118 Mod 2 (Pharmacology, Med Admin) Flashcards
Define Pharmacology
How substances interact with or alter
the function of living organisms.
What is “off label” use?
Use of a drug for a purpose not approved by the FDA (dose and route)
What must a drug label have?
manufacturing lot
number and expiration dat
Define Semisynthetic
Came from plant, animal or mineral sources
What are the 3 Names of a Medication
Chemical
Generic (nonproprietary)
Brand (proprietary)
What Medical Reference Source do Paramedics mostly use
The Maryland Medical Protocols
Whats the difference between Pharmacodynamics v Pharmacokinetics
codynamics - what the drug does to the body
(mechanism of action)
cokinetics - what the body does to the drug (how does it absorb) (biotransformation:metabolism)
Define Endogenous (chemicals)
In Body
Define Exogenous (medications)
Outside of body
What 4 things may occur (to cells) when a med binds with a receptor cite
- Channels may open or close
- Biochem messenger becomes activated
- Normal cell function is prevented
- Normal or abnorm cell function begins
Define Agonist and Antagonist
Agonist - meds initiate or alter cell activity,
have both affinities for the receptor as well as efficacy
Antagonist - Meds prevent agonist chems from reaching cell receptor sites (blocks response)
have only affinity for the receptors and zero efficacy
Where do Alpha, Beta 1, and Beta 2 meds target
Alpha - Constricting blood vessels
B1 - Heart
B2 - Lungs
Define Dose Response Curve
Is the graph of the relationship between the dose of a drug versus the effects that the drug has
Define Affinity
How much the drug likes the receptor site
(Ability to bind a particular
receptor site)
Define Threshold level
Dose at which wished for
change of cellular activity
begin
Define Therapeutic Range
Whats in-between effective range of dose
Define Efficacy
The ability to produce desired result
How fast does it take to work
(Ability to initiate or alter cell activity in a therapeutic manner)
Define Full Agonist v Partial Agonist
Full - Binds to a receptor site and initiates all activity
Partial - A chemical that binds to the receptor site but does not initiate as much cellular activity or change as other agonists do.
Define Schedule 1 med
High abuse, no medicinal purpose
Define Schedule II meds
May be used by paramedics, must be locked (2-5)
High abuse, legitimate medical use
What are the 4 processes of med admin
- Absorption
- Distribution
- Bio transformation
- Elimination
What two parts make up the Autonomic Nervous System?
Sympathetic (NorEpi)
Parasympathetic (ACh)
Name 7 things that happen in the Parasympathetic system
- Miosis - pupils constrict
- Stimulated Saliva
- Decreased HR
- Bronchoconstriction
- Peristalsis (stomach secretion)
- Bile Release
- Bladder contraction
Name 7 things that happen in the Sympathetic system
- Mydriasis - pupils dilate
- reduced saliva
- increased hr
- vasoconstriction
- reduced stomach secretion
- glycogen converts to glucose
- inhibition of bladder contraction (opposite)
Organophosphate poisoning causes?
Salivation,
Lacrimation (flow of tears),
Urination,
Diarrhea (Defecation),
GI pain,
Emesis (vomiting),
Miosis - pupil constriction
SLUDGEM
Name the parts of the nervous system
central - brain and spinal cord
peripheral - somatic and autonomic
autonomic then controls the
sympathetic & parasympathetic
Where are your Adrenergic Receptors
(and Alpha Beta receptors)
Sympathetic Nervous system -
Adrenaline and noradrenaline
Alpha and beta receptors
What system would you find your Cholinergic Receptors
(nicotinic and muscarinic receptors)
Parasympathetic nervous system -
Acetylcholine
Name 6 positive inotropic drugs (increase myocardial contractility)
Glucagon
Insulin
Amiodarone
Dopamine
Epi
Digoxin
Name negative inotropic drugs (decrease myocardial contractility)
Beta Blockers
Calcium channel blockers
Class IA and IC (antiarrhythmics)
Define Inotropic
Contract heart (heart walls contract)
Define Chronotropic
heart rate (of SA node impulses)
Dromotropic
conduction speed of the heart
Lusitropic
relax heart
Define Agonist
Penetrates receptor site, makes it work
Define Antagonist
Blocks any action from happening in receptor site
(two types non competitive and competitive)
Define Non-Competitive Antagonist
There is no competition
Unstoppable action
(opposite is competitive antagonist)
Define Beta 2
Beta 2 - agonists, bronchodilator drugs
Vasodilation
albuterol - brochodilate and relax (dilate) the airways
Relaxes peripheral resistance
Relaxes Uterine smooth muscle
Glucagon release
Glycogenolysis (muscle, liver)
What system are Adrenergic Receptors part of
Sympathetic Nervous System
Define Alpha 1
Vasoconstriction
Raise bp
Mydriasis
increase peripheral reistance (blood flow)
Closure bladder
Define Beta 1
Heart rate goes up
Lipolysis goes up
Myocardial contractility goes up
Renin goes up
Name the 4 Adrenergic Receptors
Alpha 1 - vasoconstrict
Alpha 2 - inhibits
Beta 1 - heart rate up
Beta 2 - vasodilates
What is the main Nero-transmitter in the parasympathetic nervous system?
name 4 actions when stimulated
Acetylcholine
decrease hr
increased salivation
dilation of blood vessels
smooth muscle contraction
Mechanism of action, when a medicine is administered is also known as?
Pharmaco________
Pharmacodynamics
What the drug does to the body
What are the 4 processes of pharmacodynamics?
- absorption
- distribution
- metabolism - biotransformation
- elimination
What 2 (failing) body functions causes poor
pharmacodynamics?
kidney issues
liver failure
extends the process
What two types of medications bind with receptor sites
agonist - initiates or alters the cellular activity
antagonist - prevents chemicals from reaching cell receptors
What is the difference between a generic name and a brand name?
generic is by the manufacturer
the brand is created for marketing
Differences between affinity and efficacy?
affinity - is the ability (strength) of a chemical to bind to the receptor site
efficacy - ability of drug-bound receptor to produce a response.
You see a minor improvement from a Neb treatment what is this considered
Threshold level - the dose at which cellular activity begins
Define Medication Tolerance?
A decrease in efficacy when a drug is taken repeatedly
As soon as a medication is administered the body begins?
Removing it
Duration and Effectiveness of a drug is determined by?
Dose
Route
and Clinical Status of Patient
What is the chief neurotransmitter of the sympathetic nervous system?
Nor Epinepherine
Most biotransformation occurs where?
The Liver
What type of med would you give to
asthma patient - has sob, bronchoconstriction, mucus, and bronchospasm.
Bronchodilator
BETA 2 Agonist (anticholinergic)
Ex. Atrovent 500mcg, Albuterol 2.5mg
The patient is having muscarinic and nicotonic overactivation due to organophosphate poisoning (SLUDGEM) What do you give?
Anticholinergic
Atropine - blocks muscle response to ACH acetylcholine (drying them out)
Dr wants to prescribe metoprolol for hypertension, what type of med is this?
Beta Blocker - LOL
What type of cardiac med has a negative dromotropic effect and what class is it?
calcium channel blocker
Diltiazem, Verapamil and PINES (ex. Amlodipine) usually bp related
What is the mechanism of action of EPI?
vaso constriction
stimulating beta 1 and beta 2 and alpha agonist
used for asthma and cardiac arrest, anaphylaxis
if a respiratory arrest is coming give epi first
Name some Diuretics and Ace Inhibitors
Lasix - diuretic
Lisinopril, Captopril PRIL - Ace inhibitors
What is a good way to remember calcium channel blockers
C - contractility
What kind of Medication is Narcan?
opioid - antagonist
What type of drug is Atrovent
Ipratropium bromide
Parasympatholytic
Antagonizes (blocks) muscarinic receptors
Anticholinergic bronchodilator
What type of drug is Albuterol
Beta 2 agonist
What type of drug is Terbutaline
Selective Beta 2 agonist
for bronchial asthma
What type of drug is Dexamethasone
Corticosteroid
for anaphylaxis, asthma, COPD
decreases airway inflammation
What’s the generic name of Lasix
Furosemide
What type of drug is MetroproLOL
Beta-blocker
selectively antagonizes B-1
for A-flutter, A-Fib, HTN, PSVT
Diltiazem is what type of drug
Calcium channel blocker
also known as (Cardizem)
slows HR
negative dromatropic medication
Ace-Inhibitors prevent what action?
Blocks the action of converting angiotensinogen 1 to angiotensinogen II
Angiotensin-Converting Enzyme - ACE
What are some common Ace-Inhibitors
Captopril, Lisinopril, PRIL
Cardiovascular Medication
What type of drug is Atropine
Anticholinergic - blocks muscarinic responses
Parasympathetic antagonist - for bradycardia, and excess mucous and fluid
antidote for organophosphate poisoning
What is a sympathomimetic?
It’s a synthetic chemical that mimics acetylcholine
ex. Epi (imitates what the body does)
What are the master neurotransmitters of the sympathetic nervous system?
Epinephrine (adrenaline) - stim A, B1, B2
and
Norepinephrine (Levophed) - stim A, B1
What does Nitroglycerin do?
Dilates veins and coronary arteries, relief of CP and decrease in BP
What do you use Lasix for
Diuretic for CHF, Pulmonary Edema
What effect does Aspirin have
It is an anti-platelet
prevents platelets from clumping together and forming emboli
for CP, fever, headache, Acute myocardial infarction
What effect does Plavix (clopidogrel) have
Inhibits platelet aggregation
for coronary syndrome, CP
substitute for aspirin if unable to take aspirin
What is the dosage amount for Narcan?
2mg IN, equally between nares to a max of 1mL per nare. Repeat as necessary to maintain respiratory activity
Define Isotonic Solution
Hypertonic, Hypotonic
Isotonic - is neutral solution
Hypertonic - alot of electrolytes within that solution getting the h20 out, taking water out of cell
Hypotonic - too much water in the cell
Define Diffusion
diffusion is the movement of a molecule from a high concentration to a low concentration
What does insulin do
Carrier for glucose to cross the membrane
Type 1 - can’t produce insulin, insulin dependant
Type 2- Higher bgl, non effective insulin made
bgl, glucose inside of the blood
When a medication binds to a receptor site what 4 things could happen
Channels of ion passage open or close - cal channel blocker, glucose (insulin)
Biochemical messenger activates - SSRI
Normal Cell function is prevented - cyanide
Normal or Abnormal cell function begins - epi
What is bioavailability
The amount of med available after delivery
IV is 100%, IN is close to 100%
The barrier preventing molecules from reaching tissues
blood brain barrier
What do ace inhibitor drugs usually end with
PRIL (lisinopril)