an unresponsive patient reveals pinpoint pupils. What is your primary field diagnosis?

Select one:

A. Beta-blocker overdose

B. Insulin overdose

C. Aspirin

D. Narcotic

A

D. Narcotic

28
Q

Your patient is a known diabetic who takes up to four insulin injections a day. Today he is found unresponsive, diaphoretic, and tachycardic. He is also only breathing 18 times a minute. What is likely the patient’s chief medical issue?

Select one:

A. Hypoglycemia

B. Hyperglycemia

C. Cardiovascular Event (CVA)

D. Hypertensive crisis

A

A. Hypoglycemia

29
Q

You find that your diabetic patient is hypoglycemic. You have oral glucose to give to the patient. You will give 15 grams of instant glucose to the patient except if they are ___________?

Select one:

A. Conscious with blood sugar of 80mg/dl

B. Conscious with an altered mental status and blood sugar of 80mg/dl

C. Semi-conscious with gag reflex and the ability to swallow

D. Semi-conscious without the ability to swallow

A

C. Semi-conscious without the ability to swallow

30
Q

Aspirin (Acetylsalicylic Acid)

  • Trade Names
  • Category
  • Indications
  • Contraindications
  • Doses
A

Trade Name:

Bayer®

BC® Powder

Alka-Seltzer

Category:

Anti-platelet Aggregate

Indication(s):

Chest Pain (Cardiac)

Contraindication(s):

Decreased LOC (PO)

Recent Bleeding

Hypersensitivity

Dose:

81 mg tablets x 4 [324 mg total] (PO)

31
Q

Activated Charcoal

  • Trade Names
  • Category
  • Indications
  • Contraindications
  • Doses
A

Trade Name

Actidose w/ Sorbitol

Category:

Adsorbant

Indication(s):

Oral Poisoning, Oral Overdose

Contraindication(s):

Decreased LOC (PO)

Overdose Caustics, Corrosives, Petroleum Substances

Do not give with other PO medication

Dose:

1-2 g/kg [25 - 50 g Max] (PO)

32
Q

Epinephrine

  • Trade Names
  • Category
  • Indications
  • Contraindications
  • Doses
A

Trade Names:

EpiPen

Category:

Sympathomimetic (Alpha, Beta-1, Beta-2 Agonist)

Indication(s):

Anaphylaxis

Contraindication(s):

Chest Pain (Cardiac)

Hypertension

Hypothermia

Dose:

Adult - 0.3 mg IM (Anterolateral Thigh) - Auto-Injector

Child - 0.15 mg IM (Anterolateral Thigh) - Auto-Injector

33
Q

Albuterol Sulfate

  • Trade Names
  • Category
  • Indications
  • Contraindications
  • Doses
A

Trade Names

Ventolin

Proventil

Accuneb

Category:

Bronchodilator (Beta-2 Agonist)

Indication(s):

Bronchospasm

Contraindication(s):

Chest Pain (Cardiac)

Tachycardia

Hypersensitivity

Dose:

1 - 2 Inhalations (Hold Breath for 5 seconds as tolerated) - M.D.I.

Wait 5 minutes before repeating the dose

34
Q

Naloxone

  • Trade Names
  • Category
  • Indications
  • Contraindications
  • Doses
A

Trade Name:

Narcan

AVZIO Auto-Injector

Category:

Narcotic (Opioid) Antagonist

Indication(s):

Narcotic Overdose

Contraindication(s):

Hypersensitivity

Dose:

IM - 0.4 mg (Repeat every 2 minutes) - [Auto-Injector]

IN - 1 mg / nostril (2 mg total) - [M.A.D.]

35
Q

Nitroglycerin (NTG)

  • Trade Names
  • Category
  • Indications
  • Contraindications
  • Doses
A

Trade Name:

Nitrostat

Nitrmist

Category:

Vasodilator

Indication(s):

Chest Pain (Cardiac)

Contraindication(s):

Decreased LOC (PO)

Hypotension < 100 mm Hg systolic

Erectile Dysfunction Medication < 24 hours (Female & Male)

Head Injury

Dose:

SL - 0.4 mg (tablet) - Max 3 Doses - Repeat Every 5 Minutes

SL - 0.4 mg (spray) - Max 3 Doses - Repeat Every 5 Minutes

36
Q

Oral Glucose

  • Trade Names
  • Category
  • Indications
  • Contraindications
  • Doses
A

Trade Name:

Glutose

Category:

Simple Sugar

Hyperglycemic

Indication(s):

Hypoglycemia

Contraindication(s):

Decreased LOC (PO)

Hyperglycemia

Nausea

Emesis

Dose:

½ - 1 tube (PO)

Repeat every 5 minutes

37
Q

Diphenhydramine

  • Trade Names
  • Category
  • Indications
  • Contraindications
  • Doses
A

Trade Name:

Benadryl

Category:

Antihistamine

Indication(s):

Mild Allergic Reactions

Contraindication(s):

Hypertension

Asthma

Pregnancy

Infants

Glaucoma

Dose:

Adult - 25 - 50 mg PO

38
Q

Ibuprofen

  • Trade Names
  • Category
  • Indications
  • Contraindications
  • Doses
A

Trade Name:

Advil; Infant’s Advil

Motrin IB; Children’s Motrin

Nuprin

Category:

Nonsteroidal Anti-inflammatory Drug (NSAID)

Indication(s):

Mild Pain

Fever

Headache

Muscle Aches

Contraindication(s):

Aspirin

Hypersensitivity

Dose:

Adult - 400 to 800 mg (PO); Every 4 Hours

Child - Weight Based (PO)

39
Q

Acetaminophen

  • Trade Names
  • Category
  • Indications
  • Contraindications
  • Doses
A

Trade Name:

Tylenol

Category:

Analgesic

Fever Reducer

Indication(s):

Mild Pain

Fever

Headache

Muscle Aches

Contraindication(s):

Hypersensitivity

Allergic Reactions

Dose:

Adult - 500 to 1,000 mg (PO); Every 4 to 6 Hours

Child - Weight-based (PO)

40
Q

Oxygen

  • Trade Names
  • Category
  • Indications
  • Contraindications
  • Doses
A

Trade Name:

No Trade Name

Category:

Gas

Inhalant

Indication(s):

Reverses Hypoxia

Contraindication(s):

COPD (rarely used)

Open Flames

Dose:

Adult

  • Nasal Cannula - 2 to 6 L / min <em>[IN]</em>
  • Nebulizer - 8 to 10 L / min [<em>Inhalation]</em>
  • Non-Rebreather - 10 to 15 L / min [<em>Inhalation]</em>
  • Bag-Valve Mask (BVM) 15+ L / min [<em>Inhalation]</em>

Decks in EMT Basic - NREMT Emergency Care & Transportation of the Sick & Injured Class (54):