NCTI PARAMEDIC PHARMACOLOGY
EXAMINATION SET QUESTIONS AND ANSWERS
SET A+
✔✔Procainamide
Special Note for this drug (Should not be.........) - ✔✔Note: Should not be exposed to
light.
✔✔Romazicon
Pharmacology ad Actions - ✔✔Antagonizes the effects of benzodiazepines by
competitive inhibition at the GABAbenzodiazepine receptor site
• Does not compete with alcohol or narcotic sites
• Reversal of benzodiazepine effects in 1 to 2 minutes
✔✔Romazicon
Onset of Actions - ✔✔1 to 3 minutes
✔✔Romazicon
Alternative name - ✔✔Flumazenil
✔✔Romazicon
Indications - ✔✔Reverse respiratory depression associated with benzodiazepines
✔✔Romazicon
Contraindications - ✔✔A. Hypersensitivity
,B. Cocaine or other stimulant intoxication
C. Should not be used to rule out benzodiazepine overdose
D. Not administered to patients who were given benzodiazepines for status seizure
✔✔Romazicon
Precautions and Side Effects - ✔✔Neurological:
A. May cause withdrawal effects
B. May cause seizure
C. Dizzy, vertigo, ataxia, headache, fatigue
Respiratory:
Dyspnea, hyperventilation
✔✔Romazicon
Dosage - ✔✔Adult:
• 0.2 mg IV over 30 seconds, repeat with 0.3 mg over 30 seconds. Max dose 3 mg/hour
Pediatrics
• Not recommended
✔✔Oxytocin
Pharmacology and Actions - ✔✔• Naturally occurring hormone secreted by the posterior
pituitary that causes marked contraction of the uterine smooth muscle and promotes
lactation
• Normally a neurogenic reflex caused by irritation or stretching of the uterine cervix, as
occurs at the end of pregnancy, stimulates release of this hormone
• Duration: up to 30 minutes after infusion
✔✔Oxytocin
Alternative name - ✔✔Pitocin
✔✔Oxytocin
Onset of action: - ✔✔within 1 minute
✔✔Oxytocin
Indications - ✔✔• Postpartum hemorrhage with hypotension or significant vaginal
bleeding after presentation of the placenta, if fundal massage and breast stimulation by
the infant are unsuccessful
,✔✔Oxytocin
Contraindications - ✔✔• Should not be used to induce labor in the field
• Never administer while fetus is being delivered, since contractions can rupture uterus
or cause death of fetus
✔✔Oxytocin
Precautions and Side Effects
Cardiovascular/Other - ✔✔• Hypertension and tachycardia
• Cardiac dysrhythmias may be precipitated or aggravated by oxytocin.
• Check fundus and blood pressure at least every 15 minutes.
Other:
• ALWAYS consider the presence of a second fetus prior to administration
• Excess oxytocin can cause over stimulation of the uterus and possibly cause it to
rupture
• Severe and painful uterine cramping may occur from oxytocin administration.
MONITOR
PATIENT CLOSELY WHILE ADMINISTERING MEDICATION AND TITRATE
ACCORDINGLY.
• Uterine massage and breast stimulation by nursing infant are the preferred methods of
management for post partum hemorrhage.
✔✔Oxytocin
Dosage/How supplied - ✔✔Adult Only:
• Infuse 10 units in 1000 mL NS over 60 minutes or until vaginal bleeding ceases.
• If unable to establish IV, administer 3-10 units IM
VI. How Supplied
A. 10 units in 2 mL vial
✔✔Tranexamic Acid
Pharmacology and Actions/
Onset - ✔✔• Antifibrinolytic that competitively inhibits the activation of plasminogen to
plasmin
• Binding this specific site of plasminogen and plasmin, it prevents the destruction of
fibrin - thereby preventing the breakdown of clots
Onset of action: Immediate
✔✔Tranexamic Acid
, Indications - ✔✔• Hemorrhagic shock with hypotension (BP below 90 mm HG)
• Active hemorrhaging due to trauma
✔✔Tranexamic Acid
Alternative name - ✔✔TXA
✔✔Tranexamic Acid
Contraindications - ✔✔• Hypersentivity
• Greater than 3 hours after the trauma has occurred
• DIC
• Renal Failure
• Under the age of 12
• Isolated head injuries
• Known DVT
• Hemorrhagic shock from non-traumatic events
✔✔Tranexamic Acid
Precautions and Side Effects/
Neurological and Muscleskeletal - ✔✔Neurological:
• Headache
• Tired, dizzy Gastrointestinal:
• Abdominal cramping, nausea & vomiting
Muscleskeletal:
• Back, joint, and muscle pain
✔✔Tranexamic Acid
Dosage/
How supplied - ✔✔• Adult (only): 1 gram over 10 min (put 1 gram into 100 mL normal
saline). It is then followed by 1 gram over 8 hours (put 1 gram in 500 mL of normal
saline)
How Supplied
A. 1 gram in 10 mL vial
✔✔Verapamil
Pharmacology and Actions/
Onset - ✔✔• Calcium ion antagonist (calcium channel blocker)
• Relaxation of vascular smooth muscle, causing vasodilation
• Slows conduction through the AV node, decreasing heart rate
EXAMINATION SET QUESTIONS AND ANSWERS
SET A+
✔✔Procainamide
Special Note for this drug (Should not be.........) - ✔✔Note: Should not be exposed to
light.
✔✔Romazicon
Pharmacology ad Actions - ✔✔Antagonizes the effects of benzodiazepines by
competitive inhibition at the GABAbenzodiazepine receptor site
• Does not compete with alcohol or narcotic sites
• Reversal of benzodiazepine effects in 1 to 2 minutes
✔✔Romazicon
Onset of Actions - ✔✔1 to 3 minutes
✔✔Romazicon
Alternative name - ✔✔Flumazenil
✔✔Romazicon
Indications - ✔✔Reverse respiratory depression associated with benzodiazepines
✔✔Romazicon
Contraindications - ✔✔A. Hypersensitivity
,B. Cocaine or other stimulant intoxication
C. Should not be used to rule out benzodiazepine overdose
D. Not administered to patients who were given benzodiazepines for status seizure
✔✔Romazicon
Precautions and Side Effects - ✔✔Neurological:
A. May cause withdrawal effects
B. May cause seizure
C. Dizzy, vertigo, ataxia, headache, fatigue
Respiratory:
Dyspnea, hyperventilation
✔✔Romazicon
Dosage - ✔✔Adult:
• 0.2 mg IV over 30 seconds, repeat with 0.3 mg over 30 seconds. Max dose 3 mg/hour
Pediatrics
• Not recommended
✔✔Oxytocin
Pharmacology and Actions - ✔✔• Naturally occurring hormone secreted by the posterior
pituitary that causes marked contraction of the uterine smooth muscle and promotes
lactation
• Normally a neurogenic reflex caused by irritation or stretching of the uterine cervix, as
occurs at the end of pregnancy, stimulates release of this hormone
• Duration: up to 30 minutes after infusion
✔✔Oxytocin
Alternative name - ✔✔Pitocin
✔✔Oxytocin
Onset of action: - ✔✔within 1 minute
✔✔Oxytocin
Indications - ✔✔• Postpartum hemorrhage with hypotension or significant vaginal
bleeding after presentation of the placenta, if fundal massage and breast stimulation by
the infant are unsuccessful
,✔✔Oxytocin
Contraindications - ✔✔• Should not be used to induce labor in the field
• Never administer while fetus is being delivered, since contractions can rupture uterus
or cause death of fetus
✔✔Oxytocin
Precautions and Side Effects
Cardiovascular/Other - ✔✔• Hypertension and tachycardia
• Cardiac dysrhythmias may be precipitated or aggravated by oxytocin.
• Check fundus and blood pressure at least every 15 minutes.
Other:
• ALWAYS consider the presence of a second fetus prior to administration
• Excess oxytocin can cause over stimulation of the uterus and possibly cause it to
rupture
• Severe and painful uterine cramping may occur from oxytocin administration.
MONITOR
PATIENT CLOSELY WHILE ADMINISTERING MEDICATION AND TITRATE
ACCORDINGLY.
• Uterine massage and breast stimulation by nursing infant are the preferred methods of
management for post partum hemorrhage.
✔✔Oxytocin
Dosage/How supplied - ✔✔Adult Only:
• Infuse 10 units in 1000 mL NS over 60 minutes or until vaginal bleeding ceases.
• If unable to establish IV, administer 3-10 units IM
VI. How Supplied
A. 10 units in 2 mL vial
✔✔Tranexamic Acid
Pharmacology and Actions/
Onset - ✔✔• Antifibrinolytic that competitively inhibits the activation of plasminogen to
plasmin
• Binding this specific site of plasminogen and plasmin, it prevents the destruction of
fibrin - thereby preventing the breakdown of clots
Onset of action: Immediate
✔✔Tranexamic Acid
, Indications - ✔✔• Hemorrhagic shock with hypotension (BP below 90 mm HG)
• Active hemorrhaging due to trauma
✔✔Tranexamic Acid
Alternative name - ✔✔TXA
✔✔Tranexamic Acid
Contraindications - ✔✔• Hypersentivity
• Greater than 3 hours after the trauma has occurred
• DIC
• Renal Failure
• Under the age of 12
• Isolated head injuries
• Known DVT
• Hemorrhagic shock from non-traumatic events
✔✔Tranexamic Acid
Precautions and Side Effects/
Neurological and Muscleskeletal - ✔✔Neurological:
• Headache
• Tired, dizzy Gastrointestinal:
• Abdominal cramping, nausea & vomiting
Muscleskeletal:
• Back, joint, and muscle pain
✔✔Tranexamic Acid
Dosage/
How supplied - ✔✔• Adult (only): 1 gram over 10 min (put 1 gram into 100 mL normal
saline). It is then followed by 1 gram over 8 hours (put 1 gram in 500 mL of normal
saline)
How Supplied
A. 1 gram in 10 mL vial
✔✔Verapamil
Pharmacology and Actions/
Onset - ✔✔• Calcium ion antagonist (calcium channel blocker)
• Relaxation of vascular smooth muscle, causing vasodilation
• Slows conduction through the AV node, decreasing heart rate
