Pharmacology Flashcards

A 3-year-old (15 kg) in septic shock needs a norepinephrine infusion. What hemodynamic effect makes norepinephrine preferred over dopamine in fluid-refractory cold shock?

Answer: Primarily increases SVR via alpha-1 effects

Norepinephrine's strong alpha-1 agonism raises systemic vascular resistance, making it preferred for vasodilatory (warm) shock, while its use in cold shock targets refractory cases.

Which of the following best describes the mechanism of adenosine in terminating SVT?

Answer: Transiently blocks AV nodal conduction

Adenosine transiently blocks AV nodal conduction, interrupting re-entrant SVT circuits that depend on the AV node.

What is the correct IO epinephrine dose during pediatric cardiac arrest?

Answer: 0.01 mg/kg of 1:10,000 solution

Epinephrine for cardiac arrest is 0.01 mg/kg (0.1 mL/kg of 1:10,000 solution) IV/IO, maximum 1 mg per dose.

Dopamine at a dose of 10–20 mcg/kg/min primarily exerts which effect?

Answer: Alpha-mediated vasoconstriction

At doses of 10–20 mcg/kg/min, dopamine primarily stimulates alpha-adrenergic receptors, causing vasoconstriction.

A child with wide-complex tachycardia and a pulse receives lidocaine. What is the correct IV/IO dose?

Answer: 0.5–1 mg/kg

Lidocaine for ventricular arrhythmias in children is 1 mg/kg IV/IO (range 0.5–1 mg/kg).

Which of the following is a key reason epinephrine is given every 3–5 minutes during CPR?

Answer: It has a half-life of approximately 2–3 minutes in circulation

Epinephrine has a very short half-life (~2 minutes), so repeat dosing every 3–5 minutes maintains its vasopressor effect during CPR.

Calcium chloride is indicated in pediatric resuscitation for which of these conditions?

Answer: Hyperkalemia, hypocalcemia, or calcium-channel blocker overdose

Calcium chloride is used in pediatric arrest for documented hypocalcemia, hyperkalemia, hypermagnesemia, or calcium-channel blocker toxicity.