Exam 2 Flashcards
Schedule 1
High abuse potential, no accepted medical use
Schedule 2
High abuse potential, accepted medical indications
Official Name
As listed in the USP
Efficacy
Drugs ability to produce a physiological response after binding to a receptor site
Bioassay
Essay on biological model or organism
Bioequivalence
relative therapeutic effectiveness of chemically equivalent drugs
Pharmacokinetics
Study of the basic processes that determine the duration and intensity of the drugs effect and how those drugs are absorbed, distributed, biotransformed, and eliminated
Pharmacodynamics
how a medication interacts with the body to cause its effects
onset of action
the time from administration until a medication reaches its minimum effective concentration
Down regulation
a drug or hormone decreases the number of available receptor sites, resulting in decreased sensitivity to the drug or hormone.
Up regulation
A drug or hormone causes the formation of more receptors than normal
Biotransformation
Like other chemicals that enter the body, drugs are broken down into different chemicals (metabolites)
First pass effect
The first pass through the liver may partially or completely inactivate many drugs
Benefit of IVP
Bypasses the GI tract and prevents first pass hepatic metabolism
Half life
unit of rate of decay of radioactive isotopes; the time it takes for the decaying parent isotope to decrease by half
Synergism
1+1=3. two drugs that have the same effect are given together and produce a response greater than the sum of their individual responses.
Drug profile
unique characteristics of a drug or class of drug, including their administration, absorption, metabolism, duration of action, toxicity, and interactions with foods or other meds.
Facilitated diffusion
“carrier mediated diffusion” process in which carrier proteins transport large molecules across the cell membrane
Affinity
Force of attraction between a receptor site and a drug.
Cross tolerance
by developing a tolerance to once medication, this may cause tolerance to the entire class of medications I.E. opiates
Kidney failure’s affect on drugs
The body is not able to eliminate the drugs as well.
Why is IV administration so useful
It bypasses the first pass hepatic metabolism
What are NSAIDs & how are they used
Nonsteroidal anti inflammatory drugs used to affect pain response.
What is aspirin used for in prehospital setting
Mild to moderate pain. Fever, platelet aggregation inhibitor.
Sympathetic NS effects
Increased HR, increased conductivity. Increased contraction of the heart.
Parasympathetic NS effects
pupillary constriction, secretion by digestive glands, reduction in HR and cardiac contractile force, bronchoconstriction, Increased smooth muslce contraction along digestive tract.
Alpha 1
Vasoconstriction
Beta 1
Increased HR & contraction
Beta 2
Bronchodialation
analgesics vs. anesthetics
Analgesics block pain receptors. Anesthetics induce loss of all sensation
what are beta blockers?
Beta adrenergic antagonist. Approved for treatment of arrhythmias. Indication in the treatment of tachycardias resulting from excessive sympathetic stimulation.
What does Narcan/naloxone do?
Blocks the binding of the drug to the receptor site
What are benzodiazepines?
CNS depressants
Enteral vs parental routes
Enternal (involving GI tract… mouth to butt)
parental (not involving GI tract)
Agonist vs. antagonist
Agonist: bind to receptor site and cause expected response
Antagonist: bind to the receptor site and prevents expected response from happening
What does the blood brain barrier do?
Only non-protein bound, high lipid soluble drugs can cross due to the tightly bound CNS cells
Naloxone
Trade name: narcan
Class: narcotic antagonist, opioid antagonist
actions/effects: displace narcotics at the receptor sites in CNS, attaches to the receptor and inhibits the narcotics action
Indications: narcotic overdose, respiratory depression, coma of unknown origin, man down,
Contraindication: hypersensitivity
Side effects: N/V, seizures, tachycardia, HTN, diaphoresis, blurred vision, withdrawal
Adult dose: 2-4 mg IV/IM/IN/ET/IO
Cautions: can cause seizures from withdrawal in chronic opioid users
Midazolam
Trade name: Versed
Classification: short acting benzodiazepine, CNS depressant, anti seizure
actions/effects: anti seizure, anticonvulsant, sedative, muscle relaxant
Indications: seizures, conscious sedation, chemical restraint
Contraindications: hypersensitivity, depressed CNS, shock
Cautions: pregnancy category D, should not be taken by PTs that have taken any other CNS depressants
Side effects: depressed CNS, N/V, blurred vision, headache, retrograde amnesia
Adult/ ped dose: IV 0.1mg/kg up to 5mg (1-5 min onset) IN 0.2mg/kg up to 10mg dose (3-7 min onset) 1cc per nostril, IM 0.1mg/kg up to 10mg dose (15-30 min onset)
Expected dose adult IV 2-5 mg, IN/IM 5-10 mg second dose may be given
Diazepam
Trade name: Valium
Classification: Benzodiazepine
actions/ effects: Anti Anxiety, anticonvulsant activity, acts on CNS to relax the NS
Indications: seizure control, anxiolytic/sedation
Contraindications: known hypersensitivity, hypoglycemic seizure activity. PTs with a compromised respiratory status (relative) * do not give via IN route if PT is < 6yo
Side effects: rapid administration may cause respiratory depression/arrest. Paradoxical excitement or stimulation sometimes occurs.
Adult dose: seizure- 5 mg IV/IM/IO, q 2min PRN, Max 10 mg
agitated / combative PT- 5 mg IV or 10mg IM, max 10 mg if agitation persists after 5 min, repeat first dose.
Excited Delirium- 10 mg IV/IM if agitation persist after 5 min repeat first dose
Post intubation sedation- 5 mg IV/ or 10mg IM, q2min PRN, max 10 mg
Physiological effects: modulates postsynaptic effects of gamma aminobutyric acid (GABA) transmission, which is a major inhibitory neurotransmitter in the brain
Additional info: not to be mixed with any other injectable medication, may precipitate when administered in D5W IV line.
Aspirin
Aspirin
Trade name: Bayer
Classification: Platelet inhibitor, anti inflammatory, analgesic, NSAID
Action: Decreases platelet aggregation
Indication: chest pain suggestive of MI, Pain, and fever
Contraindication: hypersensitivity, bronchospasms, angioedema, Pt receiving monoamine oxidase inhibitors
Dose: adult 160-325 mg PO
Adverse effects: nausea, vomiting, GI bleed, allergic reactions, gastric upset
Cautions: category D. aspirin allergy, ulcers, asthma
