EMS Pharmacology & Drug Administration 3 — Questions and Answers
Question 1: Which route of drug administration provides the FASTEST onset of action in EMS?
- Intramuscular (IM)
- Subcutaneous (SQ)
- Intravenous (IV) (Correct answer)
- Sublingual (SL)
Correct answer: Intravenous (IV)
Intravenous administration delivers the drug directly into the bloodstream, providing the fastest onset of action.
Question 2: A patient on warfarin presents with uncontrolled bleeding. Which reversal agent is most appropriate for EMS to consider?
- Protamine sulfate
- Vitamin K (phytonadione)
- Fresh frozen plasma
- Tranexamic acid (Correct answer)
Correct answer: Tranexamic acid
Tranexamic acid (TXA) inhibits fibrinolysis and is used in EMS for hemorrhage control, while definitive warfarin reversal agents are hospital-based.
Question 3: What is the correct pediatric dose of epinephrine 1:10,000 for cardiac arrest via IV/IO?
- 0.01 mg/kg (Correct answer)
- 0.1 mg/kg
- 0.3 mg/kg
- 1.0 mg/kg
Correct answer: 0.01 mg/kg
The pediatric cardiac arrest dose of epinephrine is 0.01 mg/kg of the 1:10,000 concentration IV/IO.
Question 4: Glucagon is indicated for hypoglycemia when IV access CANNOT be established because it:
- Works faster than IV dextrose
- Can be given intranasally or IM to stimulate hepatic glycogenolysis (Correct answer)
- Is safer than dextrose in diabetic patients
- Directly provides glucose to the bloodstream
Correct answer: Can be given intranasally or IM to stimulate hepatic glycogenolysis
Glucagon can be given IM or intranasally and stimulates the liver to convert glycogen to glucose, making it useful when IV access is unavailable.
Question 5: Which adverse effect is MOST associated with rapid IV administration of diphenhydramine (Benadryl)?
- Hypertension
- Sedation and hypotension (Correct answer)
- Bronchospasm
- Hyperglycemia
Correct answer: Sedation and hypotension
Rapid IV diphenhydramine can cause significant sedation and hypotension due to its anticholinergic and antihistamine effects.
Question 6: A patient experiencing a hypertensive emergency with signs of end-organ damage requires which EMS pharmacologic intervention?
- Oral antihypertensives such as labetalol tablets
- Sublingual nitroglycerin or IV labetalol per protocol (Correct answer)
- Furosemide 80 mg IV push immediately
- Aspirin 324 mg and transport only
Correct answer: Sublingual nitroglycerin or IV labetalol per protocol
For hypertensive emergency with end-organ damage, sublingual nitroglycerin or IV labetalol per local protocol provides controlled blood pressure reduction.
Question 7: The '6 Rights' of medication administration include all of the following EXCEPT:
- Right patient
- Right dose
- Right manufacturer (Correct answer)
- Right route
Correct answer: Right manufacturer
The 6 Rights are patient, drug, dose, route, time, and documentation — the manufacturer is not one of them.
EMS Pharmacology & Drug Administration 3
Which route of drug administration provides the FASTEST onset of action in EMS?