CPR - Certified Paramedic Response Cardiac Arrest Pharmacology Questions and Answers 1

Question 1

A 68-year-old male is in cardiac arrest with a persistent rhythm of Ventricular Fibrillation after three defibrillation attempts and a dose of epinephrine. According to the latest ACLS guidelines, which of the following is the most appropriate next pharmacological intervention?

Accepted Answer

Administer Amiodarone 300 mg IV/IO push.

Answer

For refractory Ventricular Fibrillation or pulseless Ventricular Tachycardia (VF/pVT) that is unresponsive to defibrillation and a vasopressor, the next line of treatment is an antiarrhythmic. Amiodarone, in an initial dose of 300 mg IV/IO, is the primary antiarrhythmic recommended in ACLS guidelines. While Lidocaine is an alternative, Amiodarone is generally preferred. Another dose of epinephrine would be administered later, and Sodium Bicarbonate is not routinely recommended.

Question 2

During the management of a patient in asystole, what is the recommended dose and frequency of epinephrine administration?

Accepted Answer

1 mg every 3-5 minutes

Answer

Current ACLS guidelines recommend administering 1 mg of epinephrine every 3 to 5 minutes during cardiac arrest for both shockable and non-shockable rhythms like asystole. The goal of epinephrine is to increase myocardial and cerebral blood flow through its vasoconstrictive (alpha-adrenergic) effects.

Question 3

Which of the following is the primary reason for administering epinephrine during cardiac arrest?

Accepted Answer

To cause peripheral vasoconstriction and improve coronary perfusion.

Answer

The primary benefit of epinephrine in cardiac arrest is its alpha-adrenergic effect, which causes systemic vasoconstriction. This action increases aortic diastolic pressure, leading to improved coronary and cerebral perfusion pressures, which is critical for achieving Return of Spontaneous Circulation (ROSC). While it has beta-adrenergic effects that increase contractility and rate, the alpha-mediated vasoconstriction is the key mechanism of action in this setting.

Question 4

A paramedic is treating a patient in cardiac arrest with shock-refractory Ventricular Fibrillation. Amiodarone is unavailable. Which medication is the most appropriate alternative?

Accepted Answer

Lidocaine

Answer

Lidocaine is recognized as the primary alternative antiarrhythmic agent to amiodarone for the treatment of shock-refractory VF/pVT. The standard initial dose is 1 to 1.5 mg/kg. Magnesium Sulfate is indicated for Torsades de Pointes, and Atropine is used for symptomatic bradycardia, not VF.

Question 5

In which of the following cardiac arrest situations is the administration of epinephrine recommended as early as feasible once IV/IO access is established?

Accepted Answer

Pulseless Electrical Activity (PEA)

Answer

For non-shockable rhythms, such as Pulseless Electrical Activity (PEA) and asystole, high-quality CPR and early administration of epinephrine are the cornerstones of treatment. Unlike shockable rhythms where defibrillation is the priority, in PEA, epinephrine should be given as soon as possible after access is obtained to improve perfusion.

(CPR) Certified Paramedic Response Practice Test

(CPR) Certified Paramedic Response Practice Test

CPR - Certified Paramedic Response Cardiac Arrest Pharmacology Questions and Answers 1