PSA Emergency Prescribing 1 — Questions and Answers
Question 1: What is the first-line treatment for anaphylaxis?
- Intramuscular adrenaline (epinephrine) 0.5mg (1:1000) into the anterolateral thigh (Correct answer)
- Oral antihistamines
- Intravenous steroids
- Inhaled salbutamol
Correct answer: Intramuscular adrenaline (epinephrine) 0.5mg (1:1000) into the anterolateral thigh
IM adrenaline is the first and most important treatment for anaphylaxis, addressing bronchospasm, hypotension, and angioedema. Delay can be fatal.
Question 2: What is the emergency treatment for hypoglycemia in a conscious patient?
- Fast-acting oral glucose such as glucose tablets, juice, or sugar-containing drinks (Correct answer)
- Intravenous insulin
- Intramuscular adrenaline
- No treatment needed if the patient is conscious
Correct answer: Fast-acting oral glucose such as glucose tablets, juice, or sugar-containing drinks
Conscious hypoglycemic patients should receive fast-acting oral carbohydrates (15-20g glucose) followed by a longer-acting carbohydrate snack to prevent recurrence.
Question 3: What is the drug treatment for acute asthma?
- Inhaled salbutamol (short-acting beta-2 agonist) with systemic corticosteroids for moderate-severe attacks (Correct answer)
- Only oral antibiotics
- Only oxygen therapy
- No medication is needed for acute asthma
Correct answer: Inhaled salbutamol (short-acting beta-2 agonist) with systemic corticosteroids for moderate-severe attacks
First-line treatment includes inhaled SABA (salbutamol) for bronchodilation plus systemic steroids (prednisolone or hydrocortisone) to reduce airway inflammation.
Question 4: What is naloxone used for?
- Reversing opioid overdose by blocking opioid receptors (Correct answer)
- Treating alcohol poisoning
- Reversing benzodiazepine overdose
- Treating paracetamol overdose
Correct answer: Reversing opioid overdose by blocking opioid receptors
Naloxone is an opioid antagonist that rapidly reverses respiratory depression, sedation, and hypotension caused by opioid overdose.
Question 5: What is the antidote for paracetamol (acetaminophen) overdose?
- N-acetylcysteine (NAC), which must be given within 8-10 hours for maximum effectiveness (Correct answer)
- Naloxone
- Activated charcoal only
- There is no antidote
Correct answer: N-acetylcysteine (NAC), which must be given within 8-10 hours for maximum effectiveness
NAC replenishes glutathione, which is depleted by toxic paracetamol metabolites. Early administration prevents potentially fatal liver damage.
Question 6: When should activated charcoal be considered for poisoning?
- Within 1 hour of ingestion of a potentially toxic dose of certain substances (Correct answer)
- Any time after poisoning
- Only for adult patients
- Only for specific poisons like iron
Correct answer: Within 1 hour of ingestion of a potentially toxic dose of certain substances
Activated charcoal is most effective within 1 hour of ingestion, adsorbing many drugs in the GI tract before absorption. It is not effective for all poisons.
PSA Emergency Prescribing 1
What is the first-line treatment for anaphylaxis?