ACLS Pharmacology - Section 2 of 3 in Pre-Course Assessment Latest Updated

In which situation does bradycardia require treatment? - ANSWER-Hypotension A 62-year old man has suddenly experienced difficulty speaking and left-sided weakness. He meets initial criteria for fibrinolytic therapy, and a CT scan is ordered. Which best describes the guidelines for antiplatelet and fibrinolytic therapy? - ANSWER-Hold aspirin for at least 24 hrs if rtPA administered You are caring for a 66-yr old with a history of a large intracerebral hemorrhage 2 months ago. He is being evaluated for another acute stroke. The CT scan is negative for hemorrhage. The patient is receiving oxygen via nasal cannula at 2 L/min, and an IV has been established. His blood pressure is 180/100 mm Hg. Which drug do you anticipate giving to this patient? - ANSWER-Aspirin A patient with a STEMI just got a buttload of Heparin, like 4000 units. He gettin some Heparin 1000 units per hour. He didn't take aspirin cause it messes up his fartin. That was like 5 years ago. What you givin that fool next? - ANSWER-Aspirin 160-325mg chewed A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood pressure of 80/60 mm Hg. What is the initial dose of atropine? - ANSWER-0.5 mg What is the indication for the use of magnesium in cardiac arrest? - ANSWER-pulseless ventricular tachycardia-associated torsades de pointes A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. What should you do? - ANSWER-Seek expert consultation. Actually it says "seeking expert consultation" so now we know that AHA is not the place to go for proper grammar. A patient with possible ST-segment elevation MI (STEMI) has ongoing chest discomfort. What is a containdication to the administration of nitrates? - ANSWER-Phosphodiesterase inhibitor within the past 24 hrs A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which drug and dose should be administered first? - ANSWER-Epinepherine 1mg IV/IO A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One dose of epinephrine was given after the second shock. An antiarrhythmic drug was given immediately after the third shock. You are the team leader. Which medication do you order next? - ANSWER-Epinepherine 1mg A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which drug do you give next? - ANSWER-Amiodarone 300 mg (antiarrhythmic) A patient is in refractory ventricular fibrillation and has received multiple appropriate defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg amiodarone IV. The patient is intubated. What best describes the recommended second dose of Amiodarone for this patient? - ANSWER-150 mg IV push A 57 year old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular wide-complex QRS at a rate of 180 bpm. She becomes diaphoretic, and her blood pressure is 80/60 mm Hg. Which action do you take next? - ANSWER-Perform Electrical Cardioversion (Dave is poking you with his finger but that's AHA's answer.) "SYNCHRONIZED, people!" Geez. A 35 year old woman has palpitations, light headedness, and a stable tachycardia. The monitor shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in terminating the rhythm. An IV has been established. What drug should be administered IV? - ANSWER-Adenosine 6mg A patient is in cardiac arrest. High quality chest compressions are being given. The patient is intubated, and an IV has been started. The rhythm is asystole. Which is the first drug/dose to administer? - ANSWER-Epinepherine 1mg IV/IO You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previously advised "no shock indicated". A rhythm check now finds asystole. After resuming high-quality compressions, which action do you take next? - ANSWER-Get IV/IO access. Don't call for a pulse check (NERD) and get your IV before the airway stuff. Page 10 in your 2015 ACLS handbook, yo. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total dose of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 88/56. Which therapy is now indicated? - ANSWER-Epinephrine 2-10 mcg/min