EFMB EFMB Pharmacology & Medications 2 — Questions and Answers
Question 1: What is the primary mechanism of action of tranexamic acid (TXA) in trauma patients?
- It directly clots blood vessels
- It inhibits fibrinolysis by blocking plasminogen activation (Correct answer)
- It replaces clotting factors lost through hemorrhage
- It constricts blood vessels to reduce bleeding
Correct answer: It inhibits fibrinolysis by blocking plasminogen activation
TXA inhibits fibrinolysis by competitively blocking lysine binding sites on plasminogen, preventing the breakdown of blood clots that have already formed.
Question 2: Which medication is used to reverse opioid-induced respiratory depression in a casualty?
- Naloxone (Narcan) (Correct answer)
- Flumazenil
- Physostigmine
- Neostigmine
Correct answer: Naloxone (Narcan)
Naloxone is an opioid antagonist that competitively displaces opioids from receptors, rapidly reversing respiratory depression, sedation, and analgesia.
Question 3: What is the recommended IV fluid rate for a conscious hemorrhagic shock patient to achieve hypotensive resuscitation?
- Infuse to restore normal blood pressure (120/80 mmHg)
- Infuse to achieve a systolic blood pressure of 80–90 mmHg (Correct answer)
- Infuse to achieve a systolic blood pressure of 110 mmHg
- Infuse at maximum rate regardless of blood pressure
Correct answer: Infuse to achieve a systolic blood pressure of 80–90 mmHg
Hypotensive resuscitation targets a systolic blood pressure of 80–90 mmHg in hemorrhagic shock to maintain perfusion while minimizing clot disruption.
Question 4: Epinephrine auto-injector (EpiPen) is indicated for which emergency condition?
- Hemorrhagic shock
- Tension pneumothorax
- Anaphylaxis (Correct answer)
- Airway obstruction from trauma
Correct answer: Anaphylaxis
Epinephrine is the first-line treatment for anaphylaxis because it reverses bronchoconstriction, vasodilation, and urticaria caused by severe allergic reactions.
Question 5: What is the correct route of administration for the MARK 1 autoinjector nerve agent antidote?
- Intravenous injection into the arm
- Intramuscular injection into the outer thigh (Correct answer)
- Subcutaneous injection into the abdomen
- Intranasal spray
Correct answer: Intramuscular injection into the outer thigh
The MARK 1 autoinjector is designed for intramuscular injection into the outer thigh (vastus lateralis), even through clothing if necessary.
Question 6: What oral analgesic is recommended in TCCC for casualties with mild to moderate pain who can take medications by mouth?
- Acetaminophen alone
- Meloxicam alone
- Acetaminophen 1000 mg combined with meloxicam 15 mg (Correct answer)
- Ibuprofen 800 mg alone
Correct answer: Acetaminophen 1000 mg combined with meloxicam 15 mg
TCCC recommends the combination of acetaminophen 1000 mg and meloxicam 15 mg for oral pain management in casualties who can tolerate oral medications.
EFMB EFMB Pharmacology & Medications 2
What is the primary mechanism of action of tranexamic acid (TXA) in trauma patients?