ADC Practice Question — Emergency drugs and equipment

What is the correct drug, route, and dose for immediate management of this patient?

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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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: C

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.

Source: Ch 24: Adrenaline IM 500mcg adult, anterolateral thigh, repeat every 5 min

Remy's study tip — For pharmacology vignettes, read the patient’s medical history and allergies BEFORE looking at the drug options.

Exam preparation FAQ

How should I prepare for Pharmacology & Therapeutics in the ADC exam?

Build competence across all topics. The exam tests application of guidelines to clinical scenarios, not memorisation.

How do I approach an unfamiliar Emergency drugs and equipment vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

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