LA County Paramedic Drugs Questions With Complete
Solutions
Adenosine Adult drug dose Correct Answers Adult Dose
6 or 12mg rapid IVP (per protocol), within 1-3 seconds,
followed by a rapid flush of 10mL of NS
If no conversion after 1-2 minutes, may repeat 12mg rapid IVP
followed by rapid flush of 10mL of NS.
Adenosine Adverse Effects Correct Answers Adverse Effects
Blurred vision
Bradycardia / Asystole
Chest pain / Chest pressure
Dyspnea
Head pressure
Hypotension
Lightheadedness / Dizziness
Metallic taste / Throat tightness
Numbness / Tingling palpations
Adenosine class Correct Answers Antidysrthythmic
Adenosine Contraindications Correct Answers Sinus
tachycardia
2nd and 3rd degree heart block without pacemaker
Wolff-Parkinson-White (WPW) Syndrome and atrial fibrillation
(wide-complex, irregular rhythm)
Sinus Node Disease (Sick Sinus Syndrome)
Heart transplant
Use of carbamazepine (Tegretol) for seizure disorder
,Adenosine Indications Correct Answers Cardiac Dysrhythmia:
SVT - Narrow Complex: HR ≥ 150 for adults; ≥180 for a child;
and ≥220 for infants
Perfusing unresponsive to Valsalva
Alert patients with poor perfusion
Regular/Monomorphic Wide Complex Tachycardia
Adequate perfusion
Alert patients with poor perfusion
Adenosine interactions Correct Answers Interactions
Potentiated by blocker of nucleoside transport [e.g.,
carbamazepine (Tegretol)]
Antagonized by methylxanthines such as caffeine and
theophylline
Adenosine MOA Correct Answers Mechanism of Action
Slows conduction through the AV node and interrupts AV
reentry pathways as well as conduction through
the sinoatrial (SA) node
Adenosine Peds dose Correct Answers Pediatric Dose
0.1mg/kg (3mg/mL) rapid IVP, dose per MCG 1309, maximum
first dose 6mg, followed by a rapid flush of
10mL NS
If no conversion after 1-2 minutes, may repeat one time
0.2mg/kg (3mg/mL) followed by a rapid flush of
10mL NS, dose per MCG 1309, maximum second dose 12mg
Adenosine Pharmocokinetics Correct Answers
Pharmacokinetics
Onset immediate, Duration < 10 secs
,Albuterol Adult Dose Correct Answers Adult Dose
Cardiac Dysrhythmia/Crush - Evidence of or suspected
hyperkalemia
5mg (6mL) via neb, repeat continuously until hospital arrival
Crush - at risk for Crush Syndrome
5 minutes prior to extrication: 5mg (6mL) via mask nebulization
x2 for a total dose of 10mg
Respiratory Distress, Pulmonary Edema/CHF with wheezing,
Allergic Reaction with wheezing, Inhalation
Injury with wheezing
5mg (6mL) via neb or 4 puffs via Metered-Dose Inhaler (MDI)
May repeat x2 prn for wheezing
Albuterol adverse effects Correct Answers Adverse Effects
Anxiety/Tremors
Hypertension
Hypokalemia
Palpitations/Tachycardia
Albuterol Contraindications Correct Answers
Contraindications
Do not use for patients with a known hypersensitivity/allergy to
the drug
Albuterol Indications Correct Answers LA County Prehospital
Indications
Cardiac Dysrhythmia: suspected hyperkalemia causing
bradycardia
Respiratory Distress: bronchospasm caused by acute asthma,
bronchitis, bronchiolitis, COPD, drug
, overdose, near drowning, pulmonary edema, and/or toxic gas
inhalation
Pulmonary Edema/CHF: persistent wheezing despite CPAP
Traumatic Injury: suspected hyperkalemia in the setting of crush
injury or potential for development of crush
syndrome (administer prior to release of crushed tissue)
Albuterol Interactions Correct Answers Interactions
Administer with extreme caution to patients being treated with
MAO inhibitors or tricyclic antidepressants
Beta blocking agents and Albuterol may each inhibit the effects
of the other, monitor closely
Albuterol MOA Correct Answers Mechanism of Action
Selective beta-2 adrenergic agonist that causes relaxation of
smooth muscles in the bronchial tree,
decreasing airway resistance, facilitating mucous drainage and
increasing vital capacity
Shifts potassium intracellular. Has mild beta-1 activity with mild
effect on heart rate
Albuterol Peds Dose Correct Answers Pediatric Dose
Crush - Evidence of or suspected hyperkalemia
5mg (6mL) via neb, repeat continuously until hospital arrival
Crush - at risk for Crush Syndrome
5 minutes prior to extrication: 5mg (6mL) via neb, repeat
immediately x1
Respiratory Distress, Allergic Reaction with wheezing,
Inhalation Injury with wheezing
< 4 years of age 2.5mg (3mL) via neb or 2 puffs via MDI
≥ 4 years of age 5mg (6mL) via neb or 4 puffs via MDI
Solutions
Adenosine Adult drug dose Correct Answers Adult Dose
6 or 12mg rapid IVP (per protocol), within 1-3 seconds,
followed by a rapid flush of 10mL of NS
If no conversion after 1-2 minutes, may repeat 12mg rapid IVP
followed by rapid flush of 10mL of NS.
Adenosine Adverse Effects Correct Answers Adverse Effects
Blurred vision
Bradycardia / Asystole
Chest pain / Chest pressure
Dyspnea
Head pressure
Hypotension
Lightheadedness / Dizziness
Metallic taste / Throat tightness
Numbness / Tingling palpations
Adenosine class Correct Answers Antidysrthythmic
Adenosine Contraindications Correct Answers Sinus
tachycardia
2nd and 3rd degree heart block without pacemaker
Wolff-Parkinson-White (WPW) Syndrome and atrial fibrillation
(wide-complex, irregular rhythm)
Sinus Node Disease (Sick Sinus Syndrome)
Heart transplant
Use of carbamazepine (Tegretol) for seizure disorder
,Adenosine Indications Correct Answers Cardiac Dysrhythmia:
SVT - Narrow Complex: HR ≥ 150 for adults; ≥180 for a child;
and ≥220 for infants
Perfusing unresponsive to Valsalva
Alert patients with poor perfusion
Regular/Monomorphic Wide Complex Tachycardia
Adequate perfusion
Alert patients with poor perfusion
Adenosine interactions Correct Answers Interactions
Potentiated by blocker of nucleoside transport [e.g.,
carbamazepine (Tegretol)]
Antagonized by methylxanthines such as caffeine and
theophylline
Adenosine MOA Correct Answers Mechanism of Action
Slows conduction through the AV node and interrupts AV
reentry pathways as well as conduction through
the sinoatrial (SA) node
Adenosine Peds dose Correct Answers Pediatric Dose
0.1mg/kg (3mg/mL) rapid IVP, dose per MCG 1309, maximum
first dose 6mg, followed by a rapid flush of
10mL NS
If no conversion after 1-2 minutes, may repeat one time
0.2mg/kg (3mg/mL) followed by a rapid flush of
10mL NS, dose per MCG 1309, maximum second dose 12mg
Adenosine Pharmocokinetics Correct Answers
Pharmacokinetics
Onset immediate, Duration < 10 secs
,Albuterol Adult Dose Correct Answers Adult Dose
Cardiac Dysrhythmia/Crush - Evidence of or suspected
hyperkalemia
5mg (6mL) via neb, repeat continuously until hospital arrival
Crush - at risk for Crush Syndrome
5 minutes prior to extrication: 5mg (6mL) via mask nebulization
x2 for a total dose of 10mg
Respiratory Distress, Pulmonary Edema/CHF with wheezing,
Allergic Reaction with wheezing, Inhalation
Injury with wheezing
5mg (6mL) via neb or 4 puffs via Metered-Dose Inhaler (MDI)
May repeat x2 prn for wheezing
Albuterol adverse effects Correct Answers Adverse Effects
Anxiety/Tremors
Hypertension
Hypokalemia
Palpitations/Tachycardia
Albuterol Contraindications Correct Answers
Contraindications
Do not use for patients with a known hypersensitivity/allergy to
the drug
Albuterol Indications Correct Answers LA County Prehospital
Indications
Cardiac Dysrhythmia: suspected hyperkalemia causing
bradycardia
Respiratory Distress: bronchospasm caused by acute asthma,
bronchitis, bronchiolitis, COPD, drug
, overdose, near drowning, pulmonary edema, and/or toxic gas
inhalation
Pulmonary Edema/CHF: persistent wheezing despite CPAP
Traumatic Injury: suspected hyperkalemia in the setting of crush
injury or potential for development of crush
syndrome (administer prior to release of crushed tissue)
Albuterol Interactions Correct Answers Interactions
Administer with extreme caution to patients being treated with
MAO inhibitors or tricyclic antidepressants
Beta blocking agents and Albuterol may each inhibit the effects
of the other, monitor closely
Albuterol MOA Correct Answers Mechanism of Action
Selective beta-2 adrenergic agonist that causes relaxation of
smooth muscles in the bronchial tree,
decreasing airway resistance, facilitating mucous drainage and
increasing vital capacity
Shifts potassium intracellular. Has mild beta-1 activity with mild
effect on heart rate
Albuterol Peds Dose Correct Answers Pediatric Dose
Crush - Evidence of or suspected hyperkalemia
5mg (6mL) via neb, repeat continuously until hospital arrival
Crush - at risk for Crush Syndrome
5 minutes prior to extrication: 5mg (6mL) via neb, repeat
immediately x1
Respiratory Distress, Allergic Reaction with wheezing,
Inhalation Injury with wheezing
< 4 years of age 2.5mg (3mL) via neb or 2 puffs via MDI
≥ 4 years of age 5mg (6mL) via neb or 4 puffs via MDI
