Pharmacology
Core concepts
Candidates must understand drug classifications, mechanisms of action, indications, contraindications, doses, routes, and adverse effects for medications commonly used in prehospital care. Key drugs include epinephrine, amiodarone, lidocaine, atropine, adenosine, nitroglycerin, aspirin, naloxone, albuterol, ipratropium, dextrose, glucagon, ondansetron, fentanyl, morphine, ketamine, and tranexamic acid. Understand pharmacokinetics (absorption, distribution, metabolism, excretion) and pharmacodynamics at a conceptual level. Be familiar with pediatric weight-based dosing and the concept of therapeutic index.
Traps in questions
Questions often test contraindications and adverse effects rather than mechanisms. Watch for dose-unit confusion (mg vs mcg vs g), route-specific doses (IM vs IV vs IN), and drug interactions such as nitrates with PDE inhibitors or beta-blockers masking hypoglycemia. Be careful with questions that present a "correct" drug for the wrong indication-read the whole stem.
Rule of thumb
Before selecting any drug, ask three questions: Is it indicated for this patient's presentation? Is there a contraindication? Is the dose and route correct for this patient's weight and age? If any answer is uncertain, the safest distractor is often the one that reassesses or supports ABCs instead.