Pharmacology

Question 1

In what ventricular tachycardia may adenosine be administered?

Answer 1

Regular and monomorphic

Question 2

What vital signs MUST be present to administer adenosine?

A. HR 90
B. HR > 150; SBP > 100
C. HR 100

Answer 2

B. HR > 150; SBP > 100

Question 3

Why is adenosine withheld in Wolfe-Parkinson-White?

Answer 3

WPW (a pre-excitation syndrome with both shortened PRI and delta wave) occurs with an accessory pathway (bundle of Kent)between the atria/ventricles. Usually the bundle of Kent occurs near the end of the Purkinje fibers, resulting in re-entry of the AP to the AV node.

Adenosine is withheld because it blocks normal conduction (AV node) and results in the bundle of Kent acting as a pacemaker–> unstable ventricular arrhythmias.

Question 4

Which common airway medication requires an order for a repeat dose after q15 min?

Answer 4

Albuterol, 2.5 mg in 3 male NS nebulized

Question 5

Most respiratory distress patients receive a Duo-Neb treatment (albuterol and ipratropium). In what patients is ipratropium withheld?

A. Drownings
B. Tear gas/OC spray
C. Asthma
D. Crush injuries

Answer 5

D. Crush injuries

Question 6

Amiodarone is a class III antidysrhythmic. What channel/receptor does it affect?

A. Sodium
B. Beta-receptors
C. Unknown mechanism
D. Potassium channels
E. Calcium channels

Answer 6

D. Potassium channels

Class I-affects Na+ channels
Class II-beta-R blockers
Class IV-calcium channel blockers (i.e. Diltiazem)
Class V-Unknown mechanism

Question 7

When should an amiodarone drip be administered?

Answer 7

Trick question! Never!!

Regular, monomorphic wide complex tachycardias should be given a trial of adenosine.

Question 8

Adenocard class:

a. Class I antidysrhythmic
b. Class II
c. Class III
d. Class IV
e. Class V

For your choice, also explain the mechanism of action

Answer 8

e. Class V

Acts by an unknown MOA to slow conduction of the action potential through the AV node, interrupting re-entrant rhythms.

https://en.m.wikipedia.org/wiki/Antiarrhythmic_agent#Class_V_.2F_Other_agents

Question 9

______ of CaCl2 is administered to cardiac arrest patients if no ROSC after 2 rounds of ACLS, and have a Hx of renal failure m

A. 1 gm
B. 2 gm
C. 3 gm
D. 4 gm

Answer 9

A. 1 gm

Question 10

1 gm of CaCl2 is administered slowly with Med control order in what type of injury?

Answer 10

Crush injury with suspected hyperK.

Calcium acts to antagonize hyperK effects on the heart. It’s MOA is to reduce the threshold of cardiac myocytes. This prevents them from being stimulated by changed gradient in hyperK.

Question 11

Which of the following is not a contraindication for calcium chloride?

A. V-fib
B. Digitalis use
C. Pulseless V-tach
D. ALOC

Answer 11

D. ALOC

Question 12

What dose of dopamine gives primarily alpha agonist effects?

A. 10-20 mcg/kg/min
B. 2-10 mcg/kg/min

Answer 12

A. 10-20 mcg/kg/min