Ch 11: Pharmacology Flashcards Preview

Emergency Medical Responder > Ch 11: Pharmacology > Flashcards

Flashcards in Ch 11: Pharmacology Deck (78):
1

Pharmacology

The study of drugs and how they interact with the body

2

The 6 Rights

Patient
Medication
Dose
Route
Time
Documentation

3

Addiction

A strong dependence on a drug

4

Antagonists

Drugs that combine with a receptor to prevent a response

5

Contraindication

A factor that makes it harmful to administer a medication

6

Depressant

A substance that decreases a body function or activity

7

Drug Allergy

A systemic reaction to a drug from previous exposure and development of a immunological mechanism;

An allergy to a medication

8

Drug Interaction

A modification (beneficial or detrimental) of the effects of one drug by the prior

9

Indications

The conditions that make administration of a drug appropriate

10

Potentiation

The enhancing effect of one drug on another when administered together

11

Side Effect

An unavoidable effect of using a drug

12

Synergism

The combined action of two drugs where the total effect is more than the sum of the individual effects.

13

Therapeutic Action

The desired, intended action of a drug

14

Chemical Name

The name to describe a drug's chemical composition and molecular structure.

Ie:
Acetylsalicylic Acid

15

Generic Name (Non Proprietary Name)

An abbreviated form of the chemical name

Ie:
meperidine hydrochloride

16

Trade Name (Brand Name / Proprietary Name)

A copyrighted name designated by the drug company that owns the medication license

Ie:
Demerol

17

Official Name

Followed by the initials "USP" or "NF", this name denotes the medication's listing in official publications; usually the same as the generic name.

Ie:
meperidine hyrochloride USP

18

Oxygen

Give

Classification:
Oxidizing Agent (gas)

Mechanism:
When inhaled, increases the amount of oxygen in erythrocyte hemoglobin

Indication:
Hypoxia
Patient involved in medical or trauma situation
Improve respiratory efficiency

Contraindication:
None

Precaution:
Patients with COPD
Prolonged administration in high concentration to newborns

Dose:
Nasal Cannula; 1-4 lpm, 36%
Resuscitation Mask; 6+ lpm, breathing 50%, non breathing 35%
Nonrebreather Mask: 15+ lpm, 100%
Bag Valve Mask: 15+ lpm, 100%

Route:
Inhaled

19

Oral Glucose

Give

Classification:
Monosaccharide
Carbohydrate caloric

Mechanism:
Absorbs into bloodstream, increasing blood glucose levels

Indications:
Known Diabetic History
BGL less than 4
Altered LOC

Contraindications:
Airway management cannot be controlled

Precautions:
Patient in Semi-Prone position or risk aspiration

Adverse Effects:
May increase airway management problems

Dose:
1 entire tube every 3 - 5 minutes until BGL normal

Route:
Buccal or Oral

20

Acetylsalicylic Acid
ASA
Aspirin

Give

Classification:
Salicylate
Antiplatelet
Antipyretic
Anti-inflammatory
Non-opioid analgesic

Mechanism:
Blocks prostaglandin production
Impedes blood clotting
Prevents or reduces pain
Induces peripheral vasodilation, causing sweating

Indications:
Acute symptoms suggesting myocardial infarction

Contraindications:
Drug Allergy or sensitivity
Patient has bleeding disorder
Patient is unconscious
Airway maintenance impeded

Precautions:
Patients with active ulcer disease or asthma

Dose:
1 160mg or 325mg tablet, once

Route:
Oral

21

Salbutamol
Albuterol
"Ventolin"

Assist

Classification:
Bronchodilator, Sympathomimetic

Mechanism:
Mimics sympathetic response by affecting beta2 receptors, causing relaxation of bronchial muscles and peripheral vasculature.

Indications:
Respiratory distress
Dyspnea
Anaphylaxis

Contraindications:
Drug allergy or sensitivity

Precautions:
Patient is a child or has sensitivity
Myocardial insufficiency
Dysrhythmia
Hypertension
Diabetes
Thyrotoxicosis (overactive thyroid)
Do not use with other beta-adrenergic drugs
Safety in pregnancy not firmly established

Adverse Effects:
Coughing
Bronchospasm
Restlessness
Apprehension
Tremors
Dizziness
Headache
Palpitations
Blood pressure changes
Tachycardia
Dysaryhthmia
Cardiac Arrest
Chest discomfort
Nausea
Pallor
Flushing
Sweating

Dose:
100mcg spray;
Adult 6 puffs every 10 minutes Max 20
Child 2 puffs every 10 minutes Max 10

Route:
Metered Dose Inhaler
Inhaled

22

Ipratropium Bromide
"Atrovent"

Assist

Classification:
Anticholinergic, Bronchodilator

Mechanism:
Blocks certain receptors from activating a response from the parasympathetic nervous system and dilates the bronchi and bronchioles.

Indications:
Dyspnea

Contraindications:
Drug Allergy
Ventolin must be assisted first

Precautions:
Use caution on patients with history of narrow angled glaucoma

Adverse Effects:
Coughing, increased sputum, dizziness, insomnia, tremors, nervousness, nausea.

Dose:
20mcg per spray
2 - 4 sprays every 10 minutes, Max 10

Route
Metered Dose Inhaler
Inhalation

23

Epinephrine Hydrochloride
Adrenaline
"Epi Pen"

Assist

Classification:
Sympathomimetic

Mechanism:
Mimics adrenaline response causing an increase in heart rate, cardiac output, AV conduction, irritability and bronchodilation.
In high doses it causes peripheral vasoconstriction.

Indication:
Bronchospasm
Anaphylaxis
Cardiac Dysrhythmias (Asystole, Ventricular Tachycardia, Ventricular Fibrillation)

Contraindications:
None in cardiac arrect
Drug Allergy

Precautions:
Extreme caution in bronchospasm
Cardiovascular disease
Narrow-angled glaucoma
Pregnancy
Pre Existing tachycardia

Adverse Effects:
Pulmonary Edema
Dyspnea
Nervousness
Tremors
Anxiety
Headache
Cerebral hemorrhage
Agitation
Tachycardia
Ventricular fibrillation
Palpitations
Widened pulse pressure
Hypertension
Stroke
Anginal Pain
Pallor
Sweating
Necrosis due to vasoconstriction

Dose:
Adult: 0.3 mg concentration of 1:1000 every 10 minutes
Child: 0.15 mg concentration of 1:1000 every 10 minutes

Route:
Intramuscular

24

Nitroglycerin

Assist

Classification:
Antianginal, Vasodilator

Mechanism:
Reduces cardiac oxygen demand by dilating the blood vessels, resulting in increased blood flow to cardiac tissue.

Indications:
Patient has previously prescribed nitroglycerin
Ischemia
Systolic blood pressure above 100

Contraindications:
Systolic blood pressure equal to or below 100
Drug allergy or sensitivity
Previous consumption of erectile dysfunction medication. Viagra 24 hrs, Levitra 24 hrs, Cialis 48 hrs

Precautions:
Hypotension
Administer while patient is lying comfortably
Carefully monitor vitals and blood pressure

Adverse Effects:
Hypotension
Dizziness
Weakness
Headache
Nausea
Vomiting
Syncope
Tachycardia
Tingling or burning under the tongue

Dose:
1 0.4 mg spray every 5 minutes Max 3

Route:
Sublingual

25

Routes of Drug Administration

Enteral
Parenteral

26

Enteral

Pertaining to the small intestine; within the small intestine.

27

Types of Enteral Administration

Oral
Buccal
Sublingual
Rectal

28

Oral Administration

Drug is consumed by mouth

29

Buccal Administration

Drug is placed between the check and gum and absorbed through the mucous membranes

30

Sublingual Administration

Drug is delivered under the tongue where it is rapidly absorbed into the bloodstream

31

Rectal Administration

Drug is delivered via the rectum. Solid drugs dissolve with body heat, liquid drugs can be instilled with a syringe

32

Parenteral

Introduction of a substance into the body through a route other than the digestive system

33

Intravenous Administration

Drug administered directly into vein, requires an IV line to be started

34

Aseptic Technique

The use of sterile procedures to prevent bacteria from entering the body, thus limiting the risk of infection

35

Endotracheal Administration

Intubation; placement of a flexible tube into the trachea. Reserved for advanced life support practitioners

36

Intramuscular Administration

Administration of drug into a large muscle.

37

Sucutaneous Administration

Drug administered in small volumes above muscle, below skin

38

Inhalation Administration

Drug is breathed into the lungs

39

Pharmacokinetics

The study of how the body handles a drug over a period of time.

40

Drug Absorption

The movement of drug molecules from the site of entry to the general circulation.

Variables include
Blood Flow
Solubility
pH
Concentration
Dosage
Route of Administration

41

Drug Distribution

The Transport of a drug through the blood stream to its site of action

Variables include:
Capillary permeability
Cardiac output
Regional blood flow

42

Biotransformation

The process by which a drug is chemically converted to a metabolite; to detoxify a drug and render it less active

Variables include:
Liver drug metabolism

43

Excretion

The elimination of toxic or inactive metabolites

44

Pharmacodynamics

The theory of drugs and the mechanism of their actions.

Drug receptor interaction
Agonists
Antagonists
Affinity
Efficacy
Types of receptors
Drug Enzyme interaction
Non-specific drug interaction

45

Drug-Receptor Interaction

The chemical reaction between the drug and various receptors throughout the body.

46

Autonomic Nervous System (ANS)

The part of the nervous system that functions below consciousness.

Ie: Heart rate and Digestion

47

Sympathetic Nervous System

Prepares the body for stress and emergencies

48

Parasympathetic Nervous System

Rest and restore the body to normal conditions

49

Types of Receptors

Alpha
Beta1
Beta2

50

Alpha Receptors

When stimulated cause peripheral vasoconstriction

51

Beta1 Receptors

When stimulated cause increased heart rate and force of cardiac contraction

52

Beta2 Receptors

When stimulated cause bronchodilation

53

Intravenous Therapy

An advanced skill of drug administration directly to the venous system.

54

EMR IV Permission

Set up a peripheral IV line
Replace a solution bag
Prepare an IV line

55

How to Set Up a Peripheral Intravenous Line

-Inspect the solution and packaging prior to assembly
-Confirm and assemble the appropriate drip set and lock off the line
-Hold the solution bag inverted and remove the protective cap on the port using the aseptic technique
-Support the inverted solution bag and insert the spiked end of the IV drip chamber with a straight push
-Place the solution bag in the proper vertical position and squeeze the drip chamber to fill it 1/2 - 2/3 full
-Release the line lock and purge air from the line
-Confirm the indicated solution is flowing then lock off the line
-Once IV therapy has been initiated, adjust until the correct flow rate is acheived

56

Crystalloid Solution Types

Normal Saline
Dextrose
Ringers Lactate
D5W

57

Normal Saline Solution

0.9% sodium chloride solution.
Isotonic volume expander

58

Dextrose Solution

3.3% Dextrose
0.3% Sodium Chloride

2/3 and 1/3

59

Ringer's Lactate Solution

Sodium Chloride
Potassium Chloride
Calcium Chloride
Sodium Lactate
Distilled Water

60

D5W Solution

5% dextrose in Water

61

Calculating Flow Rate

Drops/minute = ((Volume to be infused)(drops/ml of administered set)) / (Total time of infusion in minutes)

62

When to Change an IV bag

-The bag is empty or has less than 50ml
-You are given instruction to change the bag en route from medical staff. You can request that it be changed prior to or that a replacement bag is provided
-A glass bottle is changed to a plastic bag during air evacuation

63

How to Change an IV Bag

-Wash your hands and ensure aspetic technique
-Remove a new bag from out wrapping and inspect for leaks, discoloration and expiry date
-Close the flow clamp or line lock on the tubing
-Note how much solution remains in the old bag and invert the bag
-Remove the spike from the original bag, taking care not to contaminate it
-Remove the protective cap from the new IV port and insert the spike
-Unlock the line and confirm flow rate, adjust if necessary
-Document the procedure by noting the time you changed the IV bag and the amount and type of solution hung as well as the amount discarded.

64

How to Discontinue an IV

-Wash your hands, put on gloves, ensure aseptic technique
-Gather and prep supplies
-Turn off flow control clamp
-Remove the transparent dressing and tape from the site, minimizing movement of the IV and catheter. Stabilize the hub with one hand and remove with the other.
-Hold sterile gauze over the puncture site.
-Grasp the hub and pull straight back
-Do not use an alcohol swab.
-Immediately apply firm pressure to the site using gauze and continue for at least three to five minutes to stop the bleeding
-Once bleeding has stopped, cover the puncture site with an adhesive bandage
-Inspect the catheter for completeness
-Document the time the IV was discontinued, the amount of solution infused and the condition of the catheter.

65

Interstitial

IV fluid is flowing into the surrounding tissue

66

Care for Interstitial Complication

-Discontinue IV
-Record the time and the amount infused
-If swollen area is small, apply cold pack
-If swollen area is large, apply a warm, wet compress to promote reabsorption of fluid

67

Circulatory Overload

Patient's system is unable to manage the extra fluids administered, leading to heart failure or pulmonary edema.

68

Care for Circulatory Overload

-Slow the rate of the IV to keep the vein open
-Place patient in semi fowler position
-Transport patient as quickly as possible
-Monitor vitals
-Keep patient warm to promote circulation
-Document findings, including slowing the IV rate
-Treat as if congestive heart failure

69

Thrombosis

Formation of a blood clot

70

Thrombophlebitis

Inflammation of a vein due to the formation of a blood clot

71

Care for Thrombosis and Thrombophlebitis

-Discontinue the IV
-Record the time and the amount infused
-Apply a warm, wet compress to decrease pain and promote healing
-Do not massage the area as it may dislodge the clot that has formed

72

Clots May Form If:

-The IV is running too slowly
-There is injury to the vein wall
-The catheter is too large for the lumen of the vein
-The vein is too small to handle the amount of type of solution
-There is irritation to the vein by medications

73

Catheter Embolism

The catheter or a portion of it has broken off and been carried away in the bloodstream. Can be caused by attempting to rethread the needle during insertion.

74

Care for a Catheter Embolism

-Discontinue the IV but do not discard the catheter
-Give the catheter to hospital staff
-Record the time and the amount infused
-Be careful not to obstruct arterial flow, check distal pulse to ensure its presence
-Apply high flow oxygen to the patient
-Notify the hospital and transport the patient as an emergency

75

Infection of Site

Caused by hypersensitivity to an IV or an additive, resulting in a generalized rash, SOB, and hypotension

76

Care for Infection of Site

-Decrease the IV rate to keep the vein open
-Record the time the rate was changed
-Notify the hospital
-Administer oxygen

77

Air Embolism

Can be caused by allowing an IV bag to run dry, significant air in the tubing or loose connections between tubing and catheter or at piggybacking sites.

Make sure you clear tubing of all air bubbles. Change the IV bags before they are empty and make sure all connections are secured

78

Care for an Air Embolism

-Turn the patient to their left side with the head down 30 degrees. If air has enters the heart chambers this position may keep the air bubbles on the right side of the heart, where they can then enter the pulmonary circulation and be absorbed.
-Check the IV system for leaks
-Administer O2
-Notify the hospital and transport immediately