Emergency Medication Administration Quiz

• Atropine is a medication with two primary indications: hemodynamically unstable bradycardia and organophosphate or nerve gas poisoning.
• Contraindications for atropine include tachycardia, hypersensitivity, avoidance in hypothermic patients, and caution in patients with an active MI and hypoxia.
• Onset of action for atropine in treating bradycardia is rapid, and the duration is 2-6 hours. For organophosphate poisoning, the onset is also rapid, and the duration lasts until the cessation of bronchial secretions.
• The adult dose for atropine in treating bradycardia is 1 mg IV/IO every 3-5 minutes up to a maximum of 3 mg. For organophosphate poisoning, the dose is 1 to 5 mg IV/IM/IO, repeated every 3-5 minutes.
• Side effects of atropine include tachycardia, paradoxical bradycardia, mydriasis, dysrhythmias, headache, nausea/vomiting, dizziness, flushed skin, and anticholinergic effects.
• Calcium Chloride is a hypertonic solution used for indications such as hyperkalemia, hypocalcemia, hypermagnesemia, calcium channel blocker overdose, and hydrofluoric acid B poisoning.
• Contraindications for calcium chloride include V-Fib during cardiac resuscitation, digitalis toxicity, and hypercalcemia.
• Onset of action for calcium chloride is 5-15 minutes, and the duration is dose-dependent but may last up to 4 hours.
• The adult dose for calcium chloride is 1-2 g (10-20 ml) of a 10% solution given slowly IV/IO. For pediatric patients, the dose is 20 mg/kg slow IV/IO of a 10% solution.
• Side effects of calcium chloride include bradycardia, hypotension, metallic taste in the mouth, local necrosis if given IM or IV infiltration, coronary and cerebral artery spasm, paradoxical slowing in 3rd degree AV block, and dry mouth.
• Dexamethasone, a corticosteroid, is used for indications such as anaphylaxis, acute exacerbation of bronchial asthma, allergic reaction, COVID-19, HACE/AMS.
• Contraindications for dexamethasone include hypersensitivity, systemic fungal infections, and preterm infants.
• Onset of action for dexamethasone is 4-8 hours, and the duration is 24-72 hours.
• The adult dose for dexamethasone is 10 mg IM/IV/PO for anaphylaxis, acute exacerbation of bronchial asthma, and allergic reaction. For AMS, the dose is 4 mg IM/IV orally every 6 hours. For HACE, the dose is 8 mg IM/IV/PO. Pediatric doses vary based on age and condition.
• Side effects of dexamethasone include headache, restlessness, nervousness, increased appetite, insomnia, sodium and water retention.
• Dextrose, a carbohydrate, is used for indications such as hypoglycemia and altered ALOC, coma, and seizure of unknown origin.
• Contraindications for dextrose include intracranial hemorrhage, increased intracranial pressure, known or suspected stroke in the absence of hypoglycemia.
• Onset of action for dextrose is 1 minute, and the duration is variable depending on the degree of hypoglycemia.
• The adult dose for dextrose is 12.5-25 g slow IV/IO (25-50 ml 50% dextrose; 125-250 ml 10% dextrose). For pediatric patients, the dose is 0.5-1 g/kg (2-4 ml/kg) IV/IO of 25% dextrose.
• Side effects of dextrose include hyperglycemia, thrombophlebitis, and tissue necrosis if given through an infiltrated IV. D50 may cause Wernicke's encephalopathy in thiamine-deficient patients, so administer thiamine prior to D50.
• Diazepam, a benzodiazepine, is used for indications such as seizure activity, acute anxiety, skeletal muscle relaxation, sedation for pacing/cardioversion, and acute alcohol withdrawal.
• Contraindications for diazepam include hypersensitivity, respiratory depression, head injury with CNS depression, shock, and coma. Use with caution in patients with acute substance abuse.
• Onset of action for diazepam is 1-5 minutes IV and 15-30 minutes IM. The duration is 15-60 minutes IV and 15-60 minutes IM.
• The adult dose for diazepam in treating seizures is 5 to 10 mg IV/IO over 2 minutes every 10-15 minutes as needed, with a maximum of 30 mg. For premedication for pacing/cardioversion, the dose is 5-15 mg IV/IO 10 minutes prior. Pediatric doses vary based on age and condition.
• Side effects of diazepam include respiratory depression, altered LOC, hypotension, amnesia, confusion, nausea, vomiting, and blurred vision.

Test your knowledge of emergency medication administration with this quiz. Learn about indications, contraindications, onset/duration, and doses/routes for administering critical medications in emergency situations.