Free Paramedics Pharmacology and Medication Administration Questions and Answers

Question 1

You are managing a patient in cardiac arrest. Intravenous access is unsuccessful after two attempts. Which of the following is the most appropriate next action for medication administration?

Accepted Answer

Establish an intraosseous (IO) line as it provides drug absorption comparable to IV access.

Answer

When peripheral IV access cannot be quickly established in cardiac arrest, an intraosseous (IO) line is the preferred alternative. The highly vascular marrow of long bones provides a non-collapsible entry point to the systemic circulation, with drug absorption rates and effects that are comparable to IV administration. The ET route has poor and unpredictable drug absorption, IM is too slow in a low-flow state, and a central line is too time-consuming and high-risk for the prehospital setting.

Question 2

You are ordered to start a dopamine infusion at 5 mcg/kg/min for a 198 lb patient. Your dopamine concentration is 400 mg in 250 mL of D5W. Using a microdrip (60 gtt/mL) administration set, what is the correct drip rate?

Accepted Answer

17 gtts/min

Answer

Calculation Steps:
1. Convert weight: 198 lbs / 2.2 lbs/kg = 90 kg.
2. Calculate the desired dose: 5 mcg/kg/min * 90 kg = 450 mcg/min.
3. Calculate drug concentration: (400 mg * 1000 mcg/mg) / 250 mL = 1600 mcg/mL.
4. Calculate mL per minute: 450 mcg/min / 1600 mcg/mL = 0.28125 mL/min.
5. Calculate drops per minute: 0.28125 mL/min * 60 gtt/mL = 16.875 gtts/min, which rounds to 17 gtts/min.

Question 3

What is the primary mechanism of action by which adenosine terminates stable, narrow-complex supraventricular tachycardia (SVT)?

Accepted Answer

It temporarily blocks conduction through the atrioventricular (AV) node.

Answer

Adenosine's primary antiarrhythmic effect is to slow or completely block electrical conduction through the AV node. This action interrupts the re-entry circuit that is responsible for most forms of SVT, allowing the sinoatrial (SA) node to regain control and restore a normal sinus rhythm.

Question 4

You are treating a 62-year-old male with substernal chest pain. His BP is 92/60 mmHg and he states he took tadalafil (Cialis) about 12 hours ago. Which of the following is correct regarding the administration of nitroglycerin?

Accepted Answer

Nitroglycerin is contraindicated due to the risk of profound hypotension.

Answer

Nitroglycerin is absolutely contraindicated in patients who have recently used phosphodiesterase-5 (PDE-5) inhibitors like tadalafil (Cialis) or sildenafil (Viagra). Both drug classes cause vasodilation. When used together, they can cause a synergistic and severe drop in blood pressure that is often refractory to treatment. The time window for this contraindication is typically 24-48 hours.

Question 5

A 70-year-old is found unresponsive with severe bradycardia (30 bpm) and hypotension (BP 60/40 mmHg). Family states she may have taken too much of her metoprolol. After atropine is ineffective, which medication is the most appropriate specific antidote to consider?

Accepted Answer

Glucagon

Answer

In a beta-blocker overdose, glucagon is a primary antidote. It increases heart rate and contractility by activating adenylate cyclase through a separate receptor, bypassing the blocked beta-adrenergic receptors and increasing intracellular cAMP. While vasopressors like epinephrine and dopamine may be used for supportive care, glucagon specifically counteracts the toxic effects of the beta-blockade.

Paramedics Exam Practice Test

Paramedics Exam Practice Test

Free Paramedics Pharmacology and Medication Administration Questions and Answers