Critical Care Medications and Pharmacology Flashcards

Which electrolyte imbalance is most commonly associated with torsades de pointes?

Answer: Hypomagnesemia

Hypomagnesemia prolongs the QT interval and is the most common electrolyte trigger for torsades de pointes; magnesium sulfate is the treatment.

A transport patient on a fentanyl infusion develops rigidity of the chest wall. What is the immediate treatment?

Answer: Administer naloxone and/or a neuromuscular blocking agent

Opioid-induced chest wall rigidity (wooden chest syndrome) is treated with naloxone to reverse opioid effect or a neuromuscular blocking agent to facilitate ventilation.

Which drug class is used to treat alcohol withdrawal seizures and delirium tremens during transport?

Answer: Benzodiazepines

Benzodiazepines (e.g., diazepam, lorazepam) are first-line for alcohol withdrawal because they enhance GABA-A inhibition and suppress autonomic hyperactivity.

A patient with known anaphylaxis requires epinephrine. What is the correct IM dose and site for an adult?

Answer: 0.3–0.5 mg in the anterolateral thigh

Epinephrine 0.3–0.5 mg (1:1,000) IM into the anterolateral thigh provides the fastest absorption and is the first-line treatment for anaphylaxis.

Which medication is used to rapidly reduce intracranial pressure during air transport of a TBI patient?

Answer: Hypertonic saline (3% NaCl) or mannitol

Hypertonic saline or mannitol creates an osmotic gradient that draws water out of brain tissue, acutely reducing intracranial pressure.

A patient is being transported with a suspected organophosphate poisoning. Which medication is the primary antidote?

Answer: Atropine (with pralidoxime as adjunct)

Atropine blocks muscarinic receptor effects of excess acetylcholine and is the primary antidote; pralidoxime reactivates acetylcholinesterase as an adjunct.