PSA Emergency Prescribing 2

Question 1

A 25-year-old develops anaphylaxis after a bee sting with urticaria, hypotension, and bronchospasm. What is the first-line treatment?

Accepted Answer

Epinephrine 0.3mg IM (1:1,000 solution)

Answer

IM epinephrine (1:1,000) 0.3–0.5mg into the anterolateral thigh is the first-line treatment for anaphylaxis.

Question 2

A patient with acute severe asthma fails to improve with repeated salbutamol and ipratropium nebulizers plus IV corticosteroids. What IV medication should be added next?

Accepted Answer

Magnesium sulfate 2g IV over 20 minutes

Answer

IV magnesium sulfate 2g over 20 minutes is recommended for acute severe asthma refractory to initial bronchodilators due to its smooth muscle relaxant properties.

Question 3

A patient has had two doses of IV lorazepam 4mg for status epilepticus without cessation of seizures. Which drug is most appropriate as second-line therapy?

Accepted Answer

Levetiracetam 60mg/kg IV (max 4.5g)

Answer

Levetiracetam IV is a preferred second-line agent for benzodiazepine-refractory status epilepticus due to its efficacy and favorable safety profile.

Question 4

A patient has a hypertensive emergency (BP 230/140 mmHg) with acute pulmonary edema. Which agent provides the safest, most titratable blood pressure reduction?

Accepted Answer

Nicardipine IV infusion starting at 5mg/hr

Answer

IV nicardipine infusion allows precise, titratable blood pressure reduction essential in hypertensive emergencies with end-organ damage.

Question 5

A patient develops acute pulmonary edema with severe respiratory distress and an SpO2 of 82%. Which diuretic dose and route provides the fastest relief?

Accepted Answer

Furosemide 40–80mg IV bolus

Answer

IV furosemide provides rapid diuresis and immediate venodilation, making it far superior to oral formulations in acute pulmonary edema.

(PSA) Prescribing Safety Assessment Practice Test

(PSA) Prescribing Safety Assessment Practice Test

PSA Emergency Prescribing 2