Chapter 18 Flashcards
Six Rights of Medication Administration
- Right Patient
- Right Medication
- Right Dose
- Right Time
- Right Route
- Right Documentation
TRAMP-ED
Rights of Medication Administration
- T = Time
- R = Route
- A = Amount (Dose)
- M = Medication
- P = Patient
- E = Expiration
- D = Documentation
Routes of Administration (ROAs)
- Oral (PO)
- Buccal
- Sublingual (SL)
- Inhalation
- Intranasal (IN)
- Intraosseous (IO)
- Intramuscular (IM)
- Subcutaneous (SubQ)
- Intravenous (IV)
- Endotracheal (ET)
Pharmacodynamics (PD)
The study of the effects of medications on the body.
Pharmacokinetics (PK)
The study of the absorption and elimination of medications into/from the body.
Pharmacokinetics is extremely patient-specific.
Administered Medications
- Aspirin
- Oxygen
- Narcan
- Activated Charcoal (Anti-Char)
- Oral Glucose
- Epi-Pen
- Albuterol
Assisted Medications
- Nitroglycerin (Nitro)
- Inhaler
- Epi-Pen
Aspirin
- Dose: 324mg
- MOA: Anticoagulant
- Route: Oral
Adequate Breathing
- Adults: 12–20
- Children: 15–30
- Infants: 25–50
Units = Breaths/Minute
Adequate Artificial Ventilation
- Adults: 10–12
- Children/Infants: 12–20
Units = Ventilations/Minute
Indications for C-PAP
- Pulse Oximetry = < 90%
- Respiration Rate = > 25
- Use of Accessory Muscles for Respirations
Indications/Containdications of Aspirin
Indications:
* Cardiac-Associated Chest Pain
Contraindications:
* Asthma
* Recent Trauma
* Gastrointestinal Bleeding
* Noncardiac-Associated Chest Pain
Oral Glucose
- Dose = 15 g
- MOA = Increase Blood Sugar Level
- Route = Buccal
Indications/Contraindications of Oral Glucose
Indications:
* Altered Mental Status (AMS)
* History of Diabetes
* Suspected Hypoglycemia
Contraindications:
* Inability to Follow Simple Commands
* Inability to Protect Airway
Oxygen
- Dose = 12–15 LPM (Non-Rebreather) or 2–6 LPM (Nasal Cannula)
- MOA = Provides High Oxygen Concentration to Inhaled Air
- Route = Inhalation
Unit = LPM = Liters/Minute
Indications/Contraindications of Oxygen
Indications:
* Respiratory Distress
* Suspected Shock
Contraindications:
* NONE for Emergency Use
Activated Charcoal (AntiChar)
- Dose = 25–50 g (Adult) or 12.5–25 g (Pediatric)
- MOA = Binds to Ingested (Toxic) Particulates
- Route = Oral
- The dose of Activated Charcoal should be roughly 1 gram per 1 kilogram of the patient.
- Medical Command must be contacted prior to administration of AntiChar.
Indications/Contraindications of Activated Charcoal
Indications:
* Ingestion of Toxin/Poison
Contraindications:
* Inability to Swallow
* Inability to Follow Simple Commands
* Inability to Protect Airway
* Ingestion of Caustic Substance
* Non-Ingestion Exposure to Toxin/Poison
Albuterol (Brochnodilator Inhaler)
- Dose = 2 Puffs (Inhaler) or 2.5 mg (Albuterol)
- MOA = Causes Brochodilation
- Route = Inhalation
Indications/Contraindications of Albuterol
Indications:
* Respiratory Distress
* Signs of Bronchoconstriction (e.g. Wheezing)
Contraindications:
* Respiratory Distress not Caused by Bronchoconstriction
Nitroglycerin
- Dose = 0.4 mg (1 Spray)
- MOA = Dilates Coronary Arteries
- Route = Sublingual
- Dilation of coronary arteries functions to reduce the workload of the heart (and thus reduce the body’s O2 demand).
- Medical Command must be contacted for additional doses of Nitroglycerin.
Indications/Contraindications of Nitroglycerin
Indications:
* Cardiac-Associated Chest Pain
Contraindications:
* Noncardiac-Associated Chest Pain
* Recent ED Drug Use (Within 48–72 Hours)
* Systolic BP = < 100
* Recent Intake of Nitroglycerin
ED = Erectile Dysfunction
Naloxone (Narcan)
- Dose = 2.0 mg
- MOA = Reverses Effects of Narcotics
- Route = Intranasal
Effects of narcotics include depressed level of consciousness and respiratory depression.
Indications/Contraindications of Naloxone (Narcan)
Indications:
* Suspected Narcotic (Opoid) Overdose
* Coma-Like State (with Unknown Cause)
Contraindications:
* Patient is Breathing Adequately
* Patient is Able to Maintain Airway
Narcan is used to regain the patient’s adequate respiratory effort ONLY.
Epinephrine Auto-Injectors
- Dose = 0.3 mg (Adults) or 0.15 mg (Pediatrics)
- MOA = Sympathetic Activation; Bronchodilation; Vasodilation
- Route = Intramuscular (IM)
Medical Command must be contacted for additional doses of Epinephrine.
Indications/Contraindications of Epinephrine
Indications:
* Severe Allergic Reaction
* Signs of Altered Mental Status
* Signs of Respiratory Compromise
Contraindications:
* Mild Allergic Reaction
* NONE in Emergency Scenarios
Metformin
Antihyperglycemic
(Anti-Diabetic Medication)
Hydrochlorothiazide (HCTZ)
Antihypertensive (Diuretic)
“Water Pill”
HCTZ is used to treat high blood pressure and fluid retention.
Lisinopril
Antihypertensive
Lisinopril is used to treat high blood pressure and heart failure.
Amlodipine
Antihypertensive
Amlodipine is used to treat high blood pressure and chest pain.
Omeprazol
Proton-Pump Inhibtor (Akin to Antacid)
Omeprazol is used to treat heartburn, stomach ulcers, and GERD (gastroesophogeal reflux disease).
Simvastatin
Lowers LDL Levels in Blood
Simvastatin is used to treat high cholesterol and high triglyceride levels.
