PALS Pharmacology 2 — Questions and Answers
Question 1: A 4-year-old in pulseless VT requires defibrillation and medication. What is the correct dose of amiodarone for pediatric VF/pulseless VT?
- 1 mg/kg IV/IO
- 5 mg/kg IV/IO (Correct answer)
- 0.1 mg/kg IV/IO
- 10 mg/kg IV/IO
Correct answer: 5 mg/kg IV/IO
Amiodarone for pediatric VF/pulseless VT is 5 mg/kg IV/IO (maximum 300 mg per dose).
Question 2: Which vasopressor is considered first-line for anaphylaxis in the pediatric patient?
- Dopamine
- Norepinephrine
- Epinephrine (Correct answer)
- Vasopressin
Correct answer: Epinephrine
Epinephrine (IM into anterolateral thigh) is the first-line treatment for anaphylaxis in all age groups.
Question 3: A 6-year-old with symptomatic bradycardia does not respond to oxygenation and ventilation. What is the first medication given?
- Adenosine
- Atropine (Correct answer)
- Amiodarone
- Lidocaine
Correct answer: Atropine
Atropine 0.02 mg/kg IV/IO is the first-line drug for symptomatic bradycardia after oxygenation/ventilation fails.
Question 4: What is the minimum dose of atropine recommended in PALS to avoid a paradoxical bradycardic effect?
- 0.01 mg
- 0.05 mg
- 0.1 mg (Correct answer)
- 0.5 mg
Correct answer: 0.1 mg
The minimum atropine dose in PALS is 0.1 mg to prevent paradoxical bradycardia from excessive muscarinic stimulation at very low doses.
Question 5: Which drug is indicated for torsades de pointes in a pediatric patient?
- Amiodarone
- Magnesium sulfate (Correct answer)
- Lidocaine
- Adenosine
Correct answer: Magnesium sulfate
Magnesium sulfate 25–50 mg/kg IV/IO is the treatment of choice for torsades de pointes in children.
Question 6: A child with SVT weighing 20 kg receives adenosine. The correct initial dose is:
- 1 mg rapid IV push
- 3 mg rapid IV push
- 0.1 mg/kg (2 mg) rapid IV push (Correct answer)
- 0.2 mg/kg (4 mg) rapid IV push
Correct answer: 0.1 mg/kg (2 mg) rapid IV push
The initial adenosine dose is 0.1 mg/kg (maximum 6 mg) given as a rapid IV push followed by a NS flush.
Question 7: Sodium bicarbonate may be considered in pediatric arrest for which specific condition?
- Hyperkalemia-induced cardiac arrest (Correct answer)
- Hypoglycemia
- Hypovolemia
- Tension pneumothorax
Correct answer: Hyperkalemia-induced cardiac arrest
Sodium bicarbonate is considered in cardiac arrest associated with hyperkalemia or sodium-channel blocker toxicity.
PALS Pharmacology 2
A 4-year-old in pulseless VT requires defibrillation and medication.
What is the correct dose of amiodarone for pediatric VF/pulseless VT?