ECC ECC Pharmacology & Medication Management 2 — Questions and Answers
Question 1: Which antiarrhythmic drug is an acceptable alternative to amiodarone for shock-refractory VF/pulseless VT?
- Metoprolol
- Lidocaine (Correct answer)
- Verapamil
- Digoxin
Correct answer: Lidocaine
Lidocaine (1–1.5 mg/kg IV/IO) is an acceptable alternative to amiodarone for shock-refractory VF or pulseless VT.
Question 2: During ACLS, magnesium sulfate is specifically indicated for which rhythm?
- Ventricular fibrillation
- Torsades de pointes (Correct answer)
- Atrial flutter
- Asystole
Correct answer: Torsades de pointes
Magnesium sulfate (1–2 g IV/IO) is the treatment of choice for torsades de pointes (polymorphic VT with prolonged QT interval).
Question 3: A patient with stable wide-complex tachycardia of uncertain origin should receive which drug with caution?
- Adenosine
- Verapamil (Correct answer)
- Lidocaine
- Procainamide
Correct answer: Verapamil
Verapamil (a calcium channel blocker) should be avoided or used with caution in wide-complex tachycardia because it can cause hemodynamic collapse if the rhythm is ventricular tachycardia.
Question 4: What is the recommended IV/IO dose of epinephrine for anaphylaxis?
- 0.01 mg/kg of 1:10,000 solution
- 0.3 mg of 1:1,000 IM (or 0.1 mg IV slowly) (Correct answer)
- 1 mg IV push
- 5 mg IV bolus
Correct answer: 0.3 mg of 1:1,000 IM (or 0.1 mg IV slowly)
For anaphylaxis, epinephrine 0.3–0.5 mg IM (1:1,000) in the thigh is standard; if IV access is used, 0.1 mg of 1:10,000 is given slowly.
Question 5: Which drug is given to reverse opioid-induced respiratory arrest in the ECC setting?
- Flumazenil
- Physostigmine
- Naloxone (Correct answer)
- Activated charcoal
Correct answer: Naloxone
Naloxone (0.4–2 mg IV/IM/IN) is the opioid antagonist used to reverse respiratory depression caused by opioid overdose.
Question 6: When administering medications via endotracheal tube (ETT) during cardiac arrest, how should the dose be adjusted?
- Use the same dose as IV
- Use half the IV dose
- Use 2–2.5 times the IV dose (Correct answer)
- Use 10 times the IV dose
Correct answer: Use 2–2.5 times the IV dose
Endotracheal drug doses should be 2–2.5 times the IV dose, diluted in 5–10 mL of sterile water or normal saline, due to unreliable absorption.
ECC ECC Pharmacology & Medication Management 2
Which antiarrhythmic drug is an acceptable alternative to amiodarone for shock-refractory VF/pulseless VT?