AEMCA - Advanced Emergency Medical Care Assistant Pharmacology for Paramedics Questions and Answers

Question 1

A patient in refractory ventricular fibrillation has received three defibrillations and an appropriate dose of epinephrine. According to Ontario's Advanced Life Support Patient Care Standards (ALS PCS), which of the following is the correct subsequent antiarrhythmic medication and dose?

Accepted Answer

Amiodarone 300 mg IV/IO

Answer

According to the Ontario ALS PCS for medical cardiac arrest, after the third defibrillation and first dose of epinephrine have been administered, the next indicated medication for persistent Ventricular Fibrillation (VF) or pulseless Ventricular Tachycardia (pVT) is Amiodarone 300 mg via IV or IO push. Lidocaine is a secondary option if amiodarone is unavailable, and Magnesium is primarily for Torsades de Pointes.

Question 2

A paramedic is treating a 60-year-old male with chest pain and a BP of 110/70 mmHg. Which of the following patient statements would represent an absolute contraindication to the administration of Nitroglycerin?

Accepted Answer

"I took a sildenafil (Viagra) pill yesterday evening."

Answer

The use of phosphodiesterase-5 (PDE5) inhibitors, such as sildenafil, within the last 24-48 hours is an absolute contraindication for administering nitroglycerin. The combination can cause a profound and potentially fatal hypotensive effect due to synergistic vasodilation. The other options are not contraindications.

Question 3

An 80-year-old female is found unconscious with a blood glucose level of 1.8 mmol/L. IV access is unsuccessful. What is the primary mechanism of action of the medication that should be administered via the intramuscular route?

Accepted Answer

It stimulates the liver to break down glycogen into glucose.

Answer

In this scenario, Glucagon would be administered IM. Glucagon's primary mechanism of action is to stimulate the liver to convert its stored glycogen into glucose (a process called glycogenolysis) and release it into the bloodstream, thereby raising the blood glucose level. It does not directly provide glucose or stimulate insulin release.

Question 4

You are treating a patient for severe musculoskeletal pain following a traumatic injury. You choose to administer fentanyl instead of morphine. What is a key pharmacological advantage of fentanyl in a potentially hemodynamically unstable patient?

Accepted Answer

Fentanyl causes less histamine release and has greater hemodynamic stability.

Answer

Fentanyl is often preferred over morphine in trauma or cardiac patients because it is associated with less histamine release, leading to less vasodilation and a more stable hemodynamic profile (i.e., less likely to cause hypotension). Morphine is a more potent histamine-releasing agent, which can contribute to a drop in blood pressure.

Question 5

A 70 kg adult patient is in status epilepticus. The paramedic decides to administer midazolam via the IM route. The protocol calls for a dose of 10 mg. Your vial concentration is 5 mg/mL. How many milliliters should be administered?

Accepted Answer

2.0 mL

Answer

This is a drug calculation question. The formula is: (Dose Required / Concentration on Hand) = Volume to Administer. In this case, (10 mg / 5 mg/mL) = 2.0 mL. The paramedic should administer 2.0 mL of midazolam. The adult dose for status epilepticus is commonly a standard 10 mg IM for patients over a certain weight threshold, making this a typical prehospital scenario.

AEMCA - Advanced Emergency Medical Care Assistant Practice Test

AEMCA - Advanced Emergency Medical Care Assistant Practice Test

AEMCA - Advanced Emergency Medical Care Assistant Pharmacology for Paramedics Questions and Answers