118 Mod 2 (Pharmacology, Med Admin) Flashcards
1
Q
Define Pharmacology
A
How substances interact with or alter
the function of living organisms.
2
Q
What is “off label” use?
A
Use of a drug for a purpose not approved by the FDA (dose and route)
3
Q
What must a drug label have?
A
manufacturing lot
number and expiration dat
4
Q
Define Semisynthetic
A
Came from plant, animal or mineral sources
5
Q
What are the 3 Names of a Medication
A
Chemical
Generic (nonproprietary)
Brand (proprietary)
6
Q
What Medical Reference Source do Paramedics mostly use
A
The Maryland Medical Protocols
7
Q
Whats the difference between Pharmacodynamics v Pharmacokinetics
A
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)
8
Q
Define Endogenous (chemicals)
A
In Body
9
Q
Define Exogenous (medications)
A
Outside of body
10
Q
What 4 things may occur (to cells) when a med binds with a receptor cite
A
- Channels may open or close
- Biochem messenger becomes activated
- Normal cell function is prevented
- Normal or abnorm cell function begins
11
Q
Define Agonist and Antagonist
A
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
12
Q
Where do Alpha, Beta 1, and Beta 2 meds target
A
Alpha - Constricting blood vessels
B1 - Heart
B2 - Lungs
13
Q
Define Dose Response Curve
A
Is the graph of the relationship between the dose of a drug versus the effects that the drug has
14
Q
Define Affinity
A
How much the drug likes the receptor site
(Ability to bind a particular
receptor site)
15
Q
Define Threshold level
A
Dose at which wished for
change of cellular activity
begin
16
Q
Define Therapeutic Range
A
Whats in-between effective range of dose
17
Q
Define Efficacy
A
The ability to produce desired result
How fast does it take to work
(Ability to initiate or alter cell activity in a therapeutic manner)
18
Q
Define Full Agonist v Partial Agonist
A
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.
19
Q
Define Schedule 1 med
A
High abuse, no medicinal purpose
20
Q
Define Schedule II meds
A
May be used by paramedics, must be locked (2-5)
High abuse, legitimate medical use
21
Q
What are the 4 processes of med admin
A
- Absorption
- Distribution
- Bio transformation
- Elimination
22
Q
What two parts make up the Autonomic Nervous System?
A
Sympathetic (NorEpi)
Parasympathetic (ACh)
23
Q
Name 7 things that happen in the Parasympathetic system
A
- Miosis - pupils constrict
- Stimulated Saliva
- Decreased HR
- Bronchoconstriction
- Peristalsis (stomach secretion)
- Bile Release
- Bladder contraction
24
Q
Name 7 things that happen in the Sympathetic system
A
- Mydriasis - pupils dilate
- reduced saliva
- increased hr
- vasoconstriction
- reduced stomach secretion
- glycogen converts to glucose
- inhibition of bladder contraction (opposite)
25
Organophosphate poisoning causes?
Salivation,
Lacrimation (flow of tears),
Urination,
Diarrhea (Defecation),
GI pain,
Emesis (vomiting),
Miosis - pupil constriction
SLUDGEM
26
Name the parts of the nervous system
central - brain and spinal cord
peripheral - somatic and autonomic
autonomic then controls the
sympathetic & parasympathetic
27
Where are your Adrenergic Receptors
(and Alpha Beta receptors)
Sympathetic Nervous system -
Adrenaline and noradrenaline
Alpha and beta receptors
28
What system would you find your Cholinergic Receptors
(nicotinic and muscarinic receptors)
Parasympathetic nervous system -
Acetylcholine
29
Name 6 positive inotropic drugs (increase myocardial contractility)
Glucagon
Insulin
Amiodarone
Dopamine
Epi
Digoxin
30
Name negative inotropic drugs (decrease myocardial contractility)
Beta Blockers
Calcium channel blockers
Class IA and IC (antiarrhythmics)
31
Define Inotropic
Contract heart (heart walls contract)
32
Define Chronotropic
heart rate (of SA node impulses)
33
Dromotropic
conduction speed of the heart
34
Lusitropic
relax heart
35
Define Agonist
Penetrates receptor site, makes it work
36
Define Antagonist
Blocks any action from happening in receptor site
(two types non competitive and competitive)
37
Define Non-Competitive Antagonist
There is no competition
Unstoppable action
(opposite is competitive antagonist)
38
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)
39
What system are Adrenergic Receptors part of
Sympathetic Nervous System
40
Define Alpha 1
Vasoconstriction
Raise bp
Mydriasis
increase peripheral reistance (blood flow)
Closure bladder
41
Define Beta 1
Heart rate goes up
Lipolysis goes up
Myocardial contractility goes up
Renin goes up
42
Name the 4 Adrenergic Receptors
Alpha 1 - vasoconstrict
Alpha 2 - inhibits
Beta 1 - heart rate up
Beta 2 - vasodilates
43
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
44
Mechanism of action, when a medicine is administered is also known as?
Pharmaco________
Pharmacodynamics
What the drug does to the body
45
What are the 4 processes of pharmacodynamics?
1. absorption
2. distribution
3. metabolism - biotransformation
4. elimination
46
What 2 (failing) body functions causes poor
pharmacodynamics?
kidney issues
liver failure
extends the process
47
What two types of medications bind with receptor sites
agonist - initiates or alters the cellular activity
antagonist - prevents chemicals from reaching cell receptors
48
What is the difference between a generic name and a brand name?
generic is by the manufacturer
the brand is created for marketing
49
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.
50
You see a minor improvement from a Neb treatment what is this considered
Threshold level - the dose at which cellular activity begins
51
Define Medication Tolerance?
A decrease in efficacy when a drug is taken repeatedly
52
As soon as a medication is administered the body begins?
Removing it
53
Duration and Effectiveness of a drug is determined by?
Dose
Route
and Clinical Status of Patient
54
What is the chief neurotransmitter of the sympathetic nervous system?
Nor Epinepherine
55
Most biotransformation occurs where?
The Liver
56
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
57
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)
58
Dr wants to prescribe metoprolol for hypertension, what type of med is this?
Beta Blocker - LOL
59
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
60
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
61
Name some Diuretics and Ace Inhibitors
Lasix - diuretic
Lisinopril, Captopril PRIL - Ace inhibitors
62
What is a good way to remember calcium channel blockers
C - contractility
63
What kind of Medication is Narcan?
opioid - antagonist
64
What type of drug is Atrovent
Ipratropium bromide
Parasympatholytic
Antagonizes (blocks) muscarinic receptors
Anticholinergic bronchodilator
65
What type of drug is Albuterol
Beta 2 agonist
66
What type of drug is Terbutaline
Selective Beta 2 agonist
for bronchial asthma
67
What type of drug is Dexamethasone
Corticosteroid
for anaphylaxis, asthma, COPD
decreases airway inflammation
68
What's the generic name of Lasix
Furosemide
69
What type of drug is MetroproLOL
Beta-blocker
selectively antagonizes B-1
for A-flutter, A-Fib, HTN, PSVT
70
Diltiazem is what type of drug
Calcium channel blocker
also known as (Cardizem)
slows HR
negative dromatropic medication
71
Ace-Inhibitors prevent what action?
Blocks the action of converting angiotensinogen 1 to angiotensinogen II
Angiotensin-Converting Enzyme - ACE
72
What are some common Ace-Inhibitors
Captopril, Lisinopril, PRIL
Cardiovascular Medication
73
What type of drug is Atropine
Anticholinergic - blocks muscarinic responses
Parasympathetic antagonist - for bradycardia, and excess mucous and fluid
antidote for organophosphate poisoning
74
What is a sympathomimetic?
It's a synthetic chemical that mimics acetylcholine
ex. Epi (imitates what the body does)
75
What are the master neurotransmitters of the sympathetic nervous system?
Epinephrine (adrenaline) - stim A, B1, B2
and
Norepinephrine (Levophed) - stim A, B1
76
What does Nitroglycerin do?
Dilates veins and coronary arteries, relief of CP and decrease in BP
77
What do you use Lasix for
Diuretic for CHF, Pulmonary Edema
78
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
79
What effect does Plavix (clopidogrel) have
Inhibits platelet aggregation
for coronary syndrome, CP
substitute for aspirin if unable to take aspirin
80
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
81
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
82
Define Diffusion
diffusion is the movement of a molecule from a high concentration to a low concentration
83
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
84
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
85
What is bioavailability
The amount of med available after delivery
IV is 100%, IN is close to 100%
86
The barrier preventing molecules from reaching tissues
blood brain barrier
87
What do ace inhibitor drugs usually end with
PRIL (lisinopril)
88
What do beta blocker drugs usually end with
LOL (atenolol, carvedilol)
89
What is the Autonomic Nervous System made of
Sympathetic and Parasympathetic
90
Define word ending "lytic"
stops an action, blocking
91
Define word "mimetic"
to imitate
92
What two words are associated with Sympatho
adrenergic, adrenaline
93
What word is associated with parasympatho
cholinergic
94
Where is codine in the "schedule of drugs"
codine fits into different spots based on the dose amount
95
What drug is both a nonagonist and antagonist
activated charcol
96
Name 3 agonist drugs
Epi, Albuterol, fentanyl
97
Name 2 antagonist drugs
calcium channel blockers, beta blockers
98
What do ace inhibitors do?
blocks the conversion from angiotensin 1 to angiotensin 2 in the lungs
99
Name 2 calcium channel blockers
cardizem aka diltiazem
verapimill
100
Define Pharmacodynamics
the branch of pharmacology concerned with the effects of drugs and the mechanism of their action
'what the DRUG does to the body'
101
5 things needed to be documented for IV
needle gauge/size
IV attempts/success/fails
the site
type of fluid
rate of the fluid
102
Name 7 local reactions and symptoms IV
infiltration - edema, pain around site
occlusion - blood going up iv
vein irritation - itching, sting, redness
Thrombophlebitis - pain along the vein, red, edema
Hematoma - blood pooling, pain
Nerve, tendon - severe shooting pain
arterial puncture - bright red, pulsating blood
103
After accidental arterial cannulation what should you do?
stop, place dressing for 5 mins
104
Avoid SQ in shock because
severe vasoconstriction, delayed absorption
105
Whats the fastest IO site
#1 Sternum,
then #2 humerus, #3 tibia
106
IO complication vs Contraindication
complication - is a known problem that may result
contra - is a known reason NOT to perform procedure
107
4 reasons not to do IO
1. no access
2. brittle bones
3. joint replacement
4. prosthetic limb
108
5 Parenteral routes of med
Intradermal
SQ
IM
IV/IO
Percutaneous - sL, bucal
109
3 Enteral routes of med
routes invloving the GI tract
oral
OG/NG Tube
rectal
110
Whats the fastest and slowest med admin routes
fastest is IV and IO
slowest is topical
111
Big pinch for med admin
IM - to stabilize
112
Little pinch for med admin
SQ - some tissue away from muscle
113
Define Bolus
All at once
114
Which color needle is the biggest
Do NOT rely on color coding
115
What is a 3-way stopcock for?
used to draw up small doses of meds
note: inline is off
116
Stimulation of the Alpha 1 receptor causes
causes vasoconstriction
117
Stimulation of the Alpha 2 receptor causes
causes smooth muscle contraction, inhibition of insulin
118
Stimulation of the Beta 1 receptor causes
found in the heart
causes increase in HR
strength of contraction (inotropy)
(and kidneys, release renin)
increased inotropy
119
Stimulation of Beta 2 receptor causes
Lungs to bronchodilation
relaxation of the intestines, bladder
also found in the heart
120
Stimulation of Beta 3
found in fat cells,
promotes lipolysis and heat production in fat
121
Define Catecholamines
Epinephrine and Norepi
are examples of them
substances that function as neurotransmitters.
122
What are 6 factors we cant control as far as med admin
age
weight
environment
genetics
pregnancy
psychosocial
123
Define Pharmacokinetics
'what the BODY does to the drug'
124
What are receptor sites
pieces of either proteins or cell membrane that allows the drug to attach
125
Define agonist
it attaches and causes the reaction of the receptor
126
Define antagonist
attaches to the receptor site, BUT blocks something that causes action (can get knocked off)
127
What does ace stand for
Angiotensin Converting Enzyme
for bp
128
What do calcium channel blockers do?
Decreases automaticity of the cardiac conduction system
makes it harder to reach action potential and pass the message on
slows down the heart, lowers bp
(cardizem, verapimil, diltiazem)
129
Explain Zero Order Elimination
a fixed amount of a substance is removed during a certain period, regardless of the total amount in the body.
(alcohol is an example)
130
What processes fall under phramacokinetics
half life and zero order elimnation
131
Explain first order elimination
The rate of elimination is directly influenced by the plasma levels of the substance. In essence, the more substance in the plasma, the more the body works to eliminate the substance.
(is half life)
132
Explain Half Life Elemination
The half-life of a medication is the time needed in an average
person for metabolism or elimination of 50% of the substance in the plasma.
A medication half-life pertains only to the quantity of medication within the body, not necessarily to the clinical effects of the medication.
133
What does the liver do to drugs
Eliminates or Biotransforms (changing)
134
What do the kidneys do to most drugs
Eliminates (or secretes)
135
What does Enterally mean
Drug taken through GI tract
136
When a drug comes out of the liver (after biotransformation) you want it be
an active metabolite
137
What causes cell to shrink
Hypertonic, because of the fluid shift
138
What is the system the liver uses to process drugs
P450
139
What type of neurotransmitter is acetylcholine?
it is the chief neurotransmitter of the parasympathetic nervous system, the part of the autonomic nervous system
140
What is the brand name for albuterol
proventil
141
Define analgesic
(a drug) acting to relieve pain
analgesia The state of being insensible to pain while still conscious.
142
What system is are anticholinergic found
the nervous system
Anticholinergics are agents that decrease or block the actions of acetylcholine on its parasympathetic nervous system receptors on smooth muscle cells, glands and the central nervous system
143
midazalam a generic name or brand name?
generic name
brand name - versed
used for pre-anesthesia sedation and for procedural sedation for children and adults
144
What system do antihistamines come from
The immune system
145
What is cross tolerance
occurs when developing a tolerance for one substance leads to tolerance of another. Most cases of cross-tolerance occur with drugs in the same class that affects similar areas of the body.
146
Define Synergism
Two medications with a similar effect combine to produce an effect greater than the sum of the medications’ effects.
147
Define Potentiation
The effect of one medication is greatly enhanced by the presence of another medication, which does not have the ability to produce the same effect.
148
Define Neutralization
Two medications bind together in the body, creating an inactive substance.
149
Endogenous vs Exogenous
Endo - with the body
Exo - outside of the body
150
alpha 1 is a receptor site specific to what part of the nervous system
adrenergic - sympathetic
151
define efficacy
how well it works,
The ability to initiate or alter cell activity in a therapeutic or desired manner is referred to as efficacy
affinity doesn't mean it will have efficacy
152
How do antibiotics work?
They are designed to target specific substances present in the cell walls of a particular bacterium or fungus.
they work without affecting receptor sites
153
Opioids are what time of chemicals?
Exogenous - made from chemicals Originating outside the organism (body).
154
Limit of drugs where there is not longer an increased effect
Maximum range
155
Define Tachyphylaxis
Repeated doses of medication within a short time rapidly cause tolerance, making the medication virtually ineffective.
156
Define Parenteral
means "outside of the digestive tract."
157
What type of drug is atropine?
Atropine is a clinically relevant anticholinergic drug, which blocks inhibitory effects of the parasympathetic neurotransmitter acetylcholine on heart rate leading to tachycardia.
158
What type of drug is Naloxone
It is an opioid (narcotic) antagonist—meaning that it binds to opioid receptors and can reverse and block the effects of other opioids
159
What class of drug is used to reduce inflammation
corticod steroids
160
What drug helps against bronchoconstriction
albuterol
161
60 drops = how much fluid
1 mL
162
Action for local complications
Action for systemic complications
local - pull IV line, do a new one
systemic - leave line in place, needs a fluid change
163
What are the two major systems within the Nervous System
Central - brain and spinal
Peripheral - somatic and autonomic
(autonomic has the symp and parasymp)
164
What are the two Neurotransmitters of the Sympathetic System?
Norepi and Epi
165
What is the Receptor of the Sympathetic System
and its 4 Sub receptors
Adrenergic
A1 - in blood vessels - vasoconstrict
A2 - gatekeeper
B1 - heart - contractility ino, HR chrono, conduct drono
B2 - lungs - bronchodilation
166
B2 agonist would cause
bronchodilation
167
What is the neurotransmitter
and receptor of the Parasympathetic System
and subreceptors
NTM - Acetylcholine
Receptor - Cholinergic
sub - nicotinic muscurinic
168
A beta antagonist can also be called a
parasympatholytic
169
a beta blocker is aka
beta antagonist
170
When a med has Anti or Blocker its a type of?
Antagonist
171
Lams and Pams
are benzodiazpiens
172
Brand Name for Ondansetron
Zofran
173
Brand Name for Diltiazem
Cardizem
174
Brand Name for Midazolam
Versed
175
Brand Name for Furosemide
Lasix
176
Statin (is known for)
Lowers Cholesterol
177
Zepam (Zolam) (Pam)
Benzodiazepine
178
Dipine / mil (is known for)
Calcium Channel Blocker
179
Thazide (semide)
Diuretic
180
Sone (solone)
Steroid
181
What type of drug is Naloxone
Opioid Antagonist
182
What type of drug is fentanyl or morphine
opioid agonist
183
What type of drug is Atropine
184
What type of drug is Midazolam
Benzodiazepine
185
What type of drug is ASA (aspirin)
Anti-platelet
186
What type of drug is Ondansetron
antagonist
187
What type of drug is Furosemide
diuretic
188
What type of drug is EPI 1:1,000
Alpha/Beta Adrenergic Agonist
189
What type of drug is Diphenhydramine
antihistamine
190
What type of drug is Albuterol
Adrenergic Bronchodilator
191
What med should you administer 1st for Anaphylaxis?
what route
what is the max
EPI (anaphylaxis 1 to 1:000)
consentration 1mg to 1mL
note: 1 to 10,000 is cardiac epi 1mg to 10mL
IM
(max IM 5 mL)
192
PR means (what kind of route)
per rectal (parenteral route)
193
Max dose for SQ
3mL
194
T/F parenteral is more predictable rate than enteral
True
because high therapeutic concentrations are achieved reliably and rapidly. IV IM
oral doesn't absorb all of it
ET tube is highly unpredictable
195
What degree angle is IM and SQ
IM is 90 degrees
SQ is 45 degrees
196
60 drop set is a
micro drip
197
why is an anaphylactic patient pale
they are not perfusing well
198
When BETA 1 receptor is stimulated what happens
Increased HR
contractility
and Conductivity
199
What is the difference between an absolute contraindication and a relative contraindication
absolute - effect is not good enough to give drug
relative - could be bad but it is worth giving drug
200
T/F alpha 1 agonist and
alpha 1 adrenergic agonist are the same
True
201
Name an anti-emetic
Zofran - ondansetron
for nausea vomiting
(anti emesis)
202
Mechanism of Action is also known as Pharmaco_______
MOA = dynamics (what the drug does to the body)
203
Pregnancy classifications
A B C D X
for Risk reward
(a safest, X is the worst)
204
What class of med would you give for pain (9 out of 10)
Opioid Agonist
schedule 2
205
After a fall, pain what receptors are being stimulated
sympathetic,
A1 B1 B2
Positive Ino, chrono, dromo
206
Where does elimination occur in the body
The kidneys
207
How is Hep A Transmitted
Fecal/Oral
208
Hep B is transmitted by
Blood, Semen, or Bodily Fluids
209
What are the other 5 R's
Document
Assess
Refuse
Evaluation
Education
DAREE
210
When getting blood samples for hospital whats the order
Red
Blue
Green
Lavender
Red Blood Gives Lives
211
What type of drug is Warfarin (Coumadin)
Anticoagulant (not bloodthinner per say)
212
Define (med) Addition or Summation
Two meds with similar effect combine to produce an effect equal to sum
1+1=2
(note: synergism is greater effect)
213
What schedule is Diazepam and Lorazepam
Schedule IV (4)
214
What schedule is Fentanyl
Schedule II
215
What are some needle sizes for
Intradermal IV
SQ
IM
IV - 25-27g and 3/8 to 1"
SQ - 24-26g and 1/2 to 1"
IM - 21g and 1-2"
216
Define Osmosis
Movement of solvent across semipermeable membrane from high to low solvent concentration (ONLY SOLVENT MOVES)
217
Define Diffusion
Movement of molecules from high concentration to low concentration
(BOTH solvent AND Solute move)
218
GCS Pnumonics
MVE 456
Eye - SPON, HELLO, PAIN, NONE
Voice - VOICE
Motor - OLD BEN
Voiceless
Oooh (Incoherent)
Inapropreat
Confussed
Elegant
Obeys
Localizes
Draw away (Decerb)
Bends (Decore)
Extends
None
