Principles of Pharmacology - Administering part 2

Question 1

Any medication placed in the mouth requires ___

Answer 1

Constant evaluation of the airway

Question 2

Nitroglycerine is typically the only medication that you will help to administer ___

Answer 2

Sublingually

Question 3

Pain in the heart from a lack of oxygen due to a blockage or narrowing of the blood vessels supplying the heart

Answer 3

Angina pectoris

Question 4

The purpose of nitroglycerin

Answer 4

Increase blood flow by relieving the spasms or causing the arteries to dilate

Question 5

Always do what before administering nitroglycerin?

Answer 5

Take the patient’s blood pressure

Question 6

If the systolic BP is less than ___, the nitroglycerin may be harmful

Answer 6

100 mm/Hg

Question 7

How to position patient before administering nitroglycerin

Answer 7

Sitting or laying down with the head elevated

Question 8

What is a significant BP drop after administering nitroglycerin?

Answer 8

15 to 20 mm/Hg

Question 9

If after administering nitroglycerin, the patient has a significant BP drop and suddenly feels dizzy or sick, have the patient ___

Answer 9

Lie down

Question 10

Myocardial infarction

Answer 10

Heart attack

Question 11

MI

Answer 11

Myocardial infarction

Question 12

A narrowing or blockage in a coronary artery blocks the blood flow to a section of the heart muscle

Answer 12

Myocardial infarction

Question 13

If nitroglycerin no longer brings relief to a patient in whom it has previously worked, the person may be experiencing ___

Answer 13

An MI instead of an angina attack

Question 14

You cannot administer nitroglycerin without ___

Answer 14

Clearance from medical control or standing orders

Question 15

Nitroglycerin when taken with ED medication can cause ___

Answer 15

A dramatic drop in BP

Question 16

Nitroglycerin is usually taken ___

Answer 16

Sublingually

Question 17

If the nitroglycerin does not produce the typical burning sensation, it may have ___

Answer 17

Lost potency because of aging or improper storage

Question 18

Sublingual nitroglycerin should be stored in ___

Answer 18

Their original glass container with the cap screwed on tightly

Question 19

Each spray of nitroglycerin is equivalent to ___

Answer 19

One tablet

Question 20

Do not ___ the nitroglycerin canister prior to administering

Answer 20

Shake

Question 21

When administering nitroglycerin, wait ___ for a response before repeating the dose

Answer 21

5 minutes

Question 22

Wear ___ when administering nitroglycerin

Answer 22

Gloves

Question 23

General steps in administering medication

Answer 23

1. Obtain an order from medical control
2. Verify the proper medication and prescription
3. Verify the form, dose, and route of the medication
4. Check the expiration date and condition of the medication
5. Complete a cross-check procedure
6. Reassess the vital signs, especially heart rate and BP, at least every 5 minutes or as the patient’s condition changes
7. Document your actions and the patient’s response

Question 24

___ route of administration provides quick and easy access to the circulatory system without the need for placing a needle within a vein

Answer 24

IM

Question 25

Blood flow to the muscles is ___

Answer 25

Relatively stable, even during circumstances of severe illness or injury

Question 26

Main hormone that controls the body's fight or flight response and is the primary medication that you will be administering intramuscularly

Answer 26

Epinephrine

Question 27

Mimics the effect of the sympathetic nervous system

Answer 27

Sympathomimetic

Question 28

Epinephrine is secreted by the ___

Answer 28

Adrenal glands

Question 29

Epinephrine is also called ___

Answer 29

Adrenaline

Question 30

Epinephrine should not be given to patient's who ___

Answer 30

Do not show signs of airway obstruction or wheezing due to an allergic reaction, patient's with hypertension or hypothermia, or if you believe the patient may be experiencing an MI

Question 31

An over-release of histamine causes ___

Answer 31

Lowered BP by relaxing the small blood vessels and allowing them to leak. May also cause wheezing from bronchial spasms and swelling of the airway tissues (edema)

Question 32

Most prefilled naloxone IM preparations are administered in increments of ___

Answer 32

2 mg

Question 33

Administration of naloxone to opioid-dependent patients can cause ___

Answer 33

Severe withdrawal symptoms, including seizures and cardiac arrest

Question 34

Most common technique for naloxone administration

Answer 34

Intranasal

Question 35

Steps to administer medication intranasally

Answer 35

1. Obtain medical direction per local protocol 2. Confirm correct medication and expiration date 3. Attempt to determine if the patient is allergic to any medications 4. Prepare the medication and attach the atomizer. Never use a needle 5. Place the atomizer in one nostril, pointing up and slightly outward 6. Administer a half-dose (1 mL maximum) into each nostril 7. Reassess the patient and document appropriately

Question 36

If you do not have naloxone available, ___ provide necessary treatment to opioid overdose patients until definitive treatment can be reached

Answer 36

Bag-mask ventilations

Question 37

When documenting a medication, include the ___

Answer 37

1. Name of the medication 2. Dose & route 3. Vital signs before and after administration

Question 38

SVNs

Answer 38

Small-volume nebulizers

Question 39

Used to administer liquid medications that have been turned into a fine mist by flow of air or oxygen

Answer 39

MDIs and SVNs

Question 40

When medication is atomized, it is ___

Answer 40

Breathed into the lungs and delivered to the alveoli, where blood flow is very high and absorption rates are close to that found with IV medications

Question 41

Disadvantage of an MDI

Answer 41

Patient must be cooperative and control their breathing

Question 42

Adapter that fits over the inhaler like a sleeve

Answer 42

Spacer

Question 43

If an inhaler is administered improperly, most of the medication ___

Answer 43

Ends up on the roof of the patient's mouth

Question 44

Steps to administer an SVN

Answer 44

1. Obtain medical direction per local protocol 2. Confirm correct medication and expiration date 3. Confirm that the patient is not allergic to the medication 4. Add the appropriate medication and dose to the nebulizer reservoir and assemble according to the manufacturer's directions 5. Perform the medication cross-check 6. Connect to the nebulizer machine or oxygen tank at 6 to 8 L/min 7. Place the nebulizer in the patient's mouth and instruct the patient to breath until the medication is gone (usually about 5 minutes) 8. Reassess the patient and document appropriately

Question 45

If relief is not achieved with and SVN, wait ___ and repeat

Answer 45

3 to 5 minutes

Question 46

Reactive airway disease

Answer 46

Asthma

Question 47

Common OTC MDIs for asthma

Answer 47

Primatene Mist, Bronitin Mist, and Bronkaid Mist

Question 48

OTC MDIs for asthma contain ___ and can cause ___

Answer 48

1. Epinephrine 2. Tachycardia, hypertension, and restlessness

Question 49

Most patients with asthma use certain ___

Answer 49

Chemical cousins of epinephrine that produce fewer adverse effects and act more specifically on the bronchi of the lungs

Question 50

Common prescription MDIs for asthma

Answer 50

Albuterol (ProAir, Proventil, and Ventolin), ipratropium bromide (Atrovent), and levalbuterol (Xopenex)

Question 51

Often albuterol and ipratropium are ___

Answer 51

Combined in one inhaler (Combivent, DuoNeb)

Question 52

Two types of inhalers for asthma

Answer 52

1. Rescue 2. Maintenance

Question 53

Common maintenance inhalers for asthma

Answer 53

Fluticasone propionate (Flovent Diskus), budesonide (Pulmicort), mometasone furoate (Asmanex Twisthaler), beclomethasone dipropionate (Qvar), and ciclesonide (Alvesco)

Question 54

The use of multiple medications by one person

Answer 54

Polypharmacy

Question 55

In addition to prescription medications, patient's often take ___

Answer 55

Nonprescription OTC medications, herbal medications, or other supplements

Question 56

When possible, EMS providers should verbally verify which medications are ___, even when presented with a printed medication list

Answer 56

Actually being taken

Question 57

Beta adrenergic blocking agents and calcium channel blocking agents can prevent the patient's heart rate from increasing in ___

Answer 57

Sepsis, trauma, hemorrhage, and other conditions that normally would present with tachycardia

Question 58

Beta adrenergic blocking agents

Answer 58

Metoprolol (Lopressor) and atenolol (Tenormin)

Question 59

Calcium channel blocking agents

Answer 59

Amlodipine (Norvasc) and diltiazem (Cardizem)

Question 60

Decrease the ability of blood platelets to aggregate

Answer 60

Antiplatelet medications

Question 61

Antiplatelet medications

Answer 61

Aspirin and clopidogrel (Plavix)

Question 62

Interfere with other blood clotting mechanisms in the body

Answer 62

Anticoagulant medications

Question 63

Anticoagulant medications

Answer 63

Warfarin (Coumadin), apixaban (Eliquis), and rivaroxaban (Xarelto)

Question 64

Antiplatelet and anticoagulant medications are prescribed to patients who ___

Answer 64

Are susceptible to dysfunctional blood clotting conditions, including acute coronary syndrome, ischemic cerebrovascular accident (stroke), peripheral or pulmonary blood clots, and similar conditions

Question 65

An inappropriate use of a medication that could lead to patient harm

Answer 65

Medication error

Question 66

Before administering a medication, stop to ask yourself, ___

Answer 66

Why am I doing this?

Question 67

Steps if a medication error takes place

Answer 67

1. Rapidly provide any appropriate patient care that is required 2. Notify medical control as quickly as possible 3. Follow your local protocols and document the incident thoroughly, accurately, and honestly

Question 68

EMS providers should strongly suspect ___ in patients who present with an altered mental status or other neurologic symptoms

Answer 68

Intracranial hemorrhage