Ch.12 Principals Of Pharmacology Flashcards
Is the science of drugs, including their ingredients, preparation, uses, and actions on the body
Pharmacology
A __ is a substance that is used to treat or prevent disease or relieve pain
Medication
The study of the properties and effects of medications
Pharmacology
Is the process by which a medication works on the body
Pharmacodynamics
Different types of__ are located throughout the body.___ are sites on cells where medications or chemicals produced in the body can bind and produce an effect. When medications are given, they bind to these sites and either stimulate the__ to produce an effect or block the__ to prevent other chemicals or medications from binding. Thus, a medication can either increase or decrease a normal function of the body.
receptors
A medication that causes stimulation of receptors is called an
Agonist
A medication that binds to a receptor and blocks other medications it chemicals from attaching is called an __, or blocker
Antagonist
A medication used to treat infections caused by a bacterium
Antibiotic
A medication used to treat infections caused by a fungus
Antifungal
The amount of medication given on the basis of the patients size and age
Dose
The therapeutic effect of a medication on the body
Action
The desired or intended effect a medication is expected to have on the body
Therapeutic effect
The processes that the body performs on a medication, including how it is absorbed , distributed , possibly changed, and eliminated
Pharmacokinetics
Pharmacokinetic properties for a medication include the following
Onset of action. Time from medication administration until clinical effects occur.
• Duration. Length of time that clinical effects persist.
• Elimination. How medications or chemicals are removed from the body.
• Peak. The point or period when the maximum clinical effect is achieved. For EMS providers, these times become particularly important when treating pain with opioid medications or managing an opioid overdose with naloxone (Narcan).
Time from medication administration until clinical effects occur
Onset of action
Length of time that clinical effects persist
Duration
How medications or chemicals are removed from the body
Elimination
The point or period when the maximum clinical effect is achieved. For Ems providers , these times become particularly important when treating pain with opiod medications or managing an opioid overdose with naloxone(narcan)
Peak
Many medications are transformed by the liver and/or eliminated by the kidneys. Patients with liver or kidney disease will have altered ___ of many medications compared to healthy individuals
Pharmacokinetics
___, ___, and __ can profoundly alter both the pharmacodynamics and the pharmacokinetics of medications administered by prehospital providers
Shock states, altered vital signs, and medication interactions
__are the reasons or conditions for which a particular medication is given. For example, nitroglycerin relaxes the walls of all blood vessels, both veins and arteries. This increases the blood flow and the supply of oxygen to the heart muscle. In this way, nitroglycerin may relieve the discomfort that can occur with the cardiac condition called angina.
Therefore, nitroglycerin is indicated for chest pain associated with angina
Indications
The therapeutic uses for a specific medication
Indications
There are times when you should not give a medication, even if it usually is indicated for the persons condition. Such situations are called __.
Contraindications
A medication is __ when it would harm the patient or have no positive effect on the patients conditions
Contraindicated
Are any actions of a medication other than the desired ones. Can occur when the medications are administered correctly.
Adverse effects
Any unwanted clinical results of a medication
Adverse effects
There are two types of adverse effects: __ and __
Unintended effects and untoward effects
Are undesirable but pose little risk to the patient, such as a slight headache after taking nitroglycerin
Unintended effects
Can be harmful to the patient, such as hypotension after taking nitroglycerin
Untoward effects
Actions that are undesirable but pose little risk to the patient
Unintended effects
The __ name is a simple, clear, nonproprietary name. The __ name is not capitalized .
The generic name
The generic name is approved by the
Us food and drug administration (FDA) for new drugs
The __ regulates drug safety and effectiveness in the united states
FDA
The ___ act of 1938 gives the FDA authority to enforce drug safety standards
The federal food, drug, and Cosmetic Act of 1938
A __ name is the brand name that a manufacturer gives to a medication. As a proper noun, a __ name begins with a capital letter
Trade name
The original chemical name of a medication (in contrast to one of its proprietary or trade names); the name is not capitalized
Generic name
Medications that are distributed to patients only by pharmacists according to a physicians order
Prescription medications
Medications that may be purchased directly by a patient without a prescription
Otc medications
Is the process by which medications travel through body tissues until they reach the bloodstream
Absorption
Under the tongue ; a medication delivery route. Absorption rate is rapid
Sublingual (SL)
Through the rectum; a medication delivery route. Absorption rate is rapid
Per rectum (PR)
Through the mouth; a medication delivery route; same as oral. Absorption rate is slow
By mouth (PO)
An injection directly into a vein; a medication delivery route. Absorption rate is
Intravenous (IV) injection
An injection into the bone; a medication delivery route. Absorption rate is
Intraosseous (IO) injection
An injection into a muscle; a medication delivery route. Absorption rate is
Intramuscular (IM) route
A delivery route in which a medication is pushed through a specialized atomizer device called a mucosal atomizer device (MAD) into the nairs
Intranasal (IN)
Injection into the fatty tissue between the skin and muscle; a medication delivery route
Subcutaneous injection
Through the skin; medication delivery route
Transcutaneous (transdermal)
List enteral medications routes
Sublingual (SL)
Per rectum (PR)
By mouth (PO)
List parenteral medications routes
Intravenous (IV)
Intraosseous (IO)
Inhalation
Intranasal (IN)
Intramuscular (IM)
Subcutaneous
Transcutaneous
__ are gelatin shells filled with powdered or liquid medication. If the__ contains liquid, the shell is sealed and usually soft. If the __ contains powder, the shell can usually be pulled apart
Capsules
__often contain other materials that are mixed with the medication. Some _ are designed to dissolve quickly in small amounts if liquid so that they can be given sublingually(under the tongue) and absorbed rapidly
Tablets
A _ is a liquid mixture of one or more substances that cannot be separated by filtering or allowing the mixture to stand. _ can be given by almost any route. Specially prepared _ can be given as an IV, IM, or subcutaneous injection
Solution
Many substances do not dissolve well in liquids. Some of these can be ground into fine particles and evenly distributed throughout a liquid by shaking or stirring. This type of mixture is called a __.
Suspension
__ separate if they stand or are filtered. It is important that you shake it swirl a __ before administering it to ensure that the patient receives the right amount of medication
Suspensions
A___ is a miniature spray canister used to direct such substances through the mouth and into the lungs (FIGURE 12-2) and is often used by a patient with a respiratory illness such as asthma or emphysema. An__ delivers the same amount of medication each time it is used. Because an inhaled medication usually is suspended in a propellant, the__ must be shaken vigorously before the medication is administered.
metered-dose inhaler (MDI)
Lotions, creams, and ointments are_; that is, they are applied to the surface of the skin and affect only that area. Lotions contain the most water, and ointments contain the least. Lotions (such as calamine lotion) are absorbed the most rapidly, and ointments (such as triple antibiotic ointment [Neosporin]) the most slowly.
topical medications
___ medications are designed to be absorbed through the skin, or transcuraneously
Transdermal
In contrast to most topical medicines, which work directly on the application site, __ medications are usually intended for systemic (whole-body) effects. A note of caution: if you touch such a medication with your bare skin while administering it, you will absorb it just as readily as the patient will
Transdermal
A__ is a semiliquid substance that is administered orally in capsule form or through plastic tubes.__ usually have the consistency of pastes or creams but are transparent (clear). “Gelatinous” means thick and sticky, like gelatin.
Gel
__medications are neither solid nor liquid. The medication most commonly used in__ form is oxygen. You might not think of oxygen as a medication; however, in its concentrated form, it is a potent medication that has systemic effects.
Gaseous
The rights of medication administration
Right patient
Right medication and indication
Right dose
Right route
Right time
Right education
Right to refuse
Right response and evaluation
Right documentation
When administering or assisting with the administration of patient medications, you must have an order from __ to do so
Medical control
Using a __ procedure that verifies you are giving the right drug to the right patient at the right dose has been found to reduce medication errors
Verbal cross-check procedure(say what medication you are giving out loud and let ur teammate respond to it to make sure its correct)
In___ medication administration, you are administering medication to yourself or your partner. At times it may be necessary for an EMS crew to receive medications because they were exposed to a toxic nerve agent, such as during a terrorism incident. In this case, you would first treat yourself and then your partner. Typically, nerve agent antidotes are administered via an auto-injector.
peer-assisted medication
In__ medication administration, you are assisting the patient with the administration of his or her own medication, such as an EpiPen, an MD bronchodilator, or nitroglycerin. Perhaps the patient cannot find his or her medication. Maybe the patient is so upset that he or she cannot open the pill bottle or hold the MDI steady. In this circumstance, the patient is trying to administer the medication, but you need to offer some help so the task can be completed
patient-assisted medication
The last circumstance is__ medications. Here you are directly administering the medication to the patient.
EMT-administered medications
Doses of medications are usually decreased for infants and children because they have smaller bodies, and in some cases, process the drugs differently. Medications for infants and children are typically ordered based on their weight in kilograms. To safely administer medications to infants and children, EMS providers must be able to accurately determine (or estimate) a patient’s weight in kilograms. It might be necessary to convert from pounds to kilograms, by dividing the number of pounds by 2.2. For example, 22 pounds divided by 2.2 equals 10 kg. A__ tape, such as a Broselow tape, is a viable alternative if no scale is available, and the child’s caregiver cannot confidently recall a recent measured weight
length-based resuscitation tape
A tape used to estimate an infant’s or child’s weight on the basis of body length; appropriate drug doses and equipment sizes are listed on the tape.
Length based resuscitation tape
The__ that is carried in the EMS unit, as well as glucose tablets, can counteract the effects of hypoglycemia in the same way as a caloric beverage such as juice or a non-diet soda, but faster. This is because common table sugar (sucrose) and fruit sugars (fructose) are complex sugars and must be broken down before they can be absorbed. Glucose is a simple sugar that is readily absorbed by the bloodstream.
oral glucose
The medical term for an extremely low blood glucose level is_.__ can be caused by an excess of insulin, which is taken to control blood glucose levels. Patients with diabetes who use insulin regularly. usually understand the effects of this medication on the body.
hypoglycemia
A medication that is an antipyretic(reduces fever), analgesic (reduces pain), anti-inflammatory(reduces inflammation ), and a potent inhibitor of platelet aggregation(clumping)
Acetylsalicylic acid (asprin)
__is an antipyretic (reduces fever), analgesic (reduces pain), and anti-inflammatory (reduces inflammation) medication that inhibits platelet aggregation (clumping). This last property makes it one of the most used medications today. Research has shown that the aggregation of platelets in the coronary arteries under certain conditions is one of the direct causes of heart attack. Patients at risk for coronary artery disease are often prescribed one or two “baby” (children’s) aspirins per day. During a potential heart attack, aspirin may be life-saving.
Contraindications for aspirin include documented hypersensitivity to aspirin (absolute), preexisting liver damage
(absolute), bleeding disorders (relative), and asthma (relative). Because of the association of aspirin with Reve syndrome (a rare but serious condition that causes swelling in the brain and liver), it should not be given to children.
Aspirin (acetylsalicylic acid or ASA)
Many patients with cardiac conditions carry some form of fast-acting__ to relieve the pain of angina
__has been used medically since the 1800s.__ is typically the only medication that you will help to administer sublingually
nitroglycerin
If you have ever run for a prolonged period, you probably remember your muscles developed a painful, heavy. burning sensation. This is because the demand for oxygen by the muscles exceeded the supply. When a similar pain develops in heart muscle, it is called_. The cause is the same-not enough oxygen. In this case the pain is due to a blockage or narrowing in the blood vessels that supply the heart. Occasionally, the cause is a spasm in these blood vessels. Unlike a runner with sore legs, the heart muscle cannot stop and rest until the pain goes away.
The purpose of nitroglycerin is to increase blood flow by relieving the spasms or causing the arteries to dilate. It does this by relaxing the muscular walls of the coronary arteries and veins. Nitroglycerin also relaxes veins throughout the body, so less blood is returned to the heart and the heart does not have to work as hard each time it contracts. In short, blood pressure is decreased. Because of this, it is important that you always take the patient’s blood pressure before administering nitroglycerin. If the systolic blood pressure is less than 100 mm Hg, the nitroglycerin may have the harmful effect of lowering the blood flow to the heart’s own blood vessels. Even a patient who has adequate blood pressure should sit or lie down with the head elevated before taking this medication. If the patient is standing, he or she may faint when blood flow to the brain is reduced as the nitroglycerin starts to work. If a significant decrease in the patient’s blood pressure (15 to 20 mm Hg) occurs and the patient suddenly feels dizzy or sick, have the patient lie down.
angina pectoris
Transient (short-lived) chest discomfort caused by partial or temporary blockage of blood flow to the heart muscle; also called angina
Angina pectoris
__ has the following effects :
Relaxes the muscular walls of coronary arteries and veins
• Results in less blood returning to the heart
• Decreases blood pressure
• Relaxes arteries throughout the body.
Often causes a mild headache and/or burning under the tongue after administration
Nitroglycerin
The__ route of administration provides quick and easy access to the circulatory system without the need for placing a needle within a vein. Blood flow to the muscles is relatively stable, even during circumstances of severe illness or injury. This advantage makes the__ route an efficient means to deliver some medications. Al disadvantage for this route is the use of a needle and the subsequent pain it can cause. Patients may be reluctant for you to use the needle for fear of pain or injury. With proper technique, you can administer medications via the__ route and limit the amount of pain delivered to the patient.
intramuscular (IM)
__is the main hormone that controls the body’s fight-or-flight response and is the primary medication that you will be administering intramuscularly.
Epinephrine
__is a sympathomimetic. A sympathomimetic mimics the effect of the sympathetic nervous system. The body releases epinephrine when there is sudden stress, such as during exercise or when the patient is suddenly scared.
Epinephrine
Because epinephrine is secreted by the_, it is also known as adrenaline. Epinephrine has different effects on different body tissues and is used as a medication in several forms.
Generally, epinephrine will increase the heart rate and blood pressure and dilate passages in the lungs. It can ease breathing problems caused by the bronchiäl spasms common in asthma and allergic reactiöns. In a person who is close to anaphylactic shock as a result of an allergic reaction, epinephrine may also help to maintain the patient’s blood pressure. However, epinephrine is not indicated for patients who do not show signs of airway obstruction or wheezing due to an allergic reaction. In addition, this medication should not be given to patients with hypertension or hypothermia, or if you believe the patient may be experiencing an Mi.
adrenal glands
___has the following characteristics:
• Secreted naturally by the adrenal glands
• Dilates passages in the lungs
• Constricts blood vessels, causing increased blood pressure
• Increases heart rate and blood pressure
Epinephrine
A medication that increases heart rate and blood pressure but also eases breathing problems by decreasing muscle tone of the bronchiole tree; a substance produced by the body (commonly called adrenaline), and a drug produced by pharmaceutical companies that increases pulse rate and blood pressure;the drug of choice for an anaphylactic reaction
Epinephrine
In certain patients, insect venom or other allergens cause the body to over-release histamine, which lowers blood pressure by relaxing the small blood vessels and allowing them to leak. The over-release of histamine may also cause wheezing from bronchial spasms and swelling of the airway tissues (edema), which make it difficult for the patient to breathe.__ acts as a specific antidote to reverse the effects of histamines, countering both of the harmful effects. It constricts the blood vessels, allowing blood pressure to rise and reducing the swelling. In the lungs, it has the opposite effect: It dilates the air passages, so the flow of air is less restricted.
Epinephrine
A miniature spray canister used to direct medications through the mouth and into the lungs
MDI
__are used to administer liquid medications that have been turned into a fine mist by a flow of air or oxygen (FIGURE 12-10). Respiratory illness can be spread through SVNs. When the medication is atomized, it is breathed into the lungs and delivered to the alveoli. Blood flow to the alveoli is very high and absorption rates are close to those found with IV medications. This route is fast and relatively easy to access. MDis are commonly used because of their convenience and portability. The major disadvantage of an MDI is that the patient needs to be cooperative and control his or her breathing. If the patient is unconscious, an MDI cannot be used, although you could use a nebulizer. Nebulizers are often used for more severe problems.
MDIs and small-volume nebulizers (SVNs)
The use of multiple medications on a regular basis
Polypharmacy
__ medications such as aspirin decrease the ability of blood platelets to aggregate (stick together)
Antiplatelet
A medication that impairs the ability of blood to clot
Anticoagulant
A__ is inappropriate use of a medication that could lead to patient harm. For example, this could include incorrect communication of a dose or administration of an incorrect dose, An estimated 1.5 million people in the United States are harmed each year due to__ in hospitals, extended care facilities, and outpatient clinics.
medication error
