About the Pharmacology question bank
The RCIS expects you to handle the drugs you actually push in the lab. That means the anticoagulants and antiplatelets that keep the wire from clotting, the vasoactives that hold a crashing patient together, the sedatives that keep them comfortable, and the reversal agents you reach for when any of it goes too far.
Questions in this bank tie a drug to a situation. A patient with a heparin allergy and a history of HIT needs an alternative — which one? A patient becomes hypotensive after sedation — what do you give and why? Learning drugs as isolated flashcards will not survive this format; learning them by the problem they solve will.
What this bank covers
- Heparin, bivalirudin, and the direct thrombin inhibitors
- Antiplatelets — aspirin, clopidogrel, ticagrelor, prasugrel, and the GP IIb/IIIa inhibitors
- Heparin-induced thrombocytopenia and what to use instead
- Vasopressors and inotropes — the pressors, their receptors, and their effects
- Nitroglycerin, nitroprusside, and the vasodilators used intracoronary
- Antiarrhythmics used in the lab, including amiodarone, adenosine, and atropine
- Conscious sedation, its monitoring, and its reversal agents
- Contrast reactions, premedication, and anaphylaxis management
How to use it
- Learn every drug with its reversal agent attached: heparin/protamine, benzodiazepine/flumazenil, opioid/naloxone. The exam loves the pairing.
- Group vasoactives by receptor, not alphabetically — once you know what the receptor does, the drug's effect follows.
- ACT targets are high-yield and easy marks. Know them.
Frequently asked questions
Which anticoagulant do I use if the patient has HIT?
A direct thrombin inhibitor — bivalirudin or argatroban. Never re-expose a HIT patient to heparin, including heparinised flush.
What ACT is targeted during PCI?
Roughly 250–300 seconds with heparin alone, and about 200–250 seconds when a GP IIb/IIIa inhibitor is on board. Diagnostic angiography targets a lower ACT, near 200.
How is a contrast anaphylactoid reaction managed?
Stop the contrast, secure the airway, and give epinephrine for a true anaphylactoid reaction — antihistamines and steroids are adjuncts, not the primary treatment. Patients with a prior reaction are premedicated with steroids and an antihistamine.