EMS Pharmacology & Drug Administration 2 — Questions and Answers
Question 1: Which drug class does adenosine belong to, and what is its primary EMS use?
- Beta-blocker used for hypertension
- Antiarrhythmic used to convert supraventricular tachycardia (SVT) (Correct answer)
- Calcium channel blocker used for chest pain
- Diuretic used for pulmonary edema
Correct answer: Antiarrhythmic used to convert supraventricular tachycardia (SVT)
Adenosine is an endogenous antiarrhythmic that temporarily blocks AV node conduction to terminate SVT.
Question 2: A patient is experiencing an anaphylactic reaction. The standard adult dose of epinephrine 1:1,000 given IM is:
- 0.1 mg
- 0.3 mg (Correct answer)
- 0.5 mg
- 1.0 mg
Correct answer: 0.3 mg
The standard adult IM dose for anaphylaxis is 0.3 mg of epinephrine 1:1,000 into the anterolateral thigh.
Question 3: What is the mechanism of action of naloxone (Narcan)?
- It metabolizes opioids in the bloodstream
- It competitively blocks opioid receptors (Correct answer)
- It stimulates respiratory drive directly
- It binds to GABA receptors to reverse CNS depression
Correct answer: It competitively blocks opioid receptors
Naloxone works by competitively binding and blocking opioid receptors, reversing opioid-induced CNS and respiratory depression.
Question 4: When administering nitroglycerin sublingually, which vital sign must be checked BEFORE each dose?
- Heart rate
- Respiratory rate
- Blood pressure (Correct answer)
- Oxygen saturation
Correct answer: Blood pressure
Blood pressure must be checked before each nitroglycerin dose because it causes vasodilation and can precipitate dangerous hypotension.
Question 5: A 70 kg patient needs a dopamine infusion at 5 mcg/kg/min. The bag contains 400 mg in 250 mL. What is the drip rate in mL/hr?
- 13.1 mL/hr (Correct answer)
- 26.3 mL/hr
- 52.5 mL/hr
- 105 mL/hr
Correct answer: 13.1 mL/hr
Dose = 5 mcg/kg/min × 70 kg = 350 mcg/min; concentration = 400,000 mcg/250 mL = 1,600 mcg/mL; rate = 350/1,600 × 60 min = 13.1 mL/hr.
Question 6: Which of the following is an absolute contraindication to morphine sulfate in EMS?
- Patient has a history of kidney stones
- Patient has a systolic BP below 90 mmHg (Correct answer)
- Patient is over 65 years old
- Patient has mild nausea
Correct answer: Patient has a systolic BP below 90 mmHg
Morphine causes vasodilation and can worsen hypotension; a systolic BP below 90 mmHg is an absolute contraindication.
Question 7: Activated charcoal is CONTRAINDICATED in which of the following ingestion scenarios?
- Acetaminophen overdose within 1 hour
- Aspirin overdose within 2 hours
- Caustic (acid or alkali) ingestion (Correct answer)
- Benzodiazepine overdose
Correct answer: Caustic (acid or alkali) ingestion
Activated charcoal is contraindicated for caustic ingestion because it does not adsorb these substances and obscures endoscopic evaluation.
EMS Pharmacology & Drug Administration 2
Which drug class does adenosine belong to, and what is its primary EMS use?