Pharmacology

Question 1

Define:

Pharmacology

Answer 1

It focuses on how substances interact or alter living organisms.

Question 2

What is the food, drug, and cosmetic act?

Answer 2

Gives the FDA the authority to create regulations ensuring that new drugs are safe and effective.

Question 3

What does FDA stand for?

Answer 3

Food and Drug Administration

Responsible for approving new drugs.

Question 4

Define:

Controlled Substances Act

Answer 4

It classifies medications into five categories, or schedules, based on their potential for abuse and addiction, as well as their accepted medical use.

Question 5

What is a Schedule 1 drug?

Answer 5

high abuse potential

No recognized medical purpose.

E.g. heroin, marijuana, LSD

Question 6

What is a Schedule 2 drug?

Answer 6

high abuse potential

Must be kept under lock and key.

E.g. fentanyl, cocaine

Question 7

What is a Schedule 3 drug?

Answer 7

lower abuse potential

Must remain under lock and key with records kept and proper storage

E.g. hydrocodone, codeine, ketamine

Question 8

What is a Schedule 4 drug?

Answer 8

lower abuse potential

E.g. diazepam, lorazepam, midazolam

Question 9

What is a Schedule 5 drug?

Answer 9

lower abuse potential

E.g. narcotic cough drops

Question 10

Define:

synthetic

Answer 10

Substances or materials that are artificially made in a laboratory.

Question 11

Give examples of medications that come from plants, animals, minerals, and microorganisms.

Answer 11

• Plant: atropine, aspirin, digoxin, morphine.
• Animal: heparin, antivenom, insulin.
• Microorganism: streptokinase, antibiotics.
• Minerals: iron, magnesium, sulfate, lithium.

Question 12

What is the difference between:

• Chemical Name
• Generic Name
• Brand Name

Answer 12

• Chemical - the exact composition of the medication.
• Generic -it includes a “stem” to link them to other similar medications.
• Brand - it influences marketing strategies.

Example:

Chemical Name: Sodium Bicarb
Generic Name: “am” (lorazepam, diazepam, midazolam)
Brand Name: lopressor: hints at lowering blood pressure.

Question 13

Define:

Pharmacodynamics

Answer 13

The altering of one’s body through medication.

Question 14

Define:

Pharmokinetics

Answer 14

The body’s action to a medication.

Question 15

Define:

Exogenous

Answer 15

Refers to something that originates from outside of the body.

Question 16

What are agonist medications?

Answer 16

Medications that attach to receptor sites to alter or influence a change.

E.g. opiates

Question 17

What are antagonist medications?

Answer 17

They prevent the attachment of agonist cells from reaching the receptor site.

E.g. naloxone

Question 18

Define:

affinity

Answer 18

The ability of a medication to bind with a receptor site.

Question 19

What is a minimum concentration for medications?

Answer 19

The absolute minimum amount of a medication required to activate cellular activity.

Question 20

Define:

threshold level

Answer 20

When initiation of the cellular change begins.

Question 21

Define:

potency

Answer 21

The concentration of a medication required to initiate a cellular response.

When potency is low, a higher concentration is needed.

Question 22

Define:

efficacy

Answer 22

The ability to initiate cellular activity in a desired manner.

Question 23

Define:

diuretic

Answer 23

Draws excess water from certain body tissues and increases excretion of urine by the kidneys.

Question 24

Define:

Paradoxical Reaction

Answer 24

The opposite effect from a medication as intended.

Question 25

What is the **ideal body/weight formula**?

Answer 25

**Men**: 50kg + *(2.3 x patient's height in inches over 5 feet)* **Women**: 45.5kg + *(2.3 x patient's height in inches over 5 feet)*

Question 26

How does **temperature** affect **absorption** of medication?

Answer 26

* **Hyperthermia:** increases the rate of absorption. * **Hypothermia:** decreases the rate of absorption.

Question 27

What are the **pregnancy categories** for medications?

Answer 27

* **A**: No risk to fetus. * **B**: May have been an effect in rates but none shown in women. * **C**: May have shown an adverse effects on pregnancy. Drugs are given only if benefit outweighs the risk. * **D**: Fetal risk is apparent. * **X**: Fetal abnormalities, contraindicated in pregnant women.

Question 28

# Fill in the blank. The placebo effect is when a \_\_\_\_\_ medication is given and still causes a change

Answer 28

fake

Question 29

What is the **therapeutic** (desired) **response**?

Answer 29

A **desired response achieved** through medication administration.

Question 30

What are **adverse medical effects**?

Answer 30

Medication that causes clinical changes that are **not desired**. ## Footnote * Hypoglycemia after insulin administration. * Bradycardia after beta blocker. * Allergic reaction.

Question 31

# Define: Idiosyncratic Reaction

Answer 31

**Abnormal threshold** to a medication due to: * genetic factors * dysfunction of metabolic enzyme

Question 32

# Define: median lethal dose

Answer 32

"LD50" ## Footnote Weight-based dose that causes **_death_** in 50% of animals tested.

Question 33

# Define: median toxic dose

Answer 33

"TD50" ## Footnote 50% of animals tested had a **_toxic_** effect at or above the weight-based dose.

Question 34

# Define: median effect dose

Answer 34

"ED50" ## Footnote Does **_not_** harm and achieves the desired effect.

Question 35

# Define: therapeutic index

Answer 35

The relationship between: * effective dose * lethal dose * toxic dose

Question 36

# Fill in the blank. When a medication is constantly taken, the patient builds a \_\_\_\_\_\_, causing decrease in efficacy.

Answer 36

tolerance

Question 37

# Define: Tachyphylaxis

Answer 37

A rapid **build-up of tolerance** to a medication, leading to decreased effectiveness after **multiple doses** in a short time frame. ## Footnote E.g. Nitroglycerine

Question 38

# Define: stimulant

Answer 38

**Increases** physical, mental and emotional performance. ## Footnote E.g. caffeine, cocaine, amphetamines

Question 39

# Define: depressant

Answer 39

**Decreases** physical and emotional performance. ## Footnote E.g. benzo's, alcohol, opiods

Question 40

# Define: interference

Answer 40

Patients that take medications **inhibit** the actions of drugs administered by the paramedic.

Question 41

What is **onset**?

Answer 41

When medications **begin** to work.

Question 42

What is the **peak** of a medication?

Answer 42

Medication is at **max effectiveness**.

Question 43

# Define: **duration of action**

Answer 43

Refers to how **long** medications cause an effect on the body.

Question 44

# Define: Bioavailability

Answer 44

The route of administration affects how much medication enters the bloodstream.

Question 45

# Define: Synergism

Answer 45

When **two similar medications combine** to cause a greater effect (1+1=6). ## Footnote E.g. benzodiazepines with opioids

Question 46

# Define: Potentiation

Answer 46

When the effect of one medication is **greatly enhanced** by the presence of another medication. ## Footnote E.g. phenergan given to increase effects of codeine

Question 47

How does the **first pass metabolism** work?

Answer 47

Drugs travel from: **GI → portal vein → liver** to be metabolized ## Footnote E.g. giving Tylenol to patients with liver failure or liver injury.

Question 48

# Route of medication. IN

Answer 48

Intranasal ## Footnote *Close to 100% bioavailability* *Drugs Ex: fentanyl, versed, naloxone*

Question 49

# Route of medication. IV

Answer 49

Intravascular ## Footnote 100% bioavailability

Question 50

# Route of medication. IO

Answer 50

Intraosseous ## Footnote * Any IV medication can be given IO. * Can be left in place for up to 24 hours. * Contraindications: bone fractures, bone diseases, or skin infection over area.

Question 51

# Route of medication. IM

Answer 51

Intramuscular ## Footnote * 75-100% bioavailability * Absorption is determined by muscle perfusion and accuracy of administration.

Question 52

# Route of medication. SC

Answer 52

Subcutaneous ## Footnote * Abdomen or skin overlaying triceps are good landmarks * E.g. Terubtaline

Question 53

How are medications **eliminated**?

Answer 53

* kidneys (primarily) * liver

Question 54

What are the **six rights**?

Answer 54

* patient * time * dose * medication * route * documentation

Question 55

What are **Benzodiazepines**?

Answer 55

CNS depressants ## Footnote E.g. Diazepam, Lorazepam, Midazolam * Indications: seizure, sedation, anxiety * Side effects: hypotension, respiratory depression * Antidote: Romazicon

Question 56

What are **fasiculations**?

Answer 56

**Muscle twitches** that are caused by the activation of nicotinic receptors.

Question 57

What are the indications of a **malignant hyperthermia**?

Answer 57

* Rapid rise in body temperature. * Severe muscle contractions. ## Footnote Typically occurs from anesthesia.

Question 58

What do **Beta-2 agonist** medications do?

Answer 58

Smooth muscle relaxation | bronchodilation ## Footnote Examples: * Albuterol * Terbutaline * Mag Sulfate * Epinephrine (partially) * Ketamine (partially)

Question 59

What are **corticosteroids**?

Answer 59

**Reduce inflammation** (used for airway inflammation). ## Footnote E.g. Methylprednisolone & Dezamethasone

Question 60

Describe the phases of the **cardiac cycle**. | Phases 0-4

Answer 60

**0.** It begins with a rapid influx of sodium ions through channels in the cardiac cell, and potassium ions slowly exit the cell, causing depolarization. **1.** Sodium influx decreases while potassium continues to leave the cell. **2.** Movement of calcium into the cardiac cell while potassium continues to exit **3.** CCalcium movement ceases with the continued outflow of potassium. **4.** Cardiac cells are at rest, waiting for the generation of spontaneous impulses from within (automaticity).

Question 61

# Define: Absolute Refractory Period

Answer 61

**No additional depolarization** may occur during phases 0-3. ## Footnote Ensures that a certain amount of time passes between myocardial contractions.

Question 62

# Define: Relative Refractory Period

Answer 62

Allows a small window for depolarization to occur during cardiac cycle. ## Footnote Immediately follows “absolute refractory period."

Question 63

What are **Class I antiarrhythmics**?

Answer 63

Sodium channel blockers

Question 64

What are **Class II antiarrhythmics**?

Answer 64

Beta blockers

Question 65

What are **Class III antiarrhythmics**?

Answer 65

Potassium channel blockers

Question 66

What are **Class IV antiarrhythmics**?

Answer 66

Calcium channel blockers

Question 67

# Define: ACE Inhibitors | (Angiotensin Converting Enzyme)

Answer 67

**Antagonizes** the system that causes vasoconstriction and fluid retention. ## Footnote It decreases the blood pressure and cardiac afterload.

Question 68

# Define: Catecholamines

Answer 68

**Naturally occurring chemicals** that stimulate the receptor sites in sympathetic nervous system. ## Footnote Epi, NorEpi, Dopamine

Question 69

# Define: Sympathomimetics

Answer 69

Not found within the body that mimic the effects of occurring neurotransmitters of the sympathetic nervous system.

Question 70

# Define: Vasodilators

Answer 70

**Dilate veins** and **coronary arteries** to decrease preload, and reduce oxygen demand.

Question 71

What are the functions of **Phenytoin** and **Fosphenytoin**?

Answer 71

They prevent seizures.

Question 72

What are **histamine 2 receptor antagonists**?

Answer 72

Antacids that **decrease** stomach acid. ## Footnote E.g. Zantac, Tagamet, Pepcid (famotidine)

Question 73

What are **antiemetics**?

Answer 73

It prevents **nausea/vomiting**.

Question 74

What is **acetaminophen** used for?

Answer 74

**Antipyretic** and **analgesia** used for fever/pain.

Question 75

# Define: Diphenhydramine

Answer 75

Competitive **histamine 1 receptor antagonists**.

Question 76

How does **glucagon** work?

Answer 76

It **converts glycogen stores** in liver into glucose.

Question 77

What is a **ketorolac**?

Answer 77

NSAID ## Footnote It inhibits prostaglandin synthesis.

Question 78

What is **magnesium sulfate**?

Answer 78

Smooth muscle relaxer.

Question 79

What is **sodium bicarbonate**?

Answer 79

An **alkalizing agent** used for metabolic acidosis.

Question 80

What is **thiamine**?

Answer 80

Vitamin B1

Question 81

# Define: aseptic technique

Answer 81

Practice of **preventing contamination**.

Question 82

# Define: sterile

Answer 82

Free from all living microorganisms, including bacteria, viruses, fungi, and spores.