ECC ECC Pharmacology & Medication Management 1 — Questions and Answers
Question 1: Which is the first-line vasopressor recommended during cardiac arrest in the AHA ECC guidelines?
- Dopamine
- Epinephrine (Correct answer)
- Vasopressin
- Norepinephrine
Correct answer: Epinephrine
Epinephrine 1 mg IV/IO every 3–5 minutes is the first-line vasopressor for cardiac arrest per AHA ECC guidelines.
Question 2: What is the recommended dose of amiodarone for the first shock-refractory ventricular fibrillation (VF) in adults?
- 150 mg IV
- 300 mg IV (Correct answer)
- 450 mg IV
- 600 mg IV
Correct answer: 300 mg IV
The first dose of amiodarone for shock-refractory VF or pulseless VT is 300 mg IV/IO bolus.
Question 3: Adenosine is the drug of choice for terminating which arrhythmia?
- Atrial fibrillation
- Stable narrow-complex supraventricular tachycardia (Correct answer)
- Ventricular fibrillation
- Third-degree AV block
Correct answer: Stable narrow-complex supraventricular tachycardia
Adenosine is first-line treatment for stable, narrow-complex supraventricular tachycardia (SVT) due to its ability to transiently block AV node conduction.
Question 4: A patient in symptomatic bradycardia does not respond to atropine. Which drug should be considered next?
- Amiodarone
- Lidocaine
- Dopamine infusion (Correct answer)
- Adenosine
Correct answer: Dopamine infusion
Dopamine infusion (2–20 mcg/kg/min) or epinephrine infusion is recommended for symptomatic bradycardia unresponsive to atropine while preparing for transcutaneous pacing.
Question 5: What is the maximum single dose of atropine recommended for symptomatic bradycardia?
- 0.5 mg
- 1.0 mg
- 2.0 mg (Correct answer)
- 3.0 mg
Correct answer: 2.0 mg
The total maximum dose of atropine for bradycardia is 3 mg, given as 0.5–1 mg boluses; doses below 0.5 mg may paradoxically worsen bradycardia.
Question 6: Sodium bicarbonate administration during cardiac arrest is most appropriate in which scenario?
- Routine cardiac arrest
- Hyperkalemia-induced cardiac arrest (Correct answer)
- All pulseless electrical activity
- VF unresponsive to defibrillation
Correct answer: Hyperkalemia-induced cardiac arrest
Sodium bicarbonate is specifically indicated in cardiac arrest associated with hyperkalemia or tricyclic antidepressant overdose to correct metabolic acidosis.
ECC ECC Pharmacology & Medication Management 1
Which is the first-line vasopressor recommended during cardiac arrest in the AHA ECC guidelines?