Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PARAMEDIC SCHOOL > BLOCK 5: PHARMACOLOGY > Flashcards

BLOCK 5: PHARMACOLOGY Flashcards

You may prefer our related Brainscape-certified flashcards:
NREMT® Paramedic flashcards NREMT® EMT flashcards
1
Q

medication vs drug

A

medication: substance used to treat illness/condition

drug: any substance that produces a physiologic effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

every medication is a ____ but

A

drug, but not every drug is a medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

scientific study of how various substances interact with or alter the function of living organisms

A

pharmacology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

natural remedies directed toward ___, not ____

A

relieving symptoms not ending the disease process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what act prohibited altering or mislabeling meds

A

Pure Food and Drug Act of 1906

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

who is responsible for approving new medications and removing unsafe meds from market

A

US Food and Drug Administration (FDA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Schedule 1 medication description and examples

A

high abuse potential, no recognized medical purpose examples: heroin, marijuana, LSD, peyote

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Schedule 2 medication description and examples

A

high abuse potential, legitimate medical purpose
examples: opioids (codeine, fentanyl, hydrocodone, morphine) and stimulants (amphetamine, adderall, cocaine, meth, ritalin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Schedule 3 medication description and examples

A

lower potential abuse than schedule 2
examples: opioids (acetaminophen with codeine like tylenol) and nonopioids (anabolic steroids, ketamine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Schedule 4 medication description and examples

A

lower potential abuse than schedule 3
examples: alprazolam (xanax), diazepam (valium), lorazepam (ativan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Schedule 4 medication description and examples

A

lower potential for abuse than schedule 4 drugs
examples: opioid cough medicines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what three things do all schedule 2 through 5 medications require

A

locked storage, detailed record keeping, and controlled wasting procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

powdered or solid medication enclosed in a dissolvable cylindrical gelatin shell

A

capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

solid medication particles bound into a shape designed to dissolve or be swallowed

A

tablet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

small particles of medication designed to be dissolved or mixed into a solution or liquid

A

powder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

sterile solution or nonsterile liquid intended for direct administration into the nose or ear

A

droplet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

sterile solution for direction injection into a body cavity, tissue, or organ

A

parenteral solution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

gel, ointment, or paste substance designed to permit transdermal absorption

A

skin preparation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

medication in a wax like material that dissolves in the rectum or other body cavity

A

suppository

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

medication dissolved or suspended in liquid intended for oral consumption

A

liquid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

medication in gas or fine mist form intended for inhalation and absorption through the lung, airway, or oral tissues

A

inhaler/spray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is a chemical name of a medication

A

long and difficult to pronounce that indicate medication’s chemical composition during initial development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the generic or nonproprietary name of a medication

A

include a “stem” that links them to other meds in the same drug class

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is a brand name for a medication

A

for marketing purposes and sometimes linked to a particular condition that medication treats for

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is “tall man” lettering

A

capitalized letters highlight portion of name in meds with similar names

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

3 parts of pharmacokinetics

A

onset, peak, and duration (of action)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the onset of pharmacokinetics

A

estimated amount of time it will take for medication to enter the body/system and take effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the peak of pharmacokinetics

A

estimated amount of time it will take for the medication to have its greatest effect on the patient/system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the duration of action of pharmacokinetics

A

estimated amount of time that medication will have any effect of the patient/system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is pharmacodynamics

A

mechanism of action - the way in which a medication produces the intended response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

do pediatric and older patients have slower or faster medication absorption and elimination times

A

slower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

“package inserts” with every medication provide what 5 components

A

dosing, route of administration, contraindications, adverse effects, and characteristics of medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

class I interventions

A

strong evidence supports use, benefit greater than risk, intervention should be performed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

class IIa interventions

A

moderate evidence that benefit is greater than risk, intervention is reasonable and may be useful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

class IIb interventions

A

weak evidence that benefit is greater than risk, intervention may be considered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

class III no benefit interventions

A

evidence is weak, benefit equals the risk, intervention should not be performed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

class III harm interventions

A

strong evidence that risk is greater than benefit, intervention should not be performed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what are endogenous chemicals

A

those occurring naturally within the body and by the presence of meds and chemicals absorbed in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

where are receptor sites

A

in proteins connected to cells throughout the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

four possible actions that occur when medication binds with a receptor site

A
  1. channels in cell walls are opened or closed
  2. biochemical messenger actives and initiates other chemical reactions within cell
  3. normal cell function is prevented
  4. normal or abnormal function of the cell begins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

children who ingest mouse poisons will exhibit effects similar to the administration of ____

A

warfarin (coumadin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

agonist medications

A

initiate or alter cell activity by attaching to receptor sites to prompt a response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

antagonist medications

A

prevent agonist chemicals from reaching cell receptor sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is affinity

A

the ability of medication to bind with a particular receptor site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what two things affect the number of receptor sites bound by a medication

A

affinity and concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

increasing concentrations of medications cause increased effects until what

A

all receptor sites become occupied or max capability of cell is reached

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what is potency

A

concentration of medication required to initiate a cellular response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

as potency of medication increases, what decreases

A

concentration or dose required for a response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what is efficacy

A

the ability to initiate or alter cell activity in a therapeutic or desired manner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what is the dose-response curve

A

relationship between medication dose/concentration and efficacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

competitive vs noncompetitive antagonists

A

competitive: temporarily bind with cell receptor site to displace agonist chemicals

noncompetitive: permanently bind with receptor sites and prevent activation by agonist chemicals until new receptor sites or cells are created

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

partial agonist chemicals

A

bind to receptor site but do not initiate as much cell activity or change as other agonists
lower efficacy of other agonist chemicals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

two types of microbials what they do

A

antibiotics and antifungals - target specific substances present in cell walls of certain bacteria or fungus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what are chelating agents

A

bind with heavy metals like lead, mercury and arsenic in body to create a compound that can be eliminated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what are diuretic medications

A

distribute into water in the body to create osmotic changes that alter distribution of fluids and electrolytes - draws excess water from body tissues and enhances urine excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what three types of body tissues do meds become distributed into

A

water, lipids/fats, and proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

water-soluble medications are administered differently to what population and how

A

higher weight-based doses to infants because they have higher percentage of body water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

fat and lipid-soluble medications are administered differently to what population and how

A

higher weight-based doses in older adults because of their higher body fat percentage and increased fat distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

medication metabolism in the liver is affected by the what

A

cytochrome P-450 system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what are paradoxical medication reactions

A

clinical effects opposite to the intended effects of the medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

two risks that come with weight-based dosing

A

improperly estimating patient weight
wrong multiplication of numbers in a formula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

ideal body weight formulas in kg for men and women

A

men: 50 + (2.3 times patient’s height in inches over 5ft)

women: 45.5 + (2.3 times patient’s height in inches over 5ft)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

how does hyperthermia affect medication absorption, metabolism, and efficacy

A

increases hepatic blood flow which increases metabolism of drugs in the liver reducing amount of drug returned to circulation

suppresses function of the cytochrome P-450 which decreases rate of metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

how does hypothermia affect medication absorption, metabolism, and efficacy

A

impairs effectiveness of medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what increases and what decreases during pregnancy

A

increases: cardiac output, intravascular volume, tidal and minute volume, urinary output

decreases: hematocrit (% of RBCs), GI motility, resp reserve volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

error/delay in diagnosis, failure to use indicated tests, outdated tests/therapy, failure to act

A

diagnostic medical error

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

treatment medical error

A

error in performance of operation, procedure, test, error in administration, in dose/method, avoidable delay, inappropriate care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

preventative medical error

A

failure to provide prophylactic treatment (preventative) and inadequate monitoring or follow-up of treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

other type of medical error

A

failure of communication, equipment failure, or other system failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

what is cumulative action

A

several smaller doses of med produces same effect as large dose of same med - can decrease risks of too much administered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

the vast number of receptor sites within the body make medications ___ rather than ____

A

selective, specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

side effect is aka ____

A

adverse affect but adverse is more harmful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

adverse effects are aka ____

A

untoward effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what is an exaggerated therapeutic effect

A

undesired/harmful responses directly related to the intended response (bradycardia after taking metroprolol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

two groups of meds susceptible to abuse

A

stimulants and depressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

what are stimulants and examples

A

increase in physical, mental, and emotional performance
increase in LOC, HR, BP, and sympathetic nervous system
ex. caffeine, coke, amphetamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

what are depressants and examples

A

cause sedation, anxiolysis (decrease of anxiety) and decreased RR, HR, BP
reduce sympathetic nervous system
ex. alcohol, benzos, opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

what is habituation

A

abnormal tolerance to effects of a substance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

what is dependence

A

physical, emotional, or behavioral need for substances to maintain “normal” level of function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

what is medication interference

A

undesirable medication interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

the onset and peak of a medication are generally related to ___ and ____

A

absorption and distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

the duration of medication effect is generally related to ___ and ____

A

metabolism and elimination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

what is an addition or summation med interaction

A

two meds with similar effect combine to produce an effect equal to the sum of each individual effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

what is synergism med interaction

A

two meds with similar effect combine to produce effect greater than sum of med’s effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

what is potentiation med interaction

A

effect of one med is greatly enhanced by presence of another med that does not produce the same effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

what is altered absorption med interaciton

A

action of one med increases/decreases ability of another med to be absorbed in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

what is altered metabolism med interactions

A

action of one med increases/decreases the metabolism of another med within the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

what is altered distribution med interaction

A

present of one med alters area available for the distribution of another med in the body (when both meds are bound to the same site)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

what is altered elimination med interaction

A

meds may increase/decrease the functioning of kidneys or other route of elimination, influencing amount/duration of effect of another med in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

what is physiologic (drug) med interaction

A

two meds with opposite effects are present simultaneously which result in minimal or no changes

91
Q

what is neutralization med interaction

A

two meds bind together in the body to create an inactive substance

92
Q

what is bioavailability

A

the percentage of the unchanged medication that reaches the systemic circulation

93
Q

meds administered by IV have what percent bioavailability

A

100%

94
Q

many meds prescribed for chronic med conditions and prehospital meds are administered where

A

into the GI system

95
Q

what factors affect GI med absoprtion

A

GI motility (ability of med to pass through GI tract into bloodstream)

GI pH (perfusion of the GI tract that can be decreased during shock or trauma)

presence of food, liquids, or chemicals in stomach

96
Q

what can happen to GI medications in first-pass metabolism

A

med goes from GI tract into the liver, metabolism occurs, and can alter or inactivate medication before it reaches circulation

97
Q

why are oral doses higher than IV doses

A

they take into account first-pass metabolism

98
Q

who are oral doses dangerous for

A

people with liver dysfunction are at risk because first-pass effect is impaired so they can get toxic amounts

99
Q

if endotracheal route is used instead of IV, how do you adjust the dose of medication

A

2-2.5x IV dose followed by 5-10mL flush

100
Q

bioavailability of intranasal medications

A

close to 100%

101
Q

what is the preferred method of administering meds in prehospital setting

A

IVs

102
Q

what medication classes are significant concern if infiltration into tissues around blood vessels and why

A

sympathomimetics and electrolyte solutions because they cause significant pain and tissue damage

103
Q

what vein is used in proximal tibia IO

A

popliteal vein

104
Q

what vein is used in femur IO

A

femoral vein

105
Q

what vein is used for distal tibia (medial malleolus) IO

A

great saphenous vein

106
Q

what vein is used for proximal humerus IO

A

axillary vein

107
Q

what vein is used for manubrium (sternum) IO

A

internal mammary and azygos veins

108
Q

what are contraindications for IOs

A

fractured bones or bone diseases/skin infection over insertion site

109
Q

bioavailability of IM medications

A

75-100%

110
Q

what do transdermal patches do

A

deliver constant dose of medication over an extended period

111
Q

what is the bioavailability of sublingual meds and how is the dose changed compared to IV

A

very low, close to 100x larger than IV dose

112
Q

nebulized meds have the potential to cause what

A

bronchospasms

113
Q

what is the bioavailability of rectal medications and why is it higher than oral medications

A

greater than 90%
it is not subject to first-pass metabolism

114
Q

how do nonionic and lipophilic molecules enter the cell

A

easily passing through cell membranes

115
Q

how do hydrophilic and ionic molecules enter the cell

A

through pinocytosis and binding with carrier proteins

116
Q

what three barriers prevent medication molecules from passing through capillary walls

A

blood-brain, blood-placenta, and blood-testes

117
Q

how does plasma protein-binding affect medication distribution

A

med molecules attach to proteins in blood plasma to circulate around body
if another protein bound-medication with a greater affinity is administered, it can displace the first med, giving the patient toxic effects

118
Q

what is the volume of distribution

A

the extent to which a med will spread within the body

119
Q

what is a metabolite

A

medication undergoing biotransformation

120
Q

active vs inactive metabolites

A

active: main capable of some pharmacologic activity
inactive metabolites: no longer possess ability to alter cell process or body function

121
Q

where does most biotransformation occur

A

in the liver

122
Q

suspect altered medication metabolism in patients with what

A

chronic alcoholism, liver disease, or any liver condition

123
Q

medications and other chemicals are primarily removed from the body by the ___

A

kidneys

124
Q

zero-order vs. first-order elimination

A

zero: fixed amount of substance is removed during a certain period regardless of total amount in body

first: plasma levels of substance directly influence rate of elimination

125
Q

first-order elimination is quantified as what

A

the medication’s half-life

126
Q

the 9 rights of medication administration

A

right patient
right med and indication
right dose
right route
right time
right patient education
right to refuse
right response and evaluation
right documentation and reporting

127
Q

alpha 1 agonist effect

A

constriction of arteries, vascular smooth muscle, bladder, and GI

128
Q

alpha 2 agonist effect

A

stop pancreatic enzyme and insulin release, suppress norepinephrine release, stop GI motility

129
Q

beta 1 agonist effect

A

(heart) increase heart ate, contractility, and conduction

130
Q

beta 2 agonist effect

A

(lungs) bronchodilation, stop insulin release, increase glucagon release, relaxation of intestines, bladder, uterus

131
Q

beta 3 agonist effect

A

increase lipolysis and heat production in fat

132
Q

dopaminergic agonists effect

A

memory, attention, impulse control, regulation of renal function, locomotion, learning, sleep, decision making

133
Q

dopaminergic 2 agonist effect

A

locomotion, attention, sleep,

134
Q

nicotinic agonist effect

A

allow acetylcholine to stimulate muscle contraction

135
Q

muscarinic 1 agonist effect

A

cognition, arousal, gastic acid secretions

136
Q

muscarinic 2 agonist effect

A

cardiac - decrease heart rate and contractility

137
Q

muscarinic 3 agonist effect

A

stimulate gland secretion and smooth muscle contraction

138
Q

muscarinic 4 agonist effect

A

act on potassium and calcium channels

139
Q

muscarinic 5 agonist effect

A

affect dopamine release

140
Q

opioid Mu agonist receptors

A

most prominent, greatest affinity for morphine and naloxone
causes analgesia, sedation, mood changes, constricted pupils , respiratory depression, decreased GI motility

141
Q

opioid delta agonist receptors

A

spinal analgesia, respiratory depression, decreased GI motility

142
Q

opioid kappa agonist receptor

A

spinal analgesia, sedation, dysphoria, decreased GI motility

143
Q

alpha agonists cause vaso___
beta agonists cause vaso___
in arteries

A

constriction
dilation

144
Q

alpha agonists cause broncho___
beta agonists cause broncho___

A

bronchoconstriction (very little)
bronchodilation

145
Q

which receptors are in lungs, heart, and arteries?

A

lungs: beta 2 and alpha
heart: beta 1 only
arteries: alpha and beta

146
Q

drugs that act primarily on cardiac beta receptors are called what

A

beta-1 adrenergic agonists

147
Q

drugs that act primarily on pulmonary beta receptors are called

A

beta-2 adrenergic agonists

148
Q

what do beta adrenergic blockers do

A

occupy beta receptors in heart, lungs, and arteries so beta agents can’t exert their full effects

149
Q

what are etomidate and ketamine used for

A

short-acting sedative meds to facilitate airway placement

150
Q

what are benzodiazepines used for

A

seizures, anxiety, sedation

151
Q

what can benzodiazepines cause at high doses

A

hypotension

152
Q

what are benzodiazepines classified as in related to pregnancy

A

class D - potential to harm fetus

153
Q

two classes of chemical paralytic agents

A

deplarizing and nondepolarizing

154
Q

what are chemical paralytic agents used for

A

muscle relaxation for airway device placement

155
Q

how do paralytic agents work

A

bind with nicotinic receptor sites of muscles to prevent activation by ACh

156
Q

difference between depolarizing and nondepolarizing paralytics and examples of each

A

depolarizing: ACh receptor agonists activate the receptor sites (succinylcholine)
nondepolarizing: competitive antagonists to ACh, do not activate the receptor sites (rocuronium and vecuronium)

157
Q

what are beta agonist medications used for

A

acute bronchospasms related to COPD and asthma

158
Q

what are corticosteroid medications used for

A

reduce airway inflammation to improve oxygenation and ventilation

159
Q

what are leukotrienes

A

patients with asthma have an overproduction of these
they bind to receptor sites in lungs and cause powerful bronchoconstriction

160
Q

what are leukotriene receptor antagonist medications used for

A

taken by patients with asthma and allergies on a long-term basis

161
Q

what is ectopic foci

A

site of electrical impulse generation other than normal pacemaker cells

162
Q

what are antidysrhythmic mecications used for

A

target heart cells to resolve dysrhythmia and suppress ectopic foci

163
Q

what is the Vaughan-Williams classification scheme

A

breaks down the meds used to treat cardiac dysrhythmias into four classes based on mechanism of action

164
Q

5 phases of cardiac cell activity

A

phase 0: cardiac muscle cell receives an impulse, sodium enters cell and depolarization occurs

phase 1: sodium channels close and potassium exits cell

phase 2: sodium and calcium enter the cell and potassium exits the cell, repolarization begins

phase 3: calcium channels close and calcium leaves cell while potassium channels open, repolarization ends

phase 4: cardiac cells are at rest waiting for impulse

165
Q

what do class 1 antidysrhythmic medications do

A

slow the movement of sodium through channels in certain cardiac cells - potential to prolong QRS and QT intervals

166
Q

what do class 2 antidysrhythmic medications do

A

also known as beta adrenergic blocking agents (beta blockers)
completely stop catecholamine (epi and norepi) activation of beta receptor sites

167
Q

what do class 3 antidysrhythmic medications do

A

increase duration of phases 1,2, and 3
prolong absolute refractory period, treating atrial and ventricular tachycardias

168
Q

what do class 4 antidysrhythmic medications do

A

displace calcium at receptor sites or enter smooth muscle cells in place of calcium
reduces BP, controls HR, increase oxygen to heart during ischemia

169
Q

what is down-regulation

A

tolerance resulting from mechanism that reduces number of cell receptors available for binding with particular medication

169
Q

what is median toxic dose

A

50% of tested animals had toxic effects

169
Q

anaphylaxis occurs with which exposure to an allergen

A

the second

169
Q

what is cross-tolerance

A

repeated exposure to a med within a particular class causes tolerance to other meds in same class

169
Q

what is median lethal dose

A

50% death rate in animal testing

169
Q

which medications are the primary culprits of immune-mediated responses

A

aspirin, penicillin, and sulfa-based antibiotics

169
Q

what can antiseizure medications cause

A

Stevens-Johnson syndrome (mimics a burn)

169
Q

what is therapeutic index

A

relationship between median effective dose and median lethal or toxic dose

169
Q

what is tachyphylaxis

A

giving repeated doses of medication within short time frame can rapidly cause tolerance making the medication ineffective

169
Q

what is adenosine

A

the only fifth class antidysrhythmic medication
used to treat stable, regular narrow QRS tachycardia and for unstable QRS tachycardia for cardioversion

170
Q

what can antidepressant medications cause

A

cardiomyopathy

170
Q

what are idiosyncratic medication reactions

A

adverse effects completely unexpected and not previously known

171
Q

what do alpha adrenergic receptor antagonists do

A

aka alpha blockers
prevent endogenous catecholamines from reaching alpha receptors in smooth muscle of blood vessels
lower diastolic BP and systemic vascular resistance

172
Q

patients taking alpha blocking meds are susceptible to what

A

orthostatic hypotension

173
Q

what do angiotensin-converting enzyme inhibitors do

A

aka ACE inhibitors
alter renin-angiotensin system
reduces BP and cardiac afterload in pt’s with hypertension, cardiomyopathy, and heart failure

174
Q

patients who take ACE inhibitors may experience what

A

chronic dry cough

175
Q

what do anticholinergic medications do

A

used on people exposed to acetylcholinesterase inhibitors in pesticides and nerve agents
stops ACh from activating muscarinic-2 receptors
allows sympathetic stimulation to take over hyperactive vagus nerve of parasympathetic system

176
Q

what do catecholamines do

A

natural occurring chemicals in the body - cause “fight-or-flight”
mimic epi, norepi, and dopamine

177
Q

what does epi stimulate

A

alpha, beta-1 and beta-2

178
Q

what does norepinephrine stimulate and when is it used

A

alpha and beta-1 (alpha is stronger)
sepsis, neurogenic shock, anaphylactic shock

179
Q

what is dopamine used for

A

hypotension refractory to volume resuscitation

180
Q

what is dobutamine and its uses

A

synthetically manufactured catecholamine similar to dopamine
activates beta 1 and 2 and alpha sites
treats cardiogenic shock

181
Q

what do digitalis preparations do

A

increase the strength of cardiac contractions
prescribed for chronic heart failure and rapid atrial dysrhythmias

182
Q

what are patients taking digitalis preparations sensitive to

A

calcium and potassium levels

183
Q

what three major classes of drugs are used to relieve angina pain

A

nitrates, beta blockers, calcium channel blockers

184
Q

what are direct vasodilator medications used for

A

management of hypertension, heart failure, MI, cardiac ischemia, cardiogenic shock
cause vascular smooth muscle relaxation and vasodilation

185
Q

what are diuretics used for

A

eliminate certain toxins from the body and to promote excretion of excess electrolytes

186
Q

the average adult has __L of blood, making up ___ percent of body weight

A

5
7-8%

187
Q

unmatched blood transfusions are almost always type ___

A

O, Rh negative

188
Q

what are packed RBCs used for

A

to correct anemia from blood loss, inadequate RBC production, or hemolysis

189
Q

what are patients who receive PRBCs at risk for

A

hypocalcemia and hyperkalemia

190
Q

what is fresh frozen plasma used for

A

replacement of clotting factors NOT volume expansion

191
Q

what are platelets used for

A

to correct thrombocytopenia (low platelet level in blood)

192
Q

what is tranexamic acid used for

A

made of lysine amino acid that promotes blood clotting in trauma patients

193
Q

what are anticoagulant medications used for

A

impair function of clotting to treat/prevent acute coronary syndrome, deep vein thrombosis, and pulmonary embolus

194
Q

what are antiplatelet medications used for

A

reduce platelet aggregation (clumping) preventing new thrombus formation or extension of an existing one

195
Q

what are fibrinolytic drugs used for

A

dissolve blood clots in arteries and veins

196
Q

what are phenytoin and fosphenytoin used for

A

limit sodium in CNS by altering channels to prevent seizure activity

197
Q

what are histamine 2 receptor agonists used for

A

decrease acid secretion in the stomach for protection against ulcers, GI bleeding, and acid-aspiration pneumonitis

198
Q

what is a Mallory-Weiss tear

A

tear in mucous membrane of the lower esophagus or upper part of stomach

199
Q

what are antiemetic medications used for

A

prevent or treat nausea and vomiting

200
Q

what is octeotride used for

A

decreases blood flow to esophagus to reduce bleeding
stops release of serotonin, insulin, glucagon, GH

201
Q

what is acetaminophen used for

A

(tylenol) antipyretic and mild analgesia
for preventing febrile seizures

202
Q

what are calcium preparations used for

A

reverse calcium channel blocker OD
treat magnesium toxicity
prevent hyperkalemic dysrhythmias

203
Q

what is dextrose used for

A

hypoglycemia

204
Q

what is diphenhydramine used for

A

anaphylaxis, allergic reactions, mild sedative and cough suppressant

205
Q

what is glucagon used for

A

hypoglycemia in patients you cant establish an IV in

206
Q

what is ketorolac used for

A

(toradol) treats pain and inflammation

207
Q

what is magnesium sulfate used for

A

treatment of torsades de points or similar ventricular dysrhythmias
treatment of seizures for patients with pre or eclampsia

208
Q

what is sodium bicarb used for

A

raise blood pH in patients with metabolic acidosis, stabilize hyperkalemia, promote urinary excretion

209
Q

what is tetracaine used for

A

mild ophthalmic anesthetic for inserting Morgan lens into an eye for flushing the eyes

210
Q

what is thiamine used for

A

commercial version of vitamin B1 for those with a deficiency from malnourishment or chronic alcoholism before dextrose administration

211
Q

prohibited altering or mislabeling meds

A

The Pure Food and Drug Act

212
Q

Parkland formula

A

fluid amount for burns

4mL x kg x burn %

213
Q

lipophilic vs lipophobic drugs

A

lipophilic: dissolve in fats (go thru cell membrane)
lipophobic: don’t dissolve in fats (need carrier protein to cross into cell membrane)

214
Q

7 P’s for RSI

A

preparations
preoxygenation (to 95%)
pretreatment/priming (getting equip. ready/dosing)
paralytic/sedation (sedation BEFORE paralytic)
pass the tube
prove it (capno, lung sounds, chest rise)
post-intubation management (maintain sedation/oxygen)

PARAMEDIC SCHOOL (74 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions