FISDAP Pharmacology 3 — Questions and Answers
Question 1: Which beta-blocker is cardioselective and commonly used in EMS for rate control in atrial fibrillation?
- Propranolol
- Metoprolol (Correct answer)
- Carvedilol
- Labetalol
Correct answer: Metoprolol
Metoprolol is a beta-1 selective (cardioselective) blocker that slows AV conduction for rate control in atrial fibrillation.
Question 2: What is the primary concern when administering calcium channel blockers to a patient already on beta-blockers?
- Hyperkalemia
- Additive hypotension and AV block (Correct answer)
- Paradoxical tachycardia
- Increased risk of bronchospasm
Correct answer: Additive hypotension and AV block
Both drug classes depress cardiac conduction and contractility; combining them greatly increases the risk of severe hypotension and complete AV block.
Question 3: Sodium bicarbonate is indicated in the prehospital setting for which condition?
- Respiratory acidosis from COPD
- Tricyclic antidepressant overdose with widened QRS (Correct answer)
- Hypernatremia
- Diabetic ketoacidosis
Correct answer: Tricyclic antidepressant overdose with widened QRS
Sodium bicarbonate alkalinizes the serum, which reduces sodium channel blockade from TCAs and narrows the QRS complex.
Question 4: A patient experiencing anaphylaxis has received epinephrine IM. Which additional medication is typically given to block histamine receptors?
- Aspirin
- Diphenhydramine (Correct answer)
- Furosemide
- Labetalol
Correct answer: Diphenhydramine
Diphenhydramine (Benadryl) is an H1 antihistamine that blocks histamine receptors and reduces urticaria, itching, and some cardiovascular effects of anaphylaxis.
Question 5: Which medication is used prehospital to treat symptomatic bradycardia unresponsive to atropine?
- Adenosine
- Amiodarone
- Dopamine or transcutaneous pacing (Correct answer)
- Lidocaine
Correct answer: Dopamine or transcutaneous pacing
When atropine fails, dopamine infusion or transcutaneous pacing are the next steps for hemodynamically unstable bradycardia per ACLS guidelines.
Question 6: What is the correct pediatric dose of epinephrine 1:10,000 for cardiac arrest?
- 0.01 mg/kg IV/IO (Correct answer)
- 0.1 mg/kg IV/IO
- 1 mg flat dose IV/IO
- 0.5 mg/kg IV/IO
Correct answer: 0.01 mg/kg IV/IO
The PALS recommended dose is 0.01 mg/kg (0.1 mL/kg of the 1:10,000 concentration) IV or IO for pediatric cardiac arrest.
Question 7: Furosemide exerts its primary diuretic effect by acting on which part of the kidney?
- Proximal convoluted tubule
- Loop of Henle (Correct answer)
- Distal convoluted tubule
- Collecting duct
Correct answer: Loop of Henle
Furosemide is a loop diuretic that inhibits the Na-K-2Cl cotransporter in the thick ascending limb of the loop of Henle.
FISDAP Pharmacology 3
Which beta-blocker is cardioselective and commonly used in EMS for rate control in atrial fibrillation?