What is the correct drug, route, and dose for…
Pharmacology questions in the ADC written exam test applied prescribing decisions, not rote recall of drug names. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.
Ms. Priya Sharma, a 25-year-old woman with no significant medical history, is undergoing extraction of tooth 38 under inferior alveolar nerve block with 2% lidocaine with adrenaline 1:80,000. Five minutes after the injection, she develops tongue swelling, difficulty breathing, a hoarse voice, and feels dizzy. Her blood pressure drops to 80/50 mmHg and she appears pale and distressed. What is the correct drug, route, and dose for immediate management of this patient?
- A. Oral antihistamine (cetirizine) and observe for 30 minutes
- B. Hydrocortisone 200 mg IV to treat the allergic reaction
- C. Adrenaline 500 micrograms IM via autoinjector into the anterolateral thigh, repeated every 5 minutes if needed
- D. Adrenaline 500 micrograms intravenously, repeated every 5 minutes
- E. Adrenaline 300 micrograms IM into the deltoid muscle
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Show the answer and cited explanation
According to TG, for anaphylaxis: give adrenaline IM via autoinjector into the anterolateral thigh. The dose for adults/children >50 kg is 500 micrograms; for 20-50 kg is 300 micrograms; for 7.5-20 kg is 150 micrograms. Repeat every 5 minutes if needed. TG states preloaded autoinjectors are preferred over ampoules, and sufficient quantity for at least 2 doses should be available.
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