Chapter 7&8 Flashcards
What is the origin of the word pharmacology?
Greek words pharmakon (drug or poison) and logos (word or discourse)
What are the 6 Rights of Medication administration?
Right Patient
Right Medication
Right Dose
Right Route
Right Time
Right Documentation
What does Pharmacology mean?
The study of medications and their effect or actions on the body
What is a medication?
A drug that has been approved by a government agency that regulates pharmaceuticals
What is a drug?
A drug is any substance or mixture of substances manufactured, sold, or represented for use in 1. The diagnosis treatment mitigation or prevention of symptoms, 2. Restoring correcting or modifying organic functions in the body, 3. Disinfection in premises where food is manufactured prepared or kept.
What are the 3 naming designations for medications?
Chemical name
Generic name
Trade name
What are the 4 principal sources of medications?
Animal
Plant
Mineral
Laboratory (synthetic compounds)
What are the 9 drug schedules?
Schedule I: narcotics such as opium, heroin, morphine, and cocaine
Schedule II: Cannabis and Cannabis resin
Schedule III: Stimulants such as amphetamines and hallucinogenics
Schedule IV: Substances such as anabolic steroids, barbiturates, and benzodiazepines
Schedule V: Repealed
Schedule VI: Precursors that can be converted into designer drugs
Schedule VII: Repealed
Schedule VIII: Repealed
Schedule IX: Devices that may be used to produce tablets and capsules
What are the 4 Phases of clinical trials
Phase 1: Testing in healthy volunteers to compare human data to animal data
Phase 2: Double blind study in a homogenous population, involving 1 group getting a placebo
Phase 3: Drug is made available to a larger group of patients to monitor effects
Phase 4: Compare the new drug to others on the market
Which 3 groups require special considerations in medication therapy?
Pregnant patients
Paediatric patients
Geriatric patients
What are 4 guidelines that can help you responsibly administer medications?
Understand Indications and Contraindications
Practice safe and sterile administration techniques
Understand potential side effects
Understand the medications pharmacokinetics and pharmacodynamics
What is the difference between Afferent nerves and Efferent nerves?
Afferent nerves carry sensory impulses from all parts of the body
Efferent nerves carry messages from the brain to the muscles and organs of the body
What are the roles of the sympathetic and parasympathetic nervous system?
Sympathetic is responsible for fight or flight response
Parasympathetic system is responsible for rest and digest response
What does the term Adrenergic refer to?
Nerve fibres that release norepinephrine or epinephrine
What does the term Sympatholytic refer to?
Interfering or inhibiting the effect of the impulses from the sympathetic nervous system
What is the difference between an affinity and an agonist?
Affinity refers to the attraction between a medication and it’s receptors
Agonist is is a medication that stimulates a receptor site
What are the 3 forms of medications?
Liquid (Solution, Tincture, Syrup, Lotion)
Solid (Powder, Capsule, Tablet, Patch)
Gas (Vapour)
What are the rates of absorption for various medication routes? (Topical, Oral, Rectal, Subcutaneous, IM, Sublingual, Inhalation, IO, IV)
Topical: Hours-Days
Oral: 30-90 mins
Rectal: 5-30 minutes
Subcutaneous: 15-30 mins
IM: 10-20 minutes
Sublingual: 3 mins
Inhalation: 3 mins
IO: 60 secs
IV: 30-60 secs
What is the difference between percutaneous, enteral, and parenteral medication administration?
Percutaneous- absorbed through the skin or a mucous membrane
Enteral- absorbed through the gastrointestinal tract
Parenteral- any other route of administration
What is pharmacokinetics?
The study of the metabolism and action of medications within the body, with emphasis on the time required for absorption, duration of action, distribution in the body and method of excretion.
What is a loading dose vs a maintenance dose?
Loading dose- a large dose that is given quickly to reach a therapeutic level
Maintenance dose- a smaller dose administered over time to maintain the therapeutic level
What is bioavailability?
The effectiveness of the drug to reach the target cells and not be altered in non target cells.
What is Biotransformation?
The manner in which the body metabolizes medications. Occurs by transforming the medication into a metabolite or by making it more water soluble
How does the body eliminate medications?
Excretion primarily through the kidneys via 3 mechanisms,
Glomerular filtration
Tubular secretion
Partial reabsorption
What does the term Pharmacodynamics mean?
The way in which medication produces the intended response
What are the 4 ways that medications take action on the body?
They may bind to a receptor site
They may change the physical property of the cell
They may combine with other chemicals
They may alter the metabolic pathway
What is the onset of action?
How long it will take for the medication to reach the minimum effective level in the target tissue
What is duration of action?
The length of time that the medication will remain at the minimum level to produce the intended action
What is termination of action?
The amount of time after the concentration of medication falls below the minimum level to the time it is eliminated from the body
What are the 8 factors that affect drug response?
Age
Weight
Sex
Environment
Time of administration
Condition of the patient
Genetic factors
Psychological factors
What is an iatrogenic response?
An adverse condition inadvertently induced in a patient by the given treatment
What is Tachyphylaxis
A condition in which the patient rapidly becomes tolerant to a medication, it can occur with just a couple doses.
What is a summation effect?
Two medications that have the same effect that double the response
What is synergism?
Two medications with the same effect but produce a response greater than the sum of their individual responses
What is potentiation?
The interaction between two medications can cause one drug to enhance the effect of another
What is interference?
A direct biochemical interaction that takes place between two drugs
What is an Analgesic
A medication that relieves pain
What are Benzodiazepines and Barbiturates?
Sedatives
What are the 4 types of adrenergic receptors and what do they do?
Alpha 1- produce peripheral vasoconstriction, associated with mild bronchoconstriction and speed metabolism
Alpha 2- control the release of norepinephrine
Beta 1- increase the heart rate, cause cardiac muscle to contract, strengthen cardiac contraction, and trigger cardiac electrical conduction
Beta 2- stimulate vasodilation and bronchodilation
Reasons for a urinary catheter?
Relieve obstructions
Measure urinary output
Permit irrigation to prevent obstruction
Relieve inability to void
What are 3 potential complications of a urinary catheter?
Cystitis (inflammation of the bladder)
Hematuria (blood in the urine)
Pyelonephritis (inflammation of the kidney)
Why would a patient need an NG or OG tube?
Irrigation of the stomach
Removal of gastric contents
Tube feeding
Gastric testing
Decompression when motility has stopped
When is a permanent PEG tube considered?
When a feeding tube is required for 4-5 weeks or more
What is Gastroparesis?
Paralysis of the stomach
Where is the PEG tube usually located?
In the upper left quadrant of the abdomen and a few cm left of the midline
Explain the difference between Chronotropic, Inotropic, and Dromotropic?
Chronotropic: medications that effect the heart rate
Inotropic: medications that effect the force of contraction
Dromotropic: medications that effect the velocity of electrical conduction in the heart
What are Antidysrythmic medications and what are the 4 classes?
Medications that treat and prevent cardiac dysrythmia
Sodium channel blockers (slow the conduction through the heart)
Beta blockers (reduce the adrenergic stimulation of beta receptors)
Potassium channel blockers (increase the hearts contractility)
Calcium channel blockers (block the inflow of calcium into the cardiac cells thereby decreasing the force of contraction)
What is the most common medication used in the prehospital setting?
Oxygen
What are some types of Gastrointestinal medications?
Antacids (neutralize stomach acids Cytoprotective agents (treat peptic ulcers)
Antiflatulants (prevent or treat gas). Laxatives (stimulate loosening of the bowel
Digestants (aid in the digestive process) Antidiarrheals (prevent or treat diarrhea)
Antiemetics (prevent or arrest vomiting)
Cannabinoids (relieves chemotherapy symptoms)
Emetics (used to promote or cause vomiting)
H2 receptor antagonists and proton pump inhibitors (reduce acid production in the stomach)
What are the steps of documenting medication?
Name
Dose
Time
Route
Your name
Patient response
What is medical asepsis?
The practice of cleansing to prevent contamination
What does the term sterile mean?
Destruction of all living organisms achieved by using heat, gas, or chemicals
What is the difference between antiseptics and disinfectants?
Antiseptics are used to cleanse the skin before performing an invasive procedure
Disinfectants are toxic to living tissues and should not be used on a patient
Explain the breakdown of total body water?
Water makes up 60% of the body weight
45% intracellular fluid
15% extracellular fluid (interstitial fluid 10.5%, intravascular fluid 4.5%)
What is a solution?
A mixture of a solvent and a solute
What is hypokalemia?
A deficiency of potassium that can lead to decreased skeletal muscle function, gastrointestinal disturbance, and alterations in cardiac function
What is hyperkalemia?
An excess of potassium that can lead to hyperstimulation of neutral cell transmission, resulting in cardiac arrest
What is hypocalcemia?
Low levels of calcium resulting in overstimulation of nerve cells causing muscle and abdominal cramps
What is hypercalcemia?
High levels of calcium that lead to decreased stimulation of nerve cells resulting in muscle weakness and vasodilation
What is the concentration of sodium in the cells of the body?
0.9%
What are the 3 different types of IV solutions?
Crystalloids
Colloids
Blood products
Explain the differences between an Isotonic, Hypotonic, and Hypertonic solution?
Isotonic- has almost the same osmolarity (concentration of solute) as other body fluids
Hypotonic- osmolarity lower than the serum or body fluid
Hypertonic- osmolarity higher than that of the serum or body fluid
What is a crystalloid solution?
Dissolved crystals in in water that cross membranes and alter fluid levels
What is a Colloid solution?
A solution that carries molecules that are too large to pass out of the capillary membranes
Why are blood products not used in the prehospital setting?
It requires refrigeration
What’s the difference in drip rates between in macro drip and micro drip sets?
Macrodrip- 10-15 gtt/ml
Microdrip- 60 gtt/ml
What are the three types of IV catheters?
Over the needle catheter
Butterfly catheter
Through the needle catheter
What are the 2 considerations for an IV cannulation technique?
1 keep the beveled side of the catheter up when inserting
2 maintain adequate traction on the vein to prevent twisting
What 5 things need to be included in an IV insertion documentation?
The gauge of the needle
The IV attempts Vs successes
The site
The type of fluid you are administering
The rate at which the fluid is running
What are the 4 steps for changing an IV bag?
Stop the flow of fluid by closing the roller clamp
Prepare the new bag by removing the cap and inspecting the clarity and expiration date
Remove the piercing spike from the old bag and insert it in the new bag
Ensure that the drip chamber is appropriately filled and release the roller clamp
What are some possible IV site reactions?
Infiltration- escape of fluid causing edema
Thrombophlebitis- infection of the vein causing a clot
Occlusion- physical blockage of the vein or catheter
Vein irritation
Hematoma- accumulation of blood in the surrounding tissues
Nerve tendon or ligament damage
Arterial puncture- spurting blood
What is Osteomyelitis
A rare inflammation of bone and muscle at the site of an IO insertion
Contraindications to an IO insertion?
Functional IV is available
Bone fracture
Bilateral knee replacement
What is the first rule of medicine?
primum non nocere (latin)
First do no harm
What are the freezing and boiling temperatures in Celsius and Fahrenheit?
Freezing: 0°C or 32°F
Boiling 100°C or 212°F
What is drug reconstitution?
Involves injecting sterile water into a vial that contains powder thereby making a solution for injection
What are the 4 medications that can be given through a tracheal tube? (LEAN)
Lidocaine
Epinephrine
Atropine
Naloxone
