DAANCE Emergency Drugs and ACLS 4 — Questions and Answers
Question 1: Which vasopressor is the first-line drug recommended by ACLS guidelines for pulseless ventricular fibrillation or pulseless VT after the first defibrillation attempt?
- Dopamine
- Epinephrine 1 mg IV/IO (Correct answer)
- Vasopressin 40 units IV
- Norepinephrine 0.1 mcg/kg/min
Correct answer: Epinephrine 1 mg IV/IO
Epinephrine 1 mg IV/IO every 3–5 minutes is the ACLS-recommended vasopressor for shockable rhythms that persist after initial defibrillation.
Question 2: A dental patient receiving IV sedation develops sudden bronchospasm with wheezing. After epinephrine, which nebulized bronchodilator is appropriate adjunct therapy?
- Diphenhydramine
- Albuterol (Correct answer)
- Dexamethasone
- Atropine
Correct answer: Albuterol
Albuterol (a beta-2 agonist) delivered via nebulizer is an appropriate adjunct bronchodilator following epinephrine for bronchospasm.
Question 3: During ACLS, sodium bicarbonate is indicated in cardiac arrest primarily caused by which condition?
- Ventricular fibrillation
- Hyperkalemia (Correct answer)
- Hypovolemic shock
- Supraventricular tachycardia
Correct answer: Hyperkalemia
Sodium bicarbonate is specifically indicated for cardiac arrest associated with hyperkalemia or pre-existing metabolic acidosis.
Question 4: What is the recommended IV dose of atropine for symptomatic bradycardia in an adult per current ACLS guidelines?
- 0.1 mg, may repeat once
- 0.5 mg, may repeat to 3 mg total (Correct answer)
- 1 mg bolus, single dose only
- 2 mg, may repeat every 5 minutes
Correct answer: 0.5 mg, may repeat to 3 mg total
Atropine 0.5 mg IV is given for symptomatic bradycardia and may be repeated every 3–5 minutes to a maximum of 3 mg.
Question 5: A sedated patient becomes pulseless with a rhythm showing organized electrical activity on the monitor. What is this rhythm called?
- Ventricular fibrillation
- Asystole
- Pulseless electrical activity (PEA) (Correct answer)
- Junctional tachycardia
Correct answer: Pulseless electrical activity (PEA)
Pulseless electrical activity (PEA) is defined as organized cardiac electrical activity on the monitor without a palpable pulse.
Question 6: Which drug is the antidote for opioid-induced respiratory depression in dental sedation?
- Flumazenil
- Physostigmine
- Naloxone (Correct answer)
- Neostigmine
Correct answer: Naloxone
Naloxone is the specific opioid antagonist that rapidly reverses opioid-induced respiratory depression.
Question 7: In the DAANCE context, what is the primary reason epinephrine is included in dental local anesthetic cartridges as a vasoconstrictor?
- To treat allergic reactions at the injection site
- To prolong duration of anesthesia and reduce systemic absorption (Correct answer)
- To prevent syncope during the procedure
- To decrease the patient's heart rate during injection
Correct answer: To prolong duration of anesthesia and reduce systemic absorption
Epinephrine in local anesthetic cartridges causes vasoconstriction that slows systemic absorption, prolonging anesthetic duration and reducing toxicity risk.
DAANCE Emergency Drugs and ACLS 4
Which vasopressor is the first-line drug recommended by ACLS guidelines for pulseless ventricular fibrillation or pulseless VT after the first defibrillation attempt?