ALL

Question 1

Albuterol (Proventil)

Answer 1

Class: bronchodilator, sympathomimetic, beta-2 agonist

MOA: beta-2 selective, relaxes bronchial smooth muscle and peripheral vasculature

Dose: 2.5 mg/3 mL, 3-4x

Question 2

Dexamethasone (Decadron)

Answer 2

Class: glucocorticoid

MOA: inhibits prostaglandins, suppresses inflammation, potentiates beta-2 agonists

Adult dose: IV/IM - 4-20 mg/dose/day, high dose 0.4-0.8 mg/kg (max 40 mg)

Question 3

Diphenhydramine (Benadryl)

Answer 3

Class: antihistamine

MOA: blocks H1 and H2 receptors to prevent histamine uptake, adjunct for anaphylaxis, certain extrapyramidal reactions

Adult dose: 1 mg/kg (max 50 mg)

Question 4

Etomidate (Amidate)

Answer 4

Class: nonbarbiturate hypnotic, anesthetic

MOA: acts on reticular activating system to produce anesthesia

Dose: 0.2-0.6 mg/kg IV over 30-60 seconds

Question 5

Epinephrine (Adrenalin)

Answer 5

Class: sympathomimetic

MOA: alpha, beta-1, and beta-2 agonist, antagonizes histamine

Respiratory dose: 0.3 mg IM, repeat 5-15 mins

Cardiac dose: arrest - 10 mL of 0.1 mg/mL, hypotension - 0.1 mg/mL in 9 mL NS

Infusion dose: 2-20 mcg/min

Question 6

Ipratropium (Atrovent)

Answer 6

Class: anticholinergic, bronchodilator

MOA: blocks ACH at bronchial smooth muscle

Dose: 0.5 mg in 2.5 mL, 3x max

Question 7

Ketamine (Ketalar)

Answer 7

Class: nonbarbiturate anesthetic

MOA: blocks pain impulses at limbic/cortex, produces dissociative anesthesia and amnesia

Dose: 2 mg/kg IV, 4 mg/kg IM

Question 8

Magnesium Sulfate

Answer 8

Class: electrolyte, anticonvulsant, class V antidysrhythmic

MOA: reduces striated muscle contractions, blocks ACH at neuromuscular junction, slows SA node, enhances calcium/potassium/sodium movement in/out of cells

Respiratory dose: 2 g over 10-15 mins

Cardiac dose: pulse - 2 g in 50-100 mL D5 over 5-60 mins, pulseless - 2 g in 10mL of D5 over 1-2 mins

Question 9

Methylprednisolone (Solu-Medrol)

Answer 9

Class: glucocorticoid

MOA: suppresses inflammation, inhibits prostaglandins, potentiates beta adrenergists, dexamethasone, and hydrocortisone

Adult dose: 2 mg/kg (max 125 mg) IV

Question 10

Midazolam (Versed)

Answer 10

Class: short-acting benzo, anticonvulsant, anxiolytic

MOA: binds to GABA receptors in limbic/reticular activating system to produce amnesia

Adult dose: 0.2 mg/kg, max 10 mg

Question 11

Nitroglycerin (Nitrostat)

Answer 11

Class: vasodilator

MOA: dilates arterioles and veins in periphery, reduces pre and afterload

Respiratory dose: 0.8 mg (SBP >160), 1.2 mg (SBP >200), infusion – 10 - 200 mcg/min

Cardiac dose: SBP>90, 0.4 mg SL, max 1.2 mg

Question 12

Phenylephrine

Answer 12

Class: alpha-1 agonist

MOA: constricts vessels in nose

Dose: 1-2 sprays/nostril

Question 13

Racemic Epinephrine (Micronefrin)

Answer 13

Class: sympathomimetic

MOA: beta-2 agonist, inhibits histamine

Dose: 0.5 mL solution in 5 mL NS

Question 14

Succinylcholine (Anectine)

Answer 14

Class: depolarizing neuromuscular blocker

MOA: binds to ACH receptors

Dose: 1-1.5 mg/kg IV/IO, 3-4 mg/kg IM

Question 15

Calcium Chloride

Answer 15

Class: electrolyte

MOA: hypertonic solution that improves cardiac contractility

Dose: 5-10 mL of 10% over 5-10 mins

Question 16

Norepinephrine (Levophed)

Answer 16

Class: sympathomimetic

MOA: alpha and beta-1 adrenergist

Dose: 4 mg in 250mL D5, infuse at 0.02-0.4 mcg/kg/min (titrate to effect)

Question 17

Dopamine (Intropin)

Answer 17

Class: sympathomimetic

MOA: primarily acts on alpha-1 and beta-1, positive inotropy with neutral chrono/dromo

Dose: cardiac - 2-10 mcg/kg/min, pressor - 10-20 mcg/kg/min

Question 18

Verapamil (Calan)

Answer 18

Class: Class IV antidysrhythmic (calcium)

MOA: blocks calcium movement into cells, slows AV conduction, prolongs AV refractory period

Dose: 2-5 mg over 2 mins, repeat 5-10 mg if needed

Question 19

Diltiazem (Cardizem)

Answer 19

Class: Class IV antidysrhythmic (calcium)

MOA: blocks calcium movement into cardiac cells, slows AV conduction, increases AV refractoriness

Dose: cardiac - 0.25 mg/kg over 2 minutes, follow with 0.35 mg/kg, maintenance - 125 mg in 100 mL D5

Question 20

Furosemide (Lasix)

Answer 20

Class: loop diuretic

MOA: inhibits reabsorption of sodium and chloride in the loop of Henle

Dose: 0.5-1 mg/kg over 1-2 mins, follow with 2 mg/kg

Question 21

Aspirin

Answer 21

Class: antiplatelet, antipyretic, anti-inflammatory, analgesic

MOA: decreases platelet aggregation

Dose: 160-324 mg PO

Question 22

Morphine Sulfate (Astramorph)

Answer 22

Class: opioid analgesic

MOA: increases venous capacitance, decreases venous return

Dose: 2-4 mg, follow with 2-8 mg

Question 23

Atropine Sulfate (Atropine)

Answer 23

Class: anticholinergic

MOA: inhibits ACH at muscarinic receptors

Cardiac dose: 1 mg, 3 mg max

Poisoning dose: 1-2 mg over 5-15 mins, maintenance of 2-4 mg every 1-4 hrs

Question 24

Lidocaine (Xylocaine)

Answer 24

Class: Class IB antidysrhythmic (sodium)

MOA: raises VFib threshold, suppresses PVCs

Dose: pulseless - 1-1.5 mg/kg, pulse - 0.5-0.75 mg/kg

Question 25

Amiodarone (Cordarone)

Answer 25

Class: Class III antidysrhythmic MOA: prolongs refractory period and action potential Dose: pulseless - 300 mg, then 150 mg, pulse - 150 mg over 10 mins, slow infusion - 1 mg/min over 6 hours, maintenance - 0.5 mg/min over 18 hours

Question 26

Adenosine (Adenocard)

Answer 26

Class: endogenous nucleoside, Class V antidysrhythmic (miscellaneous) MOA: decreases conduction through AV node, negative chrono effects Dose: 6 mg with 20cc, then 12 mg with 20cc

Question 27

Dextrose

Answer 27

Class: carbohydrate, hypertonic solution MOA: 6-carbon sugar form of glucose, primary body carbohydrate Dose: incremental doses up to 25 g (50mL of 50%, 250mL of 10%)

Question 28

Glucagon (Baqsimi)

Answer 28

Class: pancreatic hormone, antihypoglycemic agent MOA: secreted by alpha cells in pancreas, supports glycogenolysis and gluconeogenesis Dose: 1 mg or 3 mg IN, repeat in 7-10 mins

Question 29

Vasopressin (Vasostrict)

Answer 29

Class: vasoactive agent, antidiuretic hormone analog MOA: low doses stimulate V1 receptors to increase systemic vascular resistance, higher doses stimulate V2 receptors to increase water permeability at the renal tubule Dose: 0.03-0.04 units/min continuous infusion

Question 30

Hydrocortisone Succinate (Solu-Cortef)

Answer 30

Class: corticosteroid MOA: causes sodium retention, overlaps with Solu-Medrol and Decadon Dose: 2 mg/kg, max 100 mg

Question 31

Diazepam (Valium)

Answer 31

Class: benzodiazepine MOA: raises seizure thresholds, can induce amnesia/sedation Seizure dose: 5-10 mg, 10-20 mg for AChE inhibitor seizures Electric dose: 5-15 mg

Question 32

Ondansetron (Zofran)

Answer 32

Class: antiemetic MOA: blocks 5-HT3 receptors Dose: 4 mg, max 16 mg

Question 33

Fentanyl (Sublimaze)

Answer 33

Class: opioid analgesic MOA: binds to opioid receptors in the brain, synthetic opioid Dose: 1 mcg/kg, max 100 mcg

Question 34

Pralidoxime (2-PAM)

Answer 34

Class: cholinesterase reactivator, antidote MOA: reactivates acetylcholinesterase to allow ACH degradation Dose: 30 mg/kg (max 2 g) IVP, infuse at 8-10 mg/kg/h

Question 35

Lorazepam (Ativan)

Answer 35

Class: benzodiazepine MOA: antianxiety and anticonvulsant Dose: 2 mg IV (diluted), 4 mg IM

Question 36

Sodium Bicarbonate

Answer 36

Class: buffer MOA: reacts with hydrogen ions to form water and CO2 Dose: 1mEq/kg

Question 37

Activated Charcoal (Actidose)

Answer 37

Class: adsorbent MOA: binds with toxins and drugs Dose: 1 g/kg (30-100 kg)

Question 38

Naloxone (Narcan)

Answer 38

Class: opioid antagonist MOA: competitively binds to opioid receptors Dose: 0.4-2 mg (6-10 mg max)

Question 39

Esmolol (Brevibloc)

Answer 39

Class: beta-1 blocker MOA: short-acting cardioselective beta blocker (continuous infusion) Dose: 500 mcg/kg over 1 min, then 50-300 mcg/kg/min

Question 40

Hydroxocobalamin (Cyanokit)

Answer 40

Class: vitamin, antidote MOA: vitamin B12 binds with cyanide ions, excretes through urine Dose: 5 g over 15 mins followed by additional 5 g if necessary

Question 41

Labetalol (Trandate)

Answer 41

Class: alpha/beta adrenergic blocker MOA: competitive alpha-1 and nonselective beta antagonist Dose: 10-20 mg over 2 mins, repeat every 10 to max of 300 mg

Question 42

Metoprolol (Lopressor)

Answer 42

Class: beta blocking agent MOA: Competitive beta antagonist Dose: 5 mg over 5 mins, total of 15 mg

Question 43

Pralidoxime (2-PAM)

Answer 43

Class: cholinesterase reactivator MOA: reactivates acetylcholinesterase to degrade ACH ACH overdose: 600 mg IM every 15 mins, 3x Nerve agent dose: 30 mg/kg (max 2 g), then infuse 8-10 mg/kg/hr (max 1800 mg for severe cases)

Question 44

Sodium Nitrate

Answer 44

Class: antidote, vasodilator MOA: binds to cyanide molecules to create less toxic substance Dose: 300 mg/10 mL over 3-5 mins

Question 45

Sodium Thiosulfate (Nithidote)

Answer 45

Class: antidote MOA: donates sulfur molecules to convert cyanide to less harmful substance Dose: 12.5 g over 30 mins

Question 46

Thiamine (Betaxin)

Answer 46

Class: vitamin B1 MOA: promotes carbohydrate metabolism Dose: 100 mg slow IV