Chapter 7: Pharmacology Flashcards
Define
Agonist
A medication that binds and stimulates receptors
Define
Antagonist
A medication that binds and blocks receptors
Define
Action
The therapeutic effect of a medication. The intended effect.
Define
Unintended side effects
Undesirable side effects that pose little threat to the pt
Define
Untoward side effects
Effects that can be harmful to the pt.
Define
What are the two main routes of administration?
Enteral and parenteral
Define
Enteral medications
Enter the body through the digestive system
Define
Parenteral medications
Enter the body through a route other than the GI tract.
Define
Route: PR
- Per rectum
- Usually used for pt’s for which PO won’t work, like children and unconscious pt’s
Define
Route: PO
- Per Os (mouth)
- Often takes 1 hr, unpredictable absorption because of vomiting and diarrhea
- e.g. activated charcoal
Define
Route: IV
- Intravenous
- Fastest delivery, but not appropriate for all medications
Define
Route: IO
- Intraosseous
- Like IV, but often in children who have fewer IV sites
- Because of pain, usually used with unconscious pt’s.
- FAST
Define
Route: SC (SubQ)
- Subcutaneous
- Less vasculature than muscle, so slower absorption and longer lasting effect.
- SLOW
Define
Route: IM
- Intramuscular
- Absorbed quickly because muscle is highly vascularized
- Sometimes uneven or unreliable esp. in people with poor perfusion.
- FAST
- e.g. epinepherine
Define
Route: Inhalation
- FAST
- Sometimes used for quick absorption, other times for targeting medication to the lung, minimizes medications effect in other areas.
- e.g. bronchodilators in MDIs (Metered Dose Inhalers)
Define
Route: SL
- Sublingual
- e.g. nitroglycerin
Define
Route: Transcutaneous
- Across the skin
- Longer effect because of slow absorption
- SLOW
- For systemic effects
Define
Route: IN
- Intranasal
- FAST
- Using MAD (mucosal atomizer device)
List
Forms of medication
- Tablets and capsules
- Solutions and suspensions
- MDIs (metered dose inhalers)
- Topical
- Transcutaneous (nicotine patch)
- Gels, in capsules or in tubes like oral glucose.
List
The 6 “rights” of medication
- Right patient
- Right medication
- Right dose
- Right route
- Right time
- Right documentation
List
Medications that may be administered by EMTs
- Oxygen
- Oral glucose
- Activated charcoal
- Aspirin
- Epinepherine auto-injector
- MDI medications
- Nitroglycerin
How to administer
Oral Glucose
- PO
- Smear on gums
- Contraindications: inability to swallow (unconscious pt)
Trade name
Acetaminophen
Tylenol
Trade Name
Activated charcoal
Actidose with Sorbitol
Trade name
Aspirin
Bayer
Trade name
Albuterol
Proventil, Ventolin
Trade name
Diphenhydramine
Benadryl
Trade name
Epinephrine
EpiPen
Trade name
Ibuprofen
Advil, Motrin, Nuprin
Trade name
Nitroglycerin
Nitrostat
Trade name
Oral glucose
Glutose
Generic name
Tylenol
Acetaminophen
Generic name
Actidose with Sorbitol
Activated charcoal
Generic name
Bayer
Aspirin
Generic name
Proventil, Ventolin
Albuterol
Generic name
Benadryl
Diphenhydramine
Generic name
EpiPen
Epinephrine
Generic name
Advil, Motrin, Nuprin
Ibuprofen
Generic name
Nitrostat
Nitroglycerin
Generic name
Glutose
Oral glucose
Action, Indications, Contraindications, Routes, Side Effects, Interactions, Dose, Concerns
Activated Charcoal
- Absorbs toxic substances in GI tract
- I: Most oral poisonings; overdose
- CI: Decreased LOC, overdose of corrosives, caustics, or petroleum substances (burned esophagus)
- R: PO
- SE: Nausea, vomiting, constipation, black stool
- Int: Bonds with and inactivates most medications
- D: 1-2 g/kg
- Concerns: Stains; pour into covered cup w straw (looks nasty)
Action, Indications, Contraindications, Routes, Side Effects, Interactions, Dose, Concerns
Acetaminophen
- Analgesic and antifever
- I: mild pain or fever, headache, muscle aches
- CI: hypersensitivity
- R: PO
- SE: allergic reactions
- D: 500-1000 mg every 4 hrs as needed, children are weight dependent
Action, Indications, Contraindications, Routes, Side Effects, Interactions, Dose, Concerns
Aspirin
- anti-inflammatory and anti-fever; prevents platelet aggregation (prevents clotting)
- I: mild pain, headache, muscle ache; chest pain when considering MI
- CI: hypersensitivity, recent bleeding
- R: PO
- SE: nausea, vomiting, stomach pain, bleeding, allergic rxn
- Int: Caution with pt’s on anticoagulants
- D: 160-325 mg (chewables for chest pain)
- Concerns: not for pain caused by trauma of for fevers in children
Action, Indications, Contraindications, Routes, Side Effects, Interactions, Dose, Concerns
Albuterol
- bronchodilation
- I: asthma, difficulty breathing with wheezing
- CI: hypersensitivity, tachycardia, MI
- R: MDI/inhalation
- SE: hypertension, tachycardia, anxiety, restlessness
- Int: increases effects of other nervous system stimulants
- D: 1 to 2 inhalations. Wait 5 min before repeating dose
- Concerns: Pt must inhale med in 1 breath, hold breath for 5 s after inhalation
Action, Indications, Contraindications, Routes, Side Effects, Interactions, Dose, Concerns
Diphenhydramine
- Antihistamine
- I: mild allergic reactions
- CI: asthma, glaucoma, pregnancy, hypertension, infants
- R: PO
- SE: sleepiness, dry mouth and throat
- Int: not with alcohol or MAO inhibitors (psych meds)
- D: 25-50 mg
- Concerns: can use in anaphylaxis, epinephrine used first
Action, Indications, Contraindications, Routes, Side Effects, Interactions, Dose, Concerns
Epinephrine
- Stimulates sympathetic nervous system causing bronchodilation
- I: anaphylaxis
- CI: MI, hypothermia, hypertension
- R: IM
- SE: hypertension, tachycardia, anxiety, restlessness
- Int: increases effect of other stimulants
- D: 0.3 mg adult, 0.15 mg child auto injector
- Concerns: lasts 5 min, do not repeat dose, immediately call ALS
Action, Indications, Contraindications, Routes, Side Effects, Interactions, Dose, Concerns
Ibuprofen
- NSAID that reduces inflammation and fever, analgesic
- I: mild pain or fever, headache, muscle ache
- CI: hypersensitivity
- R: PO
- SE: nausea, vomiting, stomach pain, bleeding, allergic rxn
- Int: do not take with aspirin
- D: 200-400 mg every 4-6 hrs, children based on weight
- Concerns: not for pain caused by trauma
Action, Indications, Contraindications, Routes, Side Effects, Interactions, Dose, Concerns
Nitroglycerin
- vasodilator
- I: chest pain from MI or angina
- CI: hypotension (<100 mm Hg), having taken Viagra or other ED med in last 24 hrs, head injury
- R: SL/spray
- SE: headache, burning under tongue, nausea, hypotension
- Int: increases dilating effects of other vasodilators
- D: 0.3-0.4 mg SL; 0.4 mg spray
- Concerns: call ALS immediately
Action, Indications, Contraindications, Routes, Side Effects, Interactions, Dose, Concerns
Oral glucose
- gives cells glucose for energy
- I: hypoglycemia
- CI: decreased LOC, nausea, vomiting
- R: PO
- SE: nausea, vomiting
- Int: none
- D: 1/2 to 1 tube
- Concerns: pt must have control of airway, be awake, able to follow commands
Action, Indications, Contraindications, Routes, Side Effects, Interactions, Dose, Concerns
Oxygen
- Reverses hypoxia
- I: hypoxia or suspected hypoxia
- CI: very rarely in pt’s with COPD
- R: inhalation
- SE: decreased respiratory effort in rare cases with COPD pt’s
- Concerns: never withhold from pt’s in respiratory distress
List
Steps in administering medication
- obtain order from med control
- verify proper med and prescription
- verify form, dose, route
- check expiration date and condition of med
- reassess vitals at least every 5 min
- document
