FISDAP Pharmacology 2 — Questions and Answers
Question 1: A patient in SVT receives adenosine 6 mg IV push without effect. What is the next appropriate dose?
- 6 mg repeated
- 12 mg IV push (Correct answer)
- 18 mg IV push
- Amiodarone 150 mg
Correct answer: 12 mg IV push
If the initial 6 mg adenosine dose fails, the next dose is 12 mg rapid IV push, which may be repeated once more if needed.
Question 2: Which medication is contraindicated in a patient taking MAO inhibitors who presents with hypertensive crisis?
- Nitroglycerin
- Epinephrine (Correct answer)
- Morphine
- Aspirin
Correct answer: Epinephrine
Epinephrine combined with MAO inhibitors can cause a severe, potentially fatal hypertensive crisis due to catecholamine potentiation.
Question 3: A patient receives 2.5 mg of diazepam IV for seizure control. The drug is supplied as 5 mg/mL. How many mL do you administer?
- 0.25 mL
- 0.5 mL (Correct answer)
- 1.0 mL
- 2.0 mL
Correct answer: 0.5 mL
Using the formula: volume = dose/concentration = 2.5 mg ÷ 5 mg/mL = 0.5 mL.
Question 4: Naloxone reverses opioid overdose by what mechanism?
- Stimulating opioid receptors
- Competitively blocking opioid receptors (Correct answer)
- Degrading opioid molecules in the bloodstream
- Enhancing hepatic metabolism of opioids
Correct answer: Competitively blocking opioid receptors
Naloxone is a competitive opioid antagonist that displaces opioids from mu, kappa, and delta receptors to reverse respiratory depression.
Question 5: Which of the following is the primary reason nitroglycerin is contraindicated when a patient has taken a phosphodiesterase-5 inhibitor within 48 hours?
- Risk of severe tachycardia
- Risk of severe hypotension (Correct answer)
- Risk of methemoglobinemia
- Risk of coronary vasospasm
Correct answer: Risk of severe hypotension
Both PDE-5 inhibitors and nitroglycerin cause vasodilation; combining them can produce profound, refractory hypotension.
Question 6: When administering activated charcoal, which patient presentation is an absolute contraindication?
- Ingestion of aspirin 30 minutes ago
- Unprotected airway with altered mental status (Correct answer)
- Ingestion of a tricyclic antidepressant
- Pediatric patient under 12
Correct answer: Unprotected airway with altered mental status
Activated charcoal should never be given to a patient with an unprotected airway because aspiration can cause severe airway compromise.
Question 7: A 70 kg adult patient requires dopamine at 5 mcg/kg/min. The solution is 400 mg in 250 mL. What is the correct infusion rate in mL/hr?
- 10.5 mL/hr
- 13.1 mL/hr (Correct answer)
- 21.0 mL/hr
- 26.25 mL/hr
Correct answer: 13.1 mL/hr
Concentration = 1600 mcg/mL; dose = 5 × 70 = 350 mcg/min; rate = 350/1600 × 60 = 13.125 mL/hr.
FISDAP Pharmacology 2
A patient in SVT receives adenosine 6 mg IV push without effect.
What is the next appropriate dose?