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Flashcards in Rescue Drugs Deck (45):
1

Your patient has been intubated. IV/IO access is not available. Which combination of drugs can be administered by the endotracheal route of administration?
A. Amiodarone, lidocaine, epinephrine
B. Epinephrine, vasopressin, amiodarone
C. Vasopressin, amiodarone, lidocaine
D. Lidocaine, epinephrine, vasopressin

D. Lidocaine, epinephrine, vasopressin

2

A patient is in pulseless ventricular tachycardia. Two shocks and one dose of epinephrine have been given. The next drug/dose to anticipate to administer is:
A. Amiodarone 150 mg
B. Epinephrine 3 mg
C. Lidocaine 0.5 mg/kg
D. Vasopressin 40 U

E. Amiodarone 300 mg

E. Amiodarone 300 mg

3

A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. Two attempts at peripheral IV access have been unsuccessful. The next recommended access route of administration for the delivery of drugs during CPR is:
A. Femoral vein
B. Endotracheal
C. Intraosseous
D. External jugular vein

C. Intraosseous

4

A patient is in refractory ventricular fibrillation and has received multiple appropriate defibrillations, epinephrine 1 mg IV twice, and an initial dose of lidocaine IV. The patient is intubated. A second dose of lidocaine is now called for. The recommended second dose of lidocaine is:
A. Start infusion 1 to 2 mg/min
B. 0.5 to 0.75 mg/kg IV push
C. 2to3 mg/kg IV push
D. Give endotracheal dose 2 to 4 mg/kg
E. 1 mg/kg IV push

0.5 to 0.75 mg/kg IV push

5

A patient has sinus bradycardia with a rate of 36 per minute. Atropine has been administered to a total dose of 3 mig. A transcutaneous pacemaker has failed to capture. The patient is confused and blood pressure is 100/60 mm Hg. Which of the following is now indicated?
A. Give additional 1 mg atropine
B. Start epinephrine 2 to 10 mg/min
C. Start dopamine 10-20 mg/kg per minute
D. Give normal saline bolus 250 mL to 500 mL

Start epinephrine 2 to 10 mg/min

6

A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138. He is asymptomatic with a blood pressure of 110/70 mm Hg. He has a history of angina. Which of the following actions is recommended?
A. Seek expert consultation
B. Immediate synchronized cardioversion
C. Give adenosine 6 mg IV bolus
D. Give lidocaine 1 to 1.5 mg IV bolus

A. Seek expert consultation

7

You arrive on-scene with the Code Team. High-quality CPR is in progress. An AED has previously advised “no shock indicated.” A rhythm check now finds asystole. The next action you would take is to:
A. Call for a pulse check
B. Place IV or IO access
C. Attempt endotracheal intubation with minimal CPR interruption
D. Place a Comitube or laryngeal mask airway

B. Place IV or IO access

8

Which of following is most accurate regarding the administration of vasopressin during cardiac arrest?
A. Vasopressin is indicated for VF and pulseless VT prior to the delivery of the first shock
B. Vasopressin can be administered twice during cardiac arrest
C. The correct dose of Vasopressin is 40 U administered IV or IO
D. Vasopressin is recommended instead of epinephrine for the treatment of asystole

The correct dose of Vasopressin is 40 U administered IV or IO

9

A 57-year-old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular wide- complex QRS at a rate of 180 per minute. She becomes diaphoretic and blood pressure is 80/60 mm Hg. The next action is to:
A. Perform immediate electrical cardioversion
B. Establish IV and give sedation for electrical cardioversion
C. Obtain 12 lead electrocardiogram
D. Give amiodarone 300 mg IV push

A. Perform immediate electrical cardioversion

10

A patient with a possible acute coronary syndrome has ongoing chest discomfort unresponsive to 3 sublingual nitroglycerin tablets. There are no contraindications and 4 mg of morphine sulfate was administered. Shortly, blood pressure falls to 88/60 mm Hg and the patient complains of increased chest discomfort. You would:
A. Give nitroglycerin 0.4 mg sublingually
B. Start dopamine at 2 pg/kg per minute and titrate to BP 100 mm Hg systolic
C. Give normal saline 250 mL to 500 mL fluid bolus
D. Give an additional 2 mg of morphine sulfate

C. Give normal saline 250 mL to 500 mL fluid bolus

11

A patient is in refractory ventricular fibrillation. High-quality CPR is in progress and shocks have been given. One dose of epinephrine was given after the second shock. An antiarrhythmia drug was given immediately after the third shock. What drug should the team leader request be prepared for administration next?
A. Escalating dose epinephrine 3 mg
B. Sodium bicarbonate 50 mEq
C. Repeat the antiarrhythmia drug
D. Second dose of epinephrine 1 mg

D. Second dose of epinephrine 1 mg

12

A 35-year-old woman has palpitations, lightheadedness, and a stable tachycardia. The monitor shows a regular narrow complex QRS at a rate of 180 per minute. Vagal maneuvers have not been effective in terminating the rhythm. An IV has been established. What drug should be administered IV?
A. Adenosine 6 mg
B. Atropine 0.5 mg
C. Lidocaine 1 mg/kg
D. Epinephrine 2 to10 pg/kg per minute

A. Adenosine 6 mg

13

A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. Of the following, which drug and dose should be administered first by the IV/IO route?
A. Atropine 1 mg
B. Epinephrine 1 mg
C. Sodium bicarbonate 50 mEq
D. Vasopressin 20 U

B. Epinephrine 1 mg

14

A patient with a possible ST-segment elevation MI has ongoing chest discomfort. Which of the following would be a contraindication administration of nitrates?
A. Use of phosphodiesterase inhibitor within 12 hours
B. Heart rate 90 per minute
C. Left ventricular infarct with bilateral rales
D. Blood pressure great than 180 mm Hg

Use of phosphodiesterase inhibitor within 12 hours

15

A patient with possible ACS and a bradycardia of 42 per minute has ongoing chest discomfort. What is the initial dose of atropine?
A. Atropine 0.1 mg
B. Atropine 1 mg
C. Atropine 3 mg
D. Atropine 0.5 mg

Atropine 0.5 mg

16

A 62 year old man suddenly began to experience difficulty speaking and left-sided weakness. He is brought to the emergency department. He meets initial criteria for fibrinolytic therapy and a CT scan of the brain is ordered. Guidelines for antiplatelet and antithrombotic therapy are:
A.� Do not give aspirin for at least 24 hours if tPA is administered
B.� Give aspirin 160 mg and clopidogrel 75 mg orally
�C. Administer aspirin 160-325 mg orally chewed, immediately
�D. Administer heparin if CT scan is negative for hemorrhage

Do not give aspirin for at least 24 hours if tPA is administered

17

A patient with an ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic therapy has been ordered. Heparin 4000 U IV bolus was administered and a heparin infusion 1000 U per hour is being administered, and Aspirin was not taken by the patient because he had a history of gastritis treated 5 years ago. Your next action is to:
� ��
A. Give 325 mg enteric-coated aspirin rectally
B. Substitute clopidogrel 300 mg loading dose C. Give aspirin 160 to 325 mg chewed, immediately
D. Give 75 mg enteric-coated aspirin orally

Give aspirin 160 to 325 mg chewed, immediately

18

Which of the following statements about the use of magnesium in cardiac arrest is most accurate?
A. Magnesium is contraindicated in VT associated with a normal QT interval
B. Magnesium is indicated for shock-refractory monomorphic VT
C. Magnesium is indicated for VF refractory to shock and amiodarone or lidocaine
D. Magnesium is indicated in VF/pulseless VT associated with torsades de pointes

D. Magnesium is indicated in VF/pulseless VT associated with torsades de pointes

19

A bradycardia rhythm IS treated when:

A.Blood pressure is less than 100 mm Hg systolic with or without symptoms
B. Chest pain or shortness of breath is present
C. Heart rate is less than 60 per minute with or without symptoms
D. The patient has an MI on the 12-lead electrocardiogram

Chest pain or shortness of breath is present

20

A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is intubated and an IV has been started. The rhythm is asystole. The first drug/dose to administer is:
A. Dopamine 2 to 20 pg/kg per minute IV or IO
B. Atropine 0.5 mg IV or IO
C. Atropine 1 mg IV or IO
D. Epinephrine 1 mg or Vasopressin 40 U IV or IO
E. Epinephrine 3 mg via endotracheal tube (ET)

D. Epinephrine 1 mg or Vasopressin 40 U IV or IO

21

What is the adult dose for adenosine?

6mg -> 12mg -> 12mg
(follow each with a 20cc fluid bolus)

22

What is the adult dose for amiodarone?

ARREST - 300mg -> 150mg
V Tach w/ Pulse - 150 mg X 3

23

What is the max dose for amiodarone?

450 mg

24

What is the adult dose for aspirin?

160-325 mg CHEWED

25

What is the adult dose for atropine?

1mg Q 5 mins

26

What is the max dose for atropine?

3 mg

27

what is the adult dose for clopidogrel?

300mg PO (for pts with true aspirin allergy)

28

What is the adult dose for Dopamine?

2-20 mcg/kg/min

2-10 mcg/kg/min = HR increase
10-20 mcg/kg/min = BP increase

29

What is the dosing trick for dopamine?

take pts weight (in lbs) remove 3rd digit and subtract 3 = dose (in drops/min) equivalent to 5 mg/kg/min

ex. 170lb patient
17-3 = 14 dps/min (5mg/kg/min) HR increase
14x2 = 28 dps/min (10mg/kg/min) BP increase

30

What is the adult dose for Dobutamine?

2-20 mcg/kg/min

31

What is the adult dose for Diltiazem?

15-20mg over 2 mins

32

What is the adult dose for Epinephrine?

1 mg Q 3-5 mins

33

What is the adult dose for an Epinephrine drip?

2-10 mcg/min

34

What is the adult dose for furosemide?

1mg/kg

35

What is the adult dose for glucose?

0.5-1 G/kg

36

What is the adult dose for Lidocaine for tx of dysrhythmia?

1 mg/kg (MAX 3mg/kg)

37

What is the adult dose for Magnesium?

1-2G in 10mL of D5W

38

What is the adult dose for Morphine?

2-4 mg up to 20 mg

39

What is the adult dose for Naloxone?

0.04-0.4 mg

40

What is the adult dose for Nitroglycerin?

0.4mg X 3 Sublingual (monitor BP)

41

What is the adult dose for Procainamide?

20mg/min (takes 30 mins for effect)

42

What is the max dose of Procainamide?

17mg/kg

43

What is the adult dose for Sodium Bicarbonate?

1meq/kg

44

What is the adult dose for Vasopressin?

40 U x 1

45

What is the adult dose for Verapamil?

2.5 - 5 mg over 2 mins