Ch13 Flashcards
What are the three types of medication names?
Chemical name, Generic name, Brand name
What does ‘tall man’ lettering help prevent?
Medication errors due to look-alike/sound-alike drug names
What legislation created drug schedules in the U.S.?
The Controlled Substances Act of 1970
Which drugs fall under Schedule I?
Drugs with high abuse potential and no accepted medical use (e.g., heroin)
What organization enforces the Controlled Substances Act?
The DEA (Drug Enforcement Administration)
What are the four phases of pharmacokinetics?
Absorption, Distribution, Metabolism, Elimination
What is pharmacodynamics?
The effect a drug has on the body
What is pharmacokinetics?
How the body affects a drug (movement through the body)
What is an agonist drug?
A drug that binds to and activates a receptor
What is an antagonist drug?
A drug that binds to a receptor but blocks activation
What is bioavailability?
The percentage of unchanged drug that reaches systemic circulation
What is half-life?
Time required for the concentration of a drug to be reduced by 50%
Which route of administration has 100% bioavailability?
Intravenous (IV)
Why is oral administration less reliable in emergencies?
Because of delayed onset and first-pass metabolism in the liver
What is the advantage of the intranasal route?
Rapid absorption and no risk of needle stick injury
What is an idiosyncratic drug reaction?
An unpredictable, abnormal reaction not related to dose
What is anaphylaxis?
A severe, life-threatening allergic reaction
What is the placebo effect?
A perceived benefit from an inactive substance
What is tachyphylaxis?
Rapid development of drug tolerance after repeated doses
What does ‘just culture’ encourage?
Reporting of medication errors to improve patient safety
What are sympathomimetic drugs?
Drugs that mimic the effects of the sympathetic nervous system
What does a beta-2 agonist do?
Causes bronchodilation (e.g., albuterol)
What does an alpha-1 agonist do?
Causes vasoconstriction
What is the function of atropine?
Parasympathetic blocker used to treat bradycardia
What is ketamine used for in EMS?
Inducing sedation and dissociation for airway management
What is the primary use of albuterol?
Treating bronchospasm in asthma or COPD
What class is amiodarone?
Class III antiarrhythmic
What is adenosine used for?
Treating paroxysmal supraventricular tachycardia (PSVT)
What is the P-450 system?
A liver enzyme system responsible for drug metabolism
What is the therapeutic index?
Ratio between a drug’s effective dose and lethal dose
What did the Pure Food and Drug Act of 1906 do?
Prohibited altering or mislabeling medications.
What is the role of the FDA in medication regulation?
Approves new drugs and removes unsafe ones from the market.
What is off-label use of a drug?
Using a drug for a purpose, dose, or route not approved by the FDA.
What does first-pass metabolism refer to?
The liver’s metabolism of orally administered drugs before reaching systemic circulation.
What factors affect drug absorption?
Route of administration, drug formulation, blood flow, and GI function.
What is the volume of distribution?
A measure of how extensively a drug spreads through body tissues.
What is plasma protein binding?
Temporary attachment of drug molecules to blood proteins, affecting distribution.
Which organ is primarily responsible for drug elimination?
The kidneys.
What is zero-order elimination?
A fixed amount of drug is eliminated over time regardless of concentration.
What is first-order elimination?
A constant proportion of the drug is eliminated per unit time.
What is a receptor site?
A protein on a cell where drugs bind to produce effects.
What happens when all receptor sites are occupied?
Maximum drug effect is reached; no further increase in effect.
What is a partial agonist?
Binds to receptors but produces less effect than a full agonist.
How does age affect medication dosing?
Infants and elderly may metabolize drugs slower; dosing may need adjustment.
How does obesity affect lipophilic drugs?
These drugs may be stored in fat, prolonging their effect.
How does pregnancy affect drug pharmacokinetics?
Increases in plasma volume, renal clearance, and altered metabolism.
What are paradoxical reactions?
Unexpected effects opposite to the intended action of a drug.
What are common adverse effects?
Nausea, vomiting, dizziness, sedation, respiratory depression.
What is the definition of an adverse drug reaction?
An undesired, harmful effect resulting from a medication.
What is drug tolerance?
A reduced response to a drug after repeated use.
What is cross-tolerance?
Tolerance to one drug causing tolerance to another drug in the same class.
What are drug-drug interactions?
Effects caused when one drug alters the action of another.
What is the concern with incompatible IV drugs?
They may precipitate, deactivate, or cause harmful reactions.
What are the requirements for storing controlled substances?
Locked storage, inventory tracking, and disposal documentation.
How should medications be stored in EMS vehicles?
Protected from light, heat, cold, and physical damage.
What is the intraosseous route?
Injection into bone marrow; used when IV access is not available.
What is sublingual administration?
Placement under the tongue for absorption into bloodstream.
What is a transdermal patch?
A medicated adhesive patch for continuous drug delivery through the skin.
What is rectal administration used for?
Patients who are unconscious, vomiting, or seizing.
What do beta-1 receptors primarily affect?
Heart rate, force, and automaticity.
What do alpha receptors cause when stimulated?
Vasoconstriction.
What does propranolol do?
Blocks beta receptors, reducing heart rate and blood pressure.
What is etomidate used for?
Short-acting sedative for rapid sequence intubation.
What are the effects of ketamine?
Dissociation, increased BP, bronchodilation, possible hallucinations.
What do benzodiazepines do?
Sedate, reduce anxiety, stop seizures.
What is succinylcholine?
A depolarizing paralytic that causes short-term paralysis.
What is rocuronium?
A non-depolarizing paralytic with longer duration than succinylcholine.
What does ipratropium do?
Anticholinergic bronchodilator that decreases mucus secretion.
What do corticosteroids do?
Reduce inflammation in asthma, COPD, and allergic reactions.
What are leukotriene receptor antagonists used for?
Chronic treatment of asthma and allergies.
What class is lidocaine and what does it treat?
Class I antiarrhythmic; treats ventricular dysrhythmias.
What is the action of metoprolol?
Beta-1 blocker; slows heart rate and reduces blood pressure.
What is the use of amiodarone?
Treats atrial and ventricular arrhythmias.
What does diltiazem treat?
Atrial fibrillation and flutter by slowing conduction through the AV node.
What is the use of nitroglycerin?
Vasodilator for chest pain, reduces preload and myocardial oxygen demand.
What are ACE inhibitors used for?
Hypertension, heart failure, post-MI care.
What is the major risk with ACE inhibitors?
Angioedema and chronic cough.
What is atropine used for in bradycardia?
Blocks vagal effects, increasing heart rate.
What is dopamine used for?
Increases cardiac output and blood pressure depending on dose.
What is pharmacodynamics?
The study of how a medication alters body function or processes.
What is pharmacokinetics?
The study of what the body does to a drug: absorption, distribution, metabolism, elimination.
What does affinity refer to in pharmacology?
A medication’s ability to bind with a receptor site.
What is potency?
The concentration of a drug required to initiate a cellular response.
What is efficacy?
The ability of a drug to produce a desired therapeutic effect.
What do competitive antagonists do?
Temporarily bind to receptor sites and displace agonist chemicals.
What do noncompetitive antagonists do?
Permanently bind to receptor sites and prevent activation.
What are partial agonists?
Drugs that bind to receptors and cause less activity than full agonists.
What is the AHA Classification for medications?
Class I (strong evidence) to Class III (harm); guides clinical use.
What is therapeutic index?
The ratio between a drug’s effective dose and lethal dose.
How does age affect drug dosing?
Infants and elderly metabolize drugs differently, requiring titration.
What is the P-450 system?
A liver enzyme system involved in drug metabolism.
What is the bioavailability of the intravenous route?
1
What route is preferred if the patient is unresponsive or vomiting?
Rectal administration.
What is the concern with endotracheal drug administration?
Unreliable absorption; requires 2-2.5x IV dose.
What is etomidate used for?
A sedative used for rapid sequence intubation; minimal BP effect.
What is ketamine’s benefit in airway management?
Provides dissociation and bronchodilation while preserving BP.
What class are benzodiazepines and their use?
Sedative, anxiolytic, antiseizure drugs used for seizures and sedation.
What is succinylcholine?
A depolarizing paralytic used for rapid sequence intubation.
What are rocuronium and vecuronium?
Non-depolarizing paralytics that compete with ACh.
What is albuterol?
A selective beta-2 agonist used for bronchospasm.
What is ipratropium bromide?
An anticholinergic that causes bronchodilation and reduces mucus.
What do corticosteroids do in respiratory care?
Reduce airway inflammation and improve oxygenation.
What are leukotriene receptor antagonists used for?
Long-term asthma and allergy management.
What is the function of Class I antidysrhythmic drugs?
Block sodium channels to reduce ventricular arrhythmias.
What is metoprolol used for?
A beta-1 blocker to reduce HR during myocardial ischemia.
What is amiodarone used for?
A Class III drug for atrial and ventricular tachycardias.
What is adenosine used for?
To slow AV conduction and convert supraventricular tachycardias.
What does atropine treat?
Bradycardia due to vagal stimulation.
What does epinephrine stimulate?
Alpha, beta-1, and beta-2 receptors to increase cardiac output.
What is norepinephrine used for?
Severe hypotension; stimulates alpha and beta-1 receptors.
What is dopamine’s role in EMS?
Increases BP and CO depending on dose.
What is furosemide used for?
A loop diuretic used to treat CHF and fluid overload.
What does mannitol treat?
Cerebral edema by drawing water out of tissues.
What does magnesium sulfate treat?
Eclampsia seizures, torsades de pointes, and electrolyte imbalance.
What is sodium bicarbonate used for?
Raises blood pH in acidosis or hyperkalemia.
What are packed red blood cells used for?
To treat anemia or blood loss.
What is the purpose of fresh frozen plasma?
Provides clotting factors in massive transfusions.
What is tranexamic acid (TXA)?
A clot-preserving drug given in severe trauma within 3 hours.
What is naloxone used for?
Reverses opioid overdose effects.
What are opioids like morphine and fentanyl used for?
Pain relief; risk of respiratory depression.
What are side effects of opioids?
Respiratory depression, nausea, bradycardia, hypotension.
What is ondansetron used for?
An antiemetic that blocks 5-HT3 receptors.
What is metoclopramide’s action?
Increases GI motility and promotes gastric emptying.
What are H2 blockers like famotidine used for?
Reduce stomach acid by blocking histamine receptors.
What does acetaminophen treat?
Fever and mild pain.
What is thiamine used for?
Prevents Wernicke’s encephalopathy in malnourished or alcoholic patients.
What is ketorolac used for?
A non-opioid NSAID for moderate to severe pain.
