Emergency Drugs and ACLS Flashcards

The first drug administered during pulseless ventricular fibrillation (VF) cardiac arrest, following defibrillation, is:

Answer: Epinephrine 1 mg IV every 3 to 5 minutes

After the first defibrillation attempt, ACLS guidelines call for epinephrine 1 mg IV/IO every 3 to 5 minutes during ongoing CPR.

Diphenhydramine (Benadryl) is used in anaphylaxis management primarily to:

Answer: Block H1 receptors and reduce urticaria and pruritus

Diphenhydramine is an H1 antihistamine that reduces urticaria, pruritus, and nasal symptoms. It is a secondary medication in anaphylaxis; epinephrine is primary.

When administering epinephrine for anaphylaxis in the dental office, the preferred route is:

Answer: Intramuscular injection into the anterolateral thigh

IM injection into the vastus lateralis (anterolateral thigh) provides the most reliable, rapid absorption of epinephrine during anaphylaxis.

Glucagon is used to treat refractory hypotension in anaphylaxis for patients who are:

Answer: On beta-blockers, which blunt the response to epinephrine

Patients on beta-blockers may not respond adequately to epinephrine since beta-adrenergic effects are blocked. Glucagon increases cAMP independently of beta receptors.

The recommended compression-to-ventilation ratio during two-rescuer adult CPR is:

Answer: 30:2

AHA guidelines recommend 30 compressions to 2 ventilations for adults in two-rescuer CPR when an advanced airway is not in place.

Nitroglycerin (sublingual) is indicated for an emergency involving:

Answer: Suspected acute myocardial ischemia with chest pain in a normotensive patient

Sublingual nitroglycerin is given for anginal chest pain to reduce preload and myocardial oxygen demand; it is contraindicated if the patient is hypotensive.