Paramedic Pharmacology Exam with Complete Solutions

Paramedic Pharmacology Exam with Complete Solutions Topical Benzocaine: Indications - Answer-Use of topical benzocaine is limited to assisting with the placement of an ETT. Topical Benzocaine: Administration - Answer-Topical. Topical Benzocaine: Dosage - Answer-Spray mucous membranes (nose or mouth) for 1 second. This may be repeated one time. Avoid sprays in excess of 2 seconds. Topical Benzocaine: Therapeutic Effects - Answer-Topical benzocaine is a local anesthetic chemically related to lidocaine used to facilitate the placement of an endotracheal intubation. Topical Benzocaine: Absolute Contraindications - Answer-Known hypersensitivity to benzocaine or other local anesthetics. Topical Benzocaine: Side Effects - Answer-Methemoglobinemia. Diminished gag reflex, edema of the airway mucosa, increased chance of aspiration. Topical Benzocaine: Special Notes/Restrictions - Answer-Use cautiously around the eyes. Do not apply to large inflamed tissue areas. Due to retention of the medication, topical benzocaine should not be used underneath dentures or applied to a cotton ball applicator. The use of mouth sprays containing benzocaine may impair swallowing and increase the risk of aspiration. Vasopressin: Indications - Answer-Pulseless arrest. Vasopressin: Mechanism of Action - Answer-Increases cyclic adenosine monophosphate (cAMP) which increases water permeability at the renal tubule resulting in decreased urine volume and increased osmolalit; causes peristalsis by directly stimulating the smooth muscle in the GI tract; direct vasoconstrictor without inotropic or chronotropic effects. Vasopressin: Dosage - Answer-40 Units/IV Verapamil (Calan, Isoptin, Verelan, Covera): Indications - Answer-Supraventricular tachydysrhythmias. Verapamil (Calan, Isoptin, Verelan, Covera): Administration - Answer-IV, IO. Verapamil (Calan, Isoptin, Verelan, Covera): Dosage - Answer-Adult: 2.5 to 5 mg IV over 2 minutes. Pediatric: Not indicated. Verapamil (Calan, Isoptin, Verelan, Covera): Therapeutic Effects - Answer-Calcium channel blocker. Delays impulse propagation through AV node. Dilates coronary and systemic arterial systems. Verapamil (Calan, Isoptin, Verelan, Covera): Contraindications - Answer-Wolf-Parkinson-White (WPW) syndrome. AV block. Cardiogenic shock. Hypotension. Verapamil (Calan, Isoptin, Verelan, Covera): Side Effects - Answer-AV blockade. Bradycardia. Dizziness. Headache. Hypotension. Verapamil (Calan, Isoptin, Verelan, Covera): Special Notes/Restrictions - Answer-Do not use in WPW patients as it can cause cardiac arrest. Use caution if wide complex tachycardia. Activated Charcoal: Indications - Answer-Used to treat certain types of poisonings and overdoses. Activated Charcoal: Administration - Answer-Administered PO. Activated Charcoal: Dosage - Answer-Adult: 50g. Pediatric: 1g/kg. Activated Charcoal: Therapeutic Effects - Answer-Binds and absorbs various chemicals and poisonous compounds, thereby reducing their absorption into the body. Activated Charcoal: Contraindications - Answer-Caustic/Corrosive substances. Cyanide poisonings. Semiconscious or unconscious patients. Activated Charcoal: Side Effects - Answer-Abdominal cramping, constipation, dark stools, nausea, and vomiting. Activated Charcoal: Special Notes/Restrictions - Answer-Does not absorb all drugs or toxic substances (i.e., cyanide, lithium, iron, lead, arsenic, etc.). Has no effect in methanol or organophosphate poisonings. Has little therapeutic value in caustic alkalis and acid poisonings. Should not be given with ice cream, milk, sherbet, or syrup of ipecac. Adenosine (Adenocard): Indications - Answer-Paroxysmal supraventricular tachycardia. Supraventricular tachycardia. Wolf-Parkinson-White syndrome. Adenosine (Adenocard): Administration - Answer-Rapid intravenous (IV), rapid intraosseous (IO) followed by normal saline (NS) flush. Adenosine (Adenocard): Dosage - Answer-Adult: Supraventricular tachycardia: initial 6 mg IV bolus over 1 to 2 seconds, increase to 12 mg every 1 to 2 minutes as needed for 2 doses, maximum single dose 12 mg. Pediatric: Initial: 0.1 mg/kg intravenous pyelogram (IVP) (max: 6 mg). Repeat: 0.2 mg/kg IVP (max: 12 mg). Adenosine (Adenocard): Therapeutic Effects - Answer-Slows conduction time through atrioventricular (AV) node. Interrupts reentry pathways through AV node. Restores sinus rhythm in patients with supraventricular tachycardia (SVT) Adenosine (Adenocard): Contraindications - Answer-Hypersensitivity to adenosine. Second- or third-degree AV block. Sinus node dysfunction, such as sick sinus syndrome or symptomatic bradycardia. Atrial flutter/atrial fibrillation. Sick sinus syndrome. Ventricular tachycardia. Adenosine (Adenocard): Side Effects - Answer-Transient AV block, asystole, and other dysrhythmias. Chest pressure. Dizziness. Flushing. Nausea. Shortness of breath. Adenosine (Adenocard): Special Notes/Restrictions - Answer-Onset is generally within less than 1 minute. Adverse effects are usually short-lived and easily tolerated. Effects may be more pronounced in patients on dipyridamole. Effects may be attenuated in patients on theophylline preparations. Albuterol (Ventolin, Proventil): Indications - Answer-Acute bronchospasm. Albuterol (Ventolin, Proventil): Administration - Answer-Handheld nebulizer, nebulizer mask, endotracheal tube (ETT). Albuterol (Ventolin, Proventil): Dosage - Answer-Adult: 2.5 mg/3 cc normal saline solution (NSS) Pediatric: 2.5 mg 3 cc NSS Albuterol (Ventolin, Proventil): Therapeutic Effects - Answer-Decreases bronchospasm via beta receptors. Improves pulmonary function. Albuterol (Ventolin, Proventil): Contraindications - Answer-Hypersensitivity to any of the contents of the solution. Tachydysrhythmias. Albuterol (Ventolin, Proventil): Side Effects - Answer-Cough. Dizziness or nervousness. Nausea. Tachycardia. Tremor. Albuterol (Ventolin, Proventil): Special Notes/Restrictions - Answer-May be put down the ETT in intubated asthmatics or COPD patients. Amiodarone (Cordarone): Indications - Answer-Ventricular fibrillation, ventricular tachycardia, rapid atrial fibrillation, rapid atrial flutter, SVT. Amiodarone (Cordarone): Administration - Answer-IVP or IV infusion. Amiodarone (Cordarone): Dosage - Answer-Adult: Pulseless ventricular fibrillation/ventricular tachycardia (VF/VT) - Initial: 300 mg IVP. Pulseless VF/VT - Repeat: 150 mg IVP. Rapid atrial fibrillation/flutter: 2.5 to 5 mg/kg slow IVP. Rapid atrial fibrillation/flutter (alternative): 150 mg/100 cc D5W over 10 minutes. SVT: 2.5 to 5 mg/kg IVP. SVT (alternative): 150 mg/100 cc D5W over 10 minutes. SVT: 2.5 to 5 mg/kg slow IVP. SVT (alternative): 150 mg/100 cc D5W over 10 minutes. Pulseless VF/VT: 5 mg/kg IVP. Pediatric: Rapid atrial fibrillation/flutter: 5 mg/kg IV over 20 to 60 minutes. SVT: 5 mg/kg IV over 20 to 60 minutes. SVT: 5 mg/kg IV over 10 minutes. Amiodarone (Cordarone): Therapeutic Effects - Answer-Prolongs action potential and refractory period. Reduces ventricular dysrhythmias and raises fibrillatory threshold. Amiodarone (Cordarone): Contraindications - Answer-Cardiogenic shock. Hypersensitivity to amiodarone. Second- or third-degree AV block. Severe sinus bradycardia. Severe sinus node dysfunction.