Chapter 18 | General Pharmacology Flashcards
• Which medications may be carried by the EMT • Which medications the EMT may help administer to patients • What to consider when administering any medication • The role of medical direction in medication administration • How the EMT may assist with IV therapy
1
Q
List:
names for medications
3 points
A
- chemical name
- generic name
- brand/trade name
2
Q
List:
things to know about administering medications
4 points
A
- indications
- contraindications
- side effects
- untoward/adverse effects
3
Q
Define:
indications
A
reasons for applying specific treatment
4
Q
Define:
contraindications
A
reasons for not applying specific treatment
5
Q
List:
the six rights
(and purpose)
A
- right patient
- right medication
- right dose
- right time
- right route
- right documentation
(checklist before administering medication)
6
Q
Fill in the blank:
The six rights are used to make sure a medical provider is [BLANK].
A
The six rights are used to make sure a medical provider is administering medication properly.
7
Q
Define:
TRAMP-ED
(and what it’s used for)
A
- time
- route
- amount
- medication
- patient
- expiration
- documentation
(used in medication administration)
8
Q
List:
routes of medication administration
10 points
A
- oral (PO)
- sublingual (SL)
- buccal
- inhaled
- intramuscular (IM)
- intranasal (IN)
- subcutaneous (SubQ)
- intraosseous (IO)
- endotracheal (ET)
- intravenous (IV)
9
Q
Define:
PO
(abbreviation)
A
oral administration
(stands for “per os”)
10
Q
Define:
SL
(abbreviation)
A
sublingual administration
(below the tongue)
11
Q
Define:
sublingual (SL) administration
A
administering medicine under the tongue
12
Q
Define:
IM
(abbreviation)
A
intramuscular administration
(like an Epi-Pen)
13
Q
Define
intramuscular (IM) administration
A
administering medicine injected into muscle
14
Q
Define:
IN
(abbreviation)
A
intranasal administration
15
Q
Define:
intranasal (IN) administration
A
administering medicine aromized into mist absorbed by mucus membranes in nose
16
Q
Define:
MAD
(abbreviation)
A
mucosal atomization device
makes nasal spray
17
Q
Define:
mucosal atomization device (MAD)
A
device used to create fine mist for intranasal administration (IN) of medicine
18
Q
Define:
SubQ
(abbreviation)
A
subcutaneous administration
19
Q
Define:
subcutaneous (SubQ) administration
A
administering medicine by injection in the fatty tissue (just under the skin)
20
Q
Define:
IO
(abbreviation)
A
intraosseous administration
21
Q
Define:
intraosseous (IO) administration
A
the placement of a specialized hollow bore needle through the cortex of a bone into the medullary space for infusion of medical therapy and laboratory tests
22
Q
Define:
ET
(abbreviation)
A
endotracheal administration
23
Q
Define:
endotracheal (ET) administration
A
administering medicine through endotracheal tube
24
Q
Define:
IV
(abbreviation)
A
intravenous administration
25
# Define:
intravenous (IV) administration
administering medicine through **injection into blood vessels**
26
# Define:
pharmacodynamics (PD)
study of effects of medicines on the body
27
# Define:
pharmacokinetics (PK)
study of absorption and elimination in
the body
28
# List:
medications *administered* by EMTs
| 7 points
* aspirin
* oral glucose
* activated charcoal
* oxygen
* naloxone (Narcan)
* epinepherin (Epi-Pen)
* albuterol
29
# List:
medications *assisted* by EMTs
| 3 points
* inhaler
* nitroglycerin (nitro)
* epinepherin (Epi-Pen)
30
# Explain:
proper *dosage* for **aspirin**
| (for adults)
4 baby aspirins (81mg each)
| (324 mg for adults)
31
# Explain:
administration *route* for **aspirin**
oral intake (PO)
| (usually chewable tablets)
32
# Explain:
what **aspirin** does
prevents further aggregation of platelets
| (does **not** *bust* blood clots)
33
# List:
*indications* of **aspirin**
**chest pain**/discomfort of **cardiac nature**
34
# List:
*contraindications* of **aspirin**
| 3 points
* **asthma** (often associated with aspirin allergy)
* recent **trauma** (prevents clotting)
* **GI bleeding** (prevents clotting)
35
# List:
*side effects* of **aspirin**
| 2 points
* nausea/vomiting
* light-headedness
36
# Answer:
Is medical command required to administer **aspirin**?
no
37
# Explain:
proper *dosage* for **oral glucose**
15 g
| (1 single-dose tube or 1/3 of triple-dose tube)
38
# Explain:
administration *route* for **oral glucose**
buccal administration
| (in the cheek)
39
# Define:
buccal administration
absorption of medication between gums and cheek
40
# Explain:
what **oral glucose** does
increases blood sugar level
41
# List:
*indications* of **oral glucose**
| 2 points
* AMS with history of diabetes
* suspected hypoglycemia
42
# List:
*contraindications* of **oral glucose**
| 3 points
* unable to follow simple commands
* unable to protect airway
* hyperglycemia
43
# Explain:
potential *side effect* of **oral glucose**
possible hyperglycemia
44
# Answer:
Is medical command required to administer **oral glucose**?
no
45
# Explain:
proper *dosage* for **oxygen**
0-6 L/min via nasal cannula (NC)
15 L/min via non-rebreather mask (NRB)
46
# Explain:
administration *route* for **supplemental oxygen**
inhalation
47
# Explain:
what **supplemental oxygen** does
increases percentage of oxygen in inhaled air
48
# List:
*indications* of **supplemental oxygen**
| 3 points
* **respiratory distress**
* suspected **shock**
* severe **trauma**
49
# List:
*contraindications* of **supplemental oxygen**
none
50
# Explain:
potential *side effect* of **supplemental oxygen**
long-term, non-humidified use can cause **dehydration** and **nose bleeds**
51
# Answer:
Is medical command required to administer **supplemental oxygen**?
no
52
# Explain:
proper *dosage* for **activated charcoal**
| (for adults)
25-50g
| (1-2 bottles)
53
# Explain:
proper *dosage* for **activated charcoal**
| (for children)
1g per 1kg of body weight (12.5-25g)
| (0.5-1 bottle)
54
# Explain:
administration *route* for **activated charcoal**
oral intake (PO)
| (as a powder premixed with water)
55
# Explain:
what **activated charcoal** does
binds to ingested particulate (to avoid poisoning)
56
# Explain:
primary *indication* of **activated charcoal**
ingestion of poison or toxin
57
# List:
*contraindications* of **activated charcoal**
| 3 points
* **inability to swallow**, maintain airway, or follow orders
* ingestion of **caustic substance**
* exposure to poison or toxin via means **other than ingestion**
58
# List:
potential *side effects* of **activated charcoal**
| 2 points
* vomiting
* black stool (tar in feces) for a few days later
59
# Answer:
Is medical command required to administer **activated charcoal**?
yes
| (must be contacted *before* administration)
60
# Explain:
proper *dosage* for **bronchodilator inhaler**
patient's prescribed dose
| (usually 2 puffs)
61
# Explain:
proper *dosage* for **albuterol treatment**
2.5mg
| (through handheld nebulizer)
62
# Explain:
administration *route* for **bronchodilator inhaler**
inhalation
63
# Explain:
administration *route* for **albuterol treatment**
inhalation
64
# Explain:
what **bronchodilator inhaler** does
causes **bronchodilation**
| (allows air to more easily flow to lungs)
65
# Explain:
what **albuterol treatment** does
causes **bronchodilation**
| (β-2 agonist)
66
# Explain:
primary *indication* of **bronchodilator inhaler** or **albuterol treatment**
**respiratory distress** with signs of **bronchoconstriction** and/or **wheezing**
67
# Explain:
primary *contraindication* of **bronchodilator inhaler** or **albuterol treatment**
respiratory distress *not* suspected to be caused by bronchoconstriction
68
# List:
potential *side effects* of **bronchodilator inhaler** or **albuterol treatment**
| 2 points
* increased HR
* all the feels (anxiety/shaking/nervousness)
69
# Answer:
Is medical command required to administer **bronchodilator inhaler** or **albuterol treatment**?
no for first dose
yes for subsequent doses
70
# Explain:
proper *dosage* for **nitroglycerin (nitro)**
0.4 mg
| (equivalent to 1 spray or tablet)
71
# Explain:
administration *route* for **nitroglycerin (nitro)**
sublingual (SL) administration
| under the tongue
72
# List:
what **nitroglycerin (nitro)** does
| 3 points (like how it works inside you)
* **dilates coronary arteries**
* thereby reduces workload of heart
* thereby reduces oxygen demand
73
# Fill in the blank:
Nitroglycerin reduces the workload of the heart by **[BLANK]**.
Nitroglycerin reduces the workload of the heart by **dilating the coronary arteries**.
74
# Explain:
primary *indication* of **nitroglycerin (nitro)**
**chest pain**/discomfort of **cardiac nature**
75
# List:
*contraindications* of **nitroglycerin (nitro)**
| 3 points
* non-cardiac chest pain
* ED drug used in last 24-48 hours
* systolic BP under 100
76
# List:
*side effects* of **nitroglycerin (nitro)**
| 3 points
* headaches
* increased HR
* decreased BP
| *dizziness/fainting* may occur due to BP
77
# Answer:
Is medical command required to administer **nitroglycerin (nitro)**?
no for first dose
yes for subsequent doses
78
# Explain:
proper *dosage* for **epinephrine**
| (for adults)
0.3mg
79
# Explain:
proper *dosage* for **epinephrine**
| (for children)
0.15mg
80
# Explain:
administration *route* for **epinephrine**
intramuscular (IM) administration
81
# List:
what **epinephrine** does
| 3 points
* **sympathetic activation**
* bronchodilation
* vasoconstriction
82
# Explain:
primary *indication* of **epinephrine**
**severe allergic reaction** with signs of **AMS** or **respiratory compromise**
| anaphylaxis
83
# Explain:
*contraindication* of **epinephrine**
**none** in true emergency setting
| at worst, patient could have a **mild allergic reaction**
84
# List:
*side effects* of **epinephrine**
| 4 points
* increased HR
* headache
* numbness in extremeties
* all the feels (anxiety/nervousness/shaking)
85
# Answer:
Is medical command required to administer **epinephrine**?
no for first dose
yes for subsequent doses
86
# Explain:
proper *dosage* for **naloxone (Narcan)**
2mg
87
# Explain:
administration *route* for **naloxone (Narcan)**
intranasal (IN) administration
88
# Explain:
what **naloxone (Narcan)** does
reverses effects of narcotics
| (including depressed consciousness and respiration)
89
# Explain:
*indications* of **naloxone (Narcan)**
suspected **narcotic overdose** or **coma of unknown cause**
90
# Explain:
primary *contraindication* of **naloxone (Narcan)**
patient is **breathing adequately** and able to maintain own airway
91
# Explain:
primary *side effect* of **naloxone (Narcan)**
may precipitate **withdrawal** in patients dependent on narcotics
92
# Answer:
Is medical command required to administer **naloxone (Narcan)**?
no
93
# Explain:
why **ED meds** are a contraindication for *nitroglycerin*
both ED meds and nitro cause blood vessels to dilate
**could cause dramatic drop in BP**
patient dies
94
# Define:
sympathetic response
nervous system's natural response to dangerous or stressful situations
| (increased heart rate and blood flow)
95
# Define:
sympathetic activation
trigger which causes sympathetic response
| (epinephrine causes sympathetic activation)
96
# Define:
bronchodilation
widening of bronchial tubes
| bigger tubes to move more air
97
# Define:
bronchoconstriction
constriction of bronchial tubes
| smaller tubes to move less air
98
# Define:
vasoconstriction
constriction of blood vessels
| smaller pipes to flow less blood
99
# Define:
vasodilation
widening of blood vessels
| bigger pipes to flow more blood
100
# Define:
ED
| (abbreviation)
**e**rectile **d**ysfunction
101
# Define:
GERD
| (abbreviation)
**g**astro**e**sophageal **r**eflux **d**isease
102
# Fill in the blank:
Patients may often take *metformin* for **[BLANK]**.
Patients may often take *metformin* for **hyperglycemia (diabetes)**.
103
# Fill in the blank:
Patients may often take *HCTZ* for **[BLANK]** or **[BLANK]**.
Patients may often take *HCTZ* for **high BP** or **fluid retention (edema)**.
104
# Fill in the blank:
Patients may often take *lisinopril* for **[BLANK]**.
Patients may often take *lisinopril* for **high BP**.
105
# Fill in the blank:
Patients may often take *amlodipine* for **[BLANK]**.
Patients may often take *amlodipine* for **high BP**.
106
# Fill in the blank:
Patients may often take *omeprazol* for **[BLANK]**.
Patients may often take *omeprazol* for **GERD**.
107
# Fill in the blank:
Patients may often take *simvastatin* for **[BLANK]**.
Patients may often take *simvastatin* for **high cholesterol**.
108
# Define:
epiglottitis
infection causing swelling around glottis opening
109
# List:
*signs/symptoms* of **epiglottitis**
| 5 points
* throat stuff (soreness/drooling/swallowing)
* position of stress (upright/tripod)
* muffled voice
* fever/sickness
* stridor
110
# Answer:
What are the names given to each medication listed in the *U.S. Pharmacopoeia*?
| 3 points
* trade
* chemical
* generic
111
# Answer:
You are called to an elementary school for an 8-year-old female patient who is experiencing respiratory distress. The school nurse states the patient has an epinephrine auto-injector for a possible anaphylactic reaction to bee stings. The patient also has an albuterol inhaler for exercise-induced asthma. The patient is breathing 30 times a minute, is in the tripod position, and is speaking in two- to three-word sentences. The nurse states the patient was playing basketball in the gym when she started having difficulty breathing. The patient has wheezing in all lung fields. An ALS unit is en route but it is 10 minutes away. You are 20 minutes away from the nearest hospital.
**After placing the patient on oxygen, what should your next intervention be?**
**contact medical control** and request to assist the patient with her **albuterol**
112
# Answer:
What is the *most important medication* that should be administered to a patient experiencing chest pain with difficulty breathing?
aspirin
113
# Answer:
What instructions should you give to a patient whom you are about to assist with administering epinephrine?
give notice that you will inject medication into their thigh
| “I’m gonna jab your leg now”
114
# Choose:
You are on the scene of a 48-year-old male patient complaining of chest pain. He has nitroglycerin prescribed and available. After performing your physical examination, you contact medical control and are ordered to assist the patient in taking his nitroglycerin. Five minutes after taking his nitroglycerin, the patient complains of being dizzy and having a headache. You lie the patient down on the stretcher and reassess his vital signs. He is now hypotensive.
**What is this patient suffering from?**
## Footnote
**A:** untoward reaction to nitroglycerin.
**B:** anaphylactic reaction to nitroglycerin.
**C:** allergic reaction to nitroglycerin.
**D:** side effect of nitroglycerin.
**D**
115
# Define:
untoward effect
**undesired harmful effect** resulting from a medication or other intervention
| typically **supercedes medical benefits**
116
# Choose:
You have just administered nitroglycerin to a 68-year-old patient. Within a few minutes, she complains of feeling faint and lightheaded, but states that she is still having some chest pain.
**Which of the following would be the best sequence of actions?**
## Footnote
**A:** Administer activated charcoal to prevent further absorption of the nitroglycerin and closely monitor the patient's blood pressure.
**B:** Advise the patient that this is a normal occurrence and administer a second dose of nitroglycerin.
**C:** Lower the head of the stretcher and take the patient's blood pressure.
**D:** Increase the amount of oxygen you are giving to the patient before administering a second dose of nitroglycerin.
**C**
117
# Fill in the blank:
The study of drugs, their sources, and their effects is referred to as **[BLANK]**.
The study of drugs, their sources, and their effects is referred to as **pharmacology**.
118
# Choose:
**B**
119
# Choose:
**B**
## Footnote
the brain is very sensitive to low blood sugar (which may be caused by poorly managed diabetes)
120
# Choose:
**A**
121
# Choose:
**C**
122
# Choose:
**C**
123
# Choose:
**C**
124
# Choose:
**C**
125
# Choose:
**D**
126
# Choose:
**D**
127
# Choose:
**B**
128
# Choose:
**B**
129
# Choose:
**C**
130
# Choose:
**D**
131
# Choose:
**C**
## Footnote:
**”anti-“:** against
**”dys-“:** abnormal
**”rhythmia”:** heart rhythm
132
# Choose:
**A**
133
# Choose:
**B**
| pharmacokinetics studies only the absorption and removal of medications
