AEMCA Pharmacology for Paramedics 4 — Questions and Answers
Question 1: A patient is given epinephrine 1:10,000 IV for cardiac arrest. What concentration is this in mg/mL?
- 0.01 mg/mL
- 0.1 mg/mL (Correct answer)
- 1 mg/mL
- 10 mg/mL
Correct answer: 0.1 mg/mL
1:10,000 means 1 gram per 10,000 mL, which equals 0.1 mg/mL — the standard IV cardiac arrest concentration.
Question 2: Which medication used in rapid sequence intubation causes increased intracranial pressure as a side effect?
- Rocuronium
- Succinylcholine
- Etomidate
- Ketamine (Correct answer)
Correct answer: Ketamine
Ketamine was historically avoided in head injury due to concern for ICP elevation, though this is now debated; it remains a consideration in RSI planning.
Question 3: The antidote for heparin overdose causing severe hemorrhage is:
- Vitamin K
- Protamine sulfate (Correct answer)
- Tranexamic acid
- Fresh frozen plasma
Correct answer: Protamine sulfate
Protamine sulfate binds and neutralizes heparin on a 1:1 basis, reversing its anticoagulant effect within minutes.
Question 4: A patient with anaphylaxis receives epinephrine 0.3 mg IM but shows no improvement after 5 minutes. The correct next step is:
- Switch to IV diphenhydramine 50 mg
- Give a second dose of epinephrine 0.3 mg IM (Correct answer)
- Administer methylprednisolone 125 mg IV
- Give albuterol via nebulizer and reassess
Correct answer: Give a second dose of epinephrine 0.3 mg IM
Epinephrine can be repeated every 5-15 minutes; it remains the first-line treatment and should be re-dosed before considering adjunct therapies.
Question 5: Calcium chloride is administered in the prehospital setting for all of the following EXCEPT:
- Hyperkalemia
- Hypocalcemia from massive blood transfusion
- Calcium channel blocker overdose
- Hypermagnesemia-induced cardiac arrest (Correct answer)
Correct answer: Hypermagnesemia-induced cardiac arrest
Calcium chloride is used for hyper-K, CCB overdose, and hypocalcemia; hypermagnesemia is not a primary prehospital indication for calcium in standard protocols.
Question 6: A 45-year-old with COPD presents in respiratory failure. Which inhaled medication is most appropriate as a first-line bronchodilator?
- Ipratropium bromide alone
- Albuterol (salbutamol) (Correct answer)
- Salmeterol (long-acting beta-agonist)
- Budesonide (inhaled corticosteroid)
Correct answer: Albuterol (salbutamol)
Albuterol is a short-acting beta-2 agonist and first-line bronchodilator for acute exacerbations of COPD and asthma.
Question 7: When calculating a pediatric drug dose using the Broselow tape, the primary measurement used is the child's:
- Weight estimated from age
- Length (height) (Correct answer)
- Weight from caregiver estimate
- Chest circumference
Correct answer: Length (height)
The Broselow tape uses the child's measured length to estimate weight and provide color-coded drug dosing ranges.
AEMCA Pharmacology for Paramedics 4
A patient is given epinephrine 1:10,000 IV for cardiac arrest.
What concentration is this in mg/mL?