Ch. 16: General Pharmacology Flashcards
(39 cards)
pharmacology
the study of drugs, their sources, their characteristics, and their effects.
Six medication you can administer or assist with
aspirin, oral glucose, oxygen, activated charcoal, bronchodilator inhalers, nitroglycerin, epinephrine auto-injectors, naloxone, force protection medications
Asprin
Indications:
-Relieve headache or treat a fever
-Chest pain of a suspected cardiac origin
□ Reduces the blood’s ability to clot and works to prevent clot formation that causes damage to the heart
§ Since no water, EMS carry chewable children’s aspirin (oral)
Contradictions: Allergy & Gastrointestinal bleeding
Oral Glucose
§ Sugar than can be taken by mouth by a conscious person with the ability to swallow
§ Tube of gel that you can apply to a tongue depressor and place between the patient’s cheek and gum or under the tongue. This allows the patient to swallow the glucose so it can be easily absorbed into the digestive tract and bloodstream, which carries it to the brain
Oxygen
§ Gas
§ a drug to treat any patient whose medical or traumatic condition causes him to be hypoxic (low in oxygen) or in danger of becoming hypoxic
activated charcoal
§ powder prepared from charred wood, usually premixed with water to form a slurry for use in the field
§ treat a poisoning or overdose when a substance is swallowed and is in the patient’s digestive tract. Activated charcoal will absorb some poisons (bind them to the surfaces of the charcoal) and help prevent them from being absorbed by the body
Bronchodilator Inhalers
§ Asthma, emphysema, or chronic bronchitis
§ a medication designed to enlarge constricted bronchial tubes, making breathing easier
§ Carried in an inhaler
§ have an effect on the heart, an increased heart rate and patient jitteriness are common side effects of treatment.
You may need to have permission from medical direction to help a patient self-administer a prescribed inhaler. This permission from medical direction may come by phone or radio, or there may be a standing medical order that permits you to assist a patient with this kind of medication
Nitroglycerin
§ a drug that helps to dilate the coronary vessels, which supply the heart muscle with blood. It is often called just “nitro.” A common trade name is Nitrostat.
§ People with problems such as recurrent chest pain or a history of heart attack carry
§ Pill or spray
§ Many patients are instructed by their physician to take up to three nitroglycerin pills for their chest pain and, if the chest pain persists, to call EMS.
§ Sometimes patients forget about them
§ Must be patients not family or friends
§ determine whether the patient has recently taken anything to treat erectile dysfunction, such as sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis), or similar medication. If so, he should not take nitroglycerin because of the possibility of serious negative interaction with these drugs
Epinephrine Auto-Injectors
§ For allergies such as shellfish, penicillin, or a bee sting, he may have a very severe reaction that may cause life-threatening changes in the airway and circulation
§ Epinephrine helps constrict the blood vessels and relax airway passages reversing the allergic reaction
§ increased heart rate and blood pressure commonly occur after its administration to the patient
§ Life-threatening in short periods of time
§ Brands
□ Epi-Pen® is the trade name of a commonly carried epinephrine auto-injector.
□ Auvi-QTM is the trade name of an epinephrine auto-injector that gives voice instructions for its use.
□ Twinject® is the trade name of an auto-injector that contains two doses of epinephrine.
If you need to assist a patient with the use of an epinephrine auto-injector, be sure to determine that the auto-injector is actually the patient’s and not that of someone else.
Naloxone
§ When someone takes too much of a narcotic, the person can lose consciousness, become unable to protect the airway and, most important of all, go into respiratory failure with slow, shallow breathing leading to respiratory arrest
§ Naloxone = Narcan reverses the effects of narcotics very quickly
§ Usually injected also very effective as fine nasal spray
§ Will have no effect on someone just in respiratory distress
Even if a patient has taken a narcotic, if the mucous membranes are damaged or blocked, intranasal administration will not work and you will need to use your airway management skills
Atropine
autoinjectors to treat responders in the event of a chemical weapons attack such as nerve gas
§ Be administered to yourself and your partner
Three names of drugs
the generic name, chemical name, trade/brand name
indications
specific signs, symptoms, or circumstances under which it is appropriate to administer the drug to a patient
contraindications
specific signs, symptoms, or circumstances under which it is not appropriate and may be harmful to administer the drug to the patient
Side effects
any action of a drug other than the desired action
□ Some wide side effects are predictable.
unintended effects
effects that occur in addition to the specific reason the drug was administered
untoward effects
not only unexpected but also potentially harmful to the patients (a type of unintended effect)
Routes of administrations
oral, sublingual inhaled or breathed into lungs intranasal or sprayed into the nostrils intravenous or injected into the vein intramuscular or injected into a muscle subcutaneous or injected under the skin intraosseous or injected into the bone marrow cavity endotracheal or sprayed directly into a tube inserted into the trachea
The five rights of medication administration
- right patient
- right time
- right medication
- right dose
- route of administration
pharmacodynamics
the study of the effects of medications on the body.
- Pediatric patient will require less medication
- geriatric patients will have difficulty eliminating medications and therefore feel the effects of medications longer
Physician’s Desk Reference (PDR)
additional information about a patient’s medication
○ remember that your main purpose in finding out what medications the patient is taking is not to make a field diagnosis but to report this information to the medical direction and hospital personnel
Maintaining an IV
§ The constricting band used to raise the vein for insertion of the needle may have been mistakenly left on the patient’s arm, perhaps covered by a sleeve.
§ The flow regulator may be closed.
§ The clamp may be closed on the tubing.
§ The tubing may kink.
§ The tubing may get caught under the patient or the backboard.
○ Adjusting, or even splinting, the arm may be helpful as long as the splint is not too tight. Since the IV flow usually depends on gravity, be sure that the bag is held well above the IV site and the patient’s heart.
○ Insufficient flow can cause blood to clot in the catheter. This can be prevented by adjust- ing the flow to an adequate “keep the vein open,” or KVO, rate.
§ KVO varies
□ 30 drops per min. for a micro drip
□ 10 drops per min. for a macro drip
○ If the drip chamber is overfilled, clamp the tubing, invert the drip chamber, and pump some fluid back into the bag.
An infiltrated IV is one where the needle has either punctured the vein and exited the other side or has pulled out of the vein. In either case, the fluid is flowing into the sur- rounding tissues instead of into the vein. An unnoticed infiltrated IV can be very dangerous
6 rights of Oxygen
indication: Shortness of breath, hypoxia, signs of ischemia secondary to hypoxia, SpO2 < 94% contraindication: none action: Increases SpO2 by increasing FiO2 dose: depends on device route: inhaled/gas side effects: Can dry the mouth and mucus membranes special consideration: If not needed do not give oxygen just to do something, can cause harm in the setting of MI or CVA Med Control: standing order
Dose: Nasal Cannula
2-6 liter per minute (~4)
