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1


The term affinity, as it applies to pharmacology, is MOST accurately defined as the:

A. strength of the bond between a medication and its receptor.
B. blocking of a receptor site by a particular medication.
C. process of a medication binding to a receptor.
D. ability of a medication to bind to a receptor.

D

2

Fentanyl (Sublimaze) is the preferred opioid analgesic for patients in critical or unstable condition because:

A. it hyperstimulates mu (μ) opioid receptor sites.
B. it is not as prone to causing hypotension as morphine.
C. it only requires one small dose to achieve analgesia.
D. its effects last much longer than any other opioid.

B

3

Transdermal medication patches:

A. deliver a fluctuating dose of a medication over a relatively short period of time.
B. are a reliable medication delivery route because they are unaffected by the
patient's perfusion status.
C. should never be removed by the paramedic, even if he or she is administering a
drug of the same type.
D. may alter a patient's clinical presentation or interfere with medications administered
by the paramedic.

D

4

Metoprolol has the brand name _____________, which may be a subtle reference to lowering the blood pressure.

A. Norpramin
B. Cordarone
C. Lopressor
D. Vasotec

C

5

A medication that possesses a negative chronotropic effect will:

A. cause an increase in blood pressure.
B. cause a decrease in the heart rate.
C. decrease myocardial contractile force.
D. increase cardiac electrical conduction velocity.

B

6

Phenothiazine medications exert their antiemetic properties by:

A. promoting the secretion of hormones in the brain that depress the function of the medulla oblongata.
B. antagonizing dopaminergic receptor sites in the brain, which suppresses the
function of the hypothalamus.
C. blocking histamine-2 receptors, which inhibits gastric acid production and slows
peristalsis.
D. activating dopaminergic receptors in the brain and releasing hormones that depress
the reticular activating system.

D

7

Acetylcholinesterase is an enzyme that:

A. decreases the heart rate.
B. slows cardiac conduction.
C. promotes acetylcholine secretion.
D. breaks down acetylcholine.

D

8

Repolarization and myocardial contraction are occurring through phases:

A. 2 and 3.
B. 3 and 4.
C. 0 and 1.
D. 1 and 2.

A

9

You have a 63 y/o F in moderate to severe respiratory distress. The patient presents cyanotic with extreme work of breathing and use of accessory muscles. The patient is extremely diaphoretic with vital signs of; BP 186/109, RR 38 + labored, HR 110, SpO2 80%, afebrile, and AOx3. The patient has a productive cough of pink frothy sputum and pedal edema is present. Auscultation of lung sounds reveilles crackles 2/3 of the way up bilaterally. You place the patient on CPAP and Medical Control has ordered diuresis of your patient. You have run out of Furosemide. You partner hands you Mannitol knowing it is a diuretic. Do you administer this drug?

a. Yes
b. No

B

10

Toxic effects from beta blockers include all of the following, EXCEPT:
.
A. bradycardia.
B. hypotension.
C. conduction delays.
D. tachycardia.

D

11

All of the following medications possess antiemetic properties, EXCEPT:

A. famotidine.
B. prochlorperazine.
C. ondansetron.
D. dolasetron.

A

12

All of the following are endogenous catecholamines, EXCEPT:

A. norepinephrine.
B. dopamine.
C. epinephrine.
D. atropine.

D

13

The therapeutic index of a medication is defined as the:

A. plasma level at which the medication begins to exert its effect.
B. period of time in which the medication is excreted from the body.
C. difference between the median effective dose and the median toxic dose.
D. duration of therapeutic action for a given medication on the body.

C

14

The peak of a medication's effect depends on _____________, whereas the duration of effect depends on ______________.
Choose one answer.
A. distribution, absorption
B. elimination, absorption
C. absorption, metabolism
D. metabolism, distribution

C

15

The physiologic effects of nitroglycerin when given to patients with cardiac-related chest pain include:

A. increased afterload and peripheral vasodilation.
B. coronary vasoconstriction and increased preload.
C. increased myocardial oxygen consumption.
D. decreased preload and coronary vasodilation.

D

16

The desired clinical effect after administering a beta-2 agonist medication is:

A. increased cardiac contractility
B. dilation of the systemic vasculature.
C. relaxation of bronchiole smooth muscle.
D. contraction of vascular smooth muscle.

C

17

A paramedic gives a woman with chronic pain an injection of sterile saline and tells her that it is a narcotic analgesic. The paramedic's action:

A. demonstrates compassion and empathy.
B. is acceptable under the circumstances.
C. will likely be of therapeutic benefit.
D. could result in criminal prosecution.

D

18

Patients who are genetically predisposed to an immune-mediated medication response:

A. will experience a minor reaction that is generally limited to hives.
B. should be given an antihistamine before receiving the medication.
C. typically have a history of more than one autoimmune disorder.
D. had an initial exposure and sensitization to a particular antigen.

D

19

In contrast to epinephrine, norepinephrine:

A. specifically targets beta-1 receptors.
B. has minimal effect on blood pressure.
C. stimulates beta-1 and beta-2 receptors.
D. primarily stimulates alpha receptors.

D

20

A 23 y/o F presents with and acute asthma attack. Lung sounds reveille wheezing in lower fields and capnography confirms bronchospasms with “shark fin” waveforms. Vital signs: HR 160 RR 24 BP 130/96 EtCO2 45 SpO2 88% RA and afebrile. You take a 12 lead EKG which shows narrow complex paroxymal supraventricular tachycardia. You attempt to perform vagal maneuvers with no effect. Is adenosine indicated?

a. Yes
b. No

B

21

A patient experiences profound sedation when an opioid, such as fentanyl, is given together with a benzodiazepine, such as midazolam. This is an example of:

A. summation.
B. antagonism.
C. synergism.
D. potentiation.

C

22

Which of the following medications can be administered via the intranasal route?
Choose one answer.
A. Morphine
B. Atropine
C. Naloxone
D. Diazepam

C

23

Patients who take alpha-blocking medications at home are frequently prone to:

A. vagal-induced bradycardia.
B. narrow-angle glaucoma.
C. hypertensive crisis.
D. postural hypotension.

D

24

Medications commonly administered via a nebulizer include all of the following, EXCEPT:

A. albuterol.
B. Racemic epinephrine.
C. Xopenex.
D. lidocaine.

D

25

Compared to succinylcholine, rocuronium:

A. has a rapid (30 to 60 seconds) onset of action and a relatively brief (3 to 8 minutes)
duration of action.
B. has a rapid onset of action, a longer (up to 60 minutes) duration of action, and fewer
adverse effects.
C. binds with nicotinic receptors on muscles and causes a brief activation known
as fasciculation.
D. does not bind with nicotinic receptor sites on muscle cells and does not antagonize
acetylcholine.

B