EM Pharmacology

Question 1

Community Acquired Pneumonia (No Comorbidities)

Answer 1

Doxycycline 100 mg PO BID x5d

Question 2

Community Acquired Pneumonia (Significant Comorbidities)

Answer 2

Augmentin 875 mg PO BID + Doxycycline 100 mg PO BID x5d

Question 3

COPD Exacerbation (Outpatient)

Answer 3

Augmentin 875 mg PO BID x5d or Azithromycin 500 mg PO daily x3d

Question 4

COPD Exacerbation (Inpatient)

Answer 4

Ceftriaxone 1 g IV daily
or
Cefepime 2 g IV TID vs Zosyn 4.5 g IV QID (if Pseudomonas spp. suspected)

Question 5

Pyelonephritis (Outpatient)

Answer 5

Cefpodoxime 200 mg PO BID x10-14d

Question 6

Pyelonephritis (Inpatient)

Answer 6

Ceftriaxone 1 g IV daily

Question 7

Propofol

Answer 7

1 mg/kg IV

Question 8

Etomidate

Answer 8

0.1 mg/kg IV

Question 9

Ketamine

Answer 9

1-2 mg/kg IV
4-10 mg/kg IM

Question 10

Rocuronium

Answer 10

1 mg/kg IV

Question 11

Succinylcholine

Answer 11

1 mg/kg IV

Question 12

Atrial Fibrillation w/ Rapid Ventricular Response

Answer 12

Diltiazem 0.25 mg/kg IV –> 0.35 mg/kg IV (if no response after 15 mins)
or
Metoprolol 0.07 - 0.15 mg/kg (max dose of 10 mg) IV

Question 13

Atrial Fibrillation w/ Rapid Ventricular Response (w/ severe/decompensated heart failure)

Answer 13

Digoxin 250 mcg IV
or
Amiodarone 150 mg IV

Question 14

Supraventricular Tachycardia

Answer 14

Adenosine 6 mg IV (if no response, can redose at 12 mg IV x2)

Question 15

Opioid Overdose

Answer 15

Naloxone (Narcan) 0.4 - 2 mg IV/IM/IN/IO (max dose of 10 mg)

Question 16

EtOH Withdrawal: Mild Symptoms

Answer 16

Chlordiazepoxide (Librium) 20 mg PO (max dose 100 mg PO q6H x24H)

Question 17

EtOH Withdrawal: Moderate - Severe Symptoms

Answer 17

Lorazepam (Ativan) 1-2 mg IV/PO/IM q10-15min
or
Diazepam (Valium) 5-10 mg IV/PO q10-15 mins
or
Phenobarbital 10 mg/kg IV, repeat dose of 130-260 mg q30min

Question 18

Keppra

Answer 18

60 mg/kg (max dose 4,500 mg/dose)

Question 19

Target blood pressure w/ hypertensive emergency

Answer 19

Decrease MAP 10-20% within initial 1-2 hours

Question 20

Target blood pressure w/ acute ischemic stroke

Answer 20

< 220/120 mmHg (unless thrombolytic candidate, then < 185/110 mmHg)

Question 21

Target blood pressure w/ Preeclampsia/Eclampsia

Answer 21

< 140/90 mmHg w/in first hour

Question 22

Target blood pressure w/ aortic dissection

Answer 22

SBP < 120 mmHG w/in first hour

Question 23

Target blood pressure w/ pheochromocytoma crisis

Answer 23

SBP < 150 mmHg w/in first hour

Question 24

Hypertensive Emergency: Nicardipine (Cardene)

Answer 24

5 mg/hr, titrate by 2.5 mg/hr q5min

Question 25

Hypertensive Emergency: Labetalol

Answer 25

20 mg IV
Double dose q10min
Max dose 300 mg

Question 26

Hypertensive Emergency: Nitroglycerin

Answer 26

Loading Dose: 50-100 mcg/min x1-5 mins
Infusion Dose: 50-300 mcg/min, titrate by 40 mcg/min q3-5mins

Question 27

Malignant Hyperthermia

Answer 27

Dantrolene 2.5 mg/kg IV q5min

Question 28

Drug-Induced Extrapyramidal Symptoms (e.g., dystonia, Parkinsonism)

Answer 28

Benztropine 1-2 mg IV/IM

Question 29

Refractory Ventricular Tachycardia / Fibrillation

Answer 29

Amiodarone (preferred)
- Initial Dose: 300 mg IV
- Second Dose: 150 mg IV

Lidocaine
- Initial Dose: 1.0 - 1.5 mg/kg IV
- Second Dose: 0.5 - 0.75 mg/kg IV

Question 30

Ventricular Tachycardia / Fibrillation Defibrillation Dose

Answer 30

Initial: 120 J
Subsequent: 120+ J

Question 31

Cardiogenic Shock: dobutamine

Answer 31

2-5 mcg/kg/min (max dose of 20 mcg/kg/min)

Question 32

Agitation: Versed (midazolam)

Answer 32

1-5 mg IV
or
0.07 mg/kg IM

Question 33

Agitation: Geodon (ziprasidone)

Answer 33

10-20 mg IM

Question 34

Agitation: droperidol

Answer 34

2.5-5 mg IV/IM

Question 35

Agitation: Zyprexa (olanzapine)

Answer 35

5-10 mg IV/IM

Question 36

Agitation: Haldol (haloperidol)

Answer 36

2-10 mg IV/IM

Question 37

Agitation: Ativan (lorazepam)

Answer 37

0.5-2 mg IV/IM