Emergency Pharmacology Flashcards

Which antiarrhythmic is most appropriate for stable monomorphic VT with preserved LV function?

Answer: Procainamide 20–50 mg/min IV

Procainamide 20–50 mg/min IV (max 17 mg/kg) is a first-line agent for stable monomorphic VT with preserved ejection fraction.

After ROSC, a patient is hypotensive with MAP 55 mmHg. Which vasopressor infusion is recommended first-line?

Answer: Norepinephrine 0.1–0.5 mcg/kg/min

Norepinephrine is a first-line vasopressor for post-cardiac arrest hypotension due to its potent alpha-1 vasoconstriction with mild beta-1 support.

A patient has pulseless electrical activity (PEA) from suspected tension pneumothorax. What drug should be given while preparing needle decompression?

Answer: Epinephrine 1 mg IV immediately

Epinephrine 1 mg IV/IO every 3–5 minutes is given per ACLS protocol for PEA while reversible causes like tension pneumothorax are corrected.

What is the correct endotracheal dose of epinephrine if IV/IO access cannot be established?

Answer: 2–2.5 mg diluted in 5–10 mL NS

The endotracheal dose of epinephrine is 2–2.5 times the IV dose (2–2.5 mg) diluted in 5–10 mL of sterile water or NS.

A patient with SVT receives adenosine 6 mg without effect. What is the appropriate next step?

Answer: Give adenosine 12 mg IV rapid push

If the initial 6 mg adenosine dose does not convert SVT, the second dose is 12 mg IV rapid push.

Which drug interaction must be considered before giving adenosine to a patient on theophylline?

Answer: Theophylline blocks adenosine receptors, requiring a higher dose

Theophylline competitively blocks adenosine receptors, so patients on theophylline may require a higher adenosine dose to terminate SVT.

In opioid-induced cardiac arrest, what modification to the standard ACLS algorithm is recommended?

Answer: Administer naloxone 0.4–2 mg IV/IO/IM as soon as possible

Naloxone 0.4–2 mg IV/IO/IM should be given as soon as possible in suspected opioid-induced cardiac arrest alongside standard ACLS.