Ch 11 Principles Flashcards
What is the USP?
United States Pharmacopeia
pharmacodynamics is…
The Mechanism of Action, intended effects, and results of medication administration.
untoward effect
A negative side-effect.
enteral
Through the GI tract
parenteral
Routes other than GI, including:
- percutaneous: IM, IV, IO, SubQ (SC)
- transmucosal: buccal, sublingual, intranasal
Medication Routes from Fastest to Slowest
IV/IO Transmucosal IM SubQ Rectal TD [?] Oral
Major forms drugs come in
solid
liquid
semisolid / gel
gas
DEA Schedule I drugs
1) Highly addictive, with
2) High potential for abuse, and
2) NO ACCEPTED MEDICAL USE
e.g. heroin, LSD, mescaline, cannabis
DEA Schedule II drugs
1) Highly addictive, with
2) High potential for abuse, BUT
2) WITH ACCEPTED MEDICAL USE
e.g. morphine, cocaine, codeine
DEA Schedule III-V drugs
Progressively become less addictive, less potential for abuse. All have medical use.
FDA Pregnancy Category A
No identified risks.
FDA Pregnancy Category B
Animal studies show risks.
Human studies inadequate.
FDA Pregnancy Category C
Animal studies show adverse reactions.
Human studies inadequate.
FDA Pregnancy Category D
Studies show risks to fetus.
In some situations, benefits > risks.
FDA Pregnancy Category X
Studies show risks to fetus.
In all situations, risks > benefits.
teratogenic
causing harm to the fetus
Medication volume formula
Vol on Hand
VOL = ———————– * Desired Dose
Dose on Hand
Medical Profile includes…
name classification mechanism of action indications pharmacokinetics side effects route contraindication dose how supplied
pharmacokinetics
How a drug is absorbed, distributed, and eliminated from the body.
indications
Conditions that indicate the drug should be administered.
contraindications
Conditions that indicate the drug may be harmful to administer.
Pure Food and Drug Act of 1906 required…
proper labelling
Harrison Narcotic Act of 1914….
Addressed opium and cocaine
Regulations on import, mfg, sale, use
Penalties for violations
Food, Drug, and Cosmetic Act of 1938…
- Formed the FDA
- Mandated dispensation with prescription, if harmful or addictive.
- Required labeling of addictive drugs
- Required labeling of side effects
- Revised in 1952 and 1962
Durham-Humphrey Amendments of 1951…
- Required written or verbal prescription for certain meds.
- Defined the OTC category.
Comprehensive Drug Abuse Prevention and Control Act of 1970…
- AKA the Controlled Substances Act
- Created the 5 Schedules
prescription drugs can be used by EMS personnel because…
They are prescribed by the medical director (in protocols). But prescribed based on your assessment.
Phase I drug trials address…
- safe dose
- absorption
- elimination
Phase II drug trials…
- needed dose to treat
- use patients with the indicated condition
Phase III drug trials…
- large sample size
Phase IV drug trials…
- compare to other drugs on the market
The 4 drugs names are…
1) Trade
2) Chemical
3) Generic
4) Official
Types of Liquid meds include…
- solutions
- suspensions
- tinctures: alcohol extraction, usually topical
- spirits: solutions in alcohol for oral route
- elixirs: mixed with sweeters & flavorings
- syrups: thick, sweet elixirs
- emulsions: combination of 2 insolubles using emulsifier. oil and water components.
Types of semisolid meds include…
- patches: TD route
- lotion: most water = absorbed fastest
- cream: middle in speed, less water
- ointment: slower, less water
Drugs Classification is based on…
- MOA
- target tissue
- how it treats
- body system affected
adrenergic receptors are found in the…
sympathetic nervous system
adrenergic neurotransmitters
epinephrine & norepinephrine
adrenergic receptor types
α1 : peripheral vasoconstriction
α2 : peripheral vasodilation
β1 : increased hr, automaticity, contractility, conductivity
β2 : broncodilation, vasoconstriction
cholinergic receptors are found in the….
parasympathetic nervous system
parasympathetic neurotransmitter
acetylcholine
parasympathetic receptors cause…
- lower HR, BP
- constricted pupils
- higher GI system activity
sympathomimetics
≡ adrenergic agonists
mimic effects of sympathetic nervous system
sympatholytics
inhibit sympathetic n.s.
parasympathomimetics
≡ cholinergics
≡ parasympathetic agonists
direct-acting cholinergics
MOA
stimulate ACh receptors directly
indirect-acting cholinergics
MOA
affect acetylcholinesterase (which breaks down ACh in the synapse) prolonging cholinergic effects
parasympatholytics
MOA
blocks ACh at receptor site
prototypical med = atropine
analgesics
reduce pain
opioid agonist-antagonist
- acts as both
- reduces pain w/o side effects of resp. & CNS depression
NO (nitrous oxide) class
analgesic (non-opioid)
non-opioid analgesics
- not derived from opium.
- some OTC
- NO
- NSAIDS
NSAIDs
Non-steroidal anti-inflammatory drugs
e.g. ibuprofen, salicylates, acetaminophen
barbiturates
- sedative
- MOA: increase affinity between GABA & its receptors
GABA
gamma-aminobutyric acid
benzodiazepines
- most commonly prescribed sedatives
- act on GABA, similar to barbiturates
nonbarbiturate hypnotics
- MOA similar to barbs & benzos
- fewer side effects
- e.g. Ambien (zolpidem)
stimulants…
- Either increase excitatory neurotransmitter activity
- or decrease release of inhibitory neurotransmitters
- decreasing fatigue and increasing awareness
- side effects: tachycardia, HTN, seizures
- e.g. caffeine, cocaine, meth
depressants
- slow CNS activity
- treat anxiety, muscle tension, stress, pain, insomnia
- e.g. bezos, barbs, narcotics
3 common benzos
diazepam
alprazolam
midazolam
anticonvulsants
- treat seizures or epilepsy
- thought to inhibit influx of Na into cells, decreasing ability to polarize
